Pregnancy related changes in Doppler gradients and left ventricular mechanics in women with sub-valvular or valvular aortic stenosis
Open accessAbstract
Abstract Background The aim of our study was to characterize echocardiographic changes during pregnancy in women with known LVOT obstruction or AS compared to the healthy pregnancy controls, and to assess the relationship with pregnancy outcomes. Methods We retrospectively studied 34 pregnant patients with congenital LVOT obstruction or AS with healthy age‐matched pregnant controls. Patients with other significant valvular lesions, structural heart disease (LVEF < 40%), or prior valve surgery were excluded. All LVOTO/AS patients underwent a minimum of two consecutive echocardiograms between 1 year pre‐conception and 1 year postpartum, with at least two studies during the pregnancy. Comprehensive echocardiographic evaluation was performed including speckle‐tracking LV global longitudinal strain. Results A total of 83 echocardiograms from the study group and 34 echocardiograms from the control group were evaluated. Over the range of LVOTO/AS, a significantly greater increase in the AV gradients and LV and LA volumes were observed as compared with the controls. In the sub‐group of LVOTO/AS pregnant women with ≥ moderate (n = 8) versus < moderate LVOTO/AS (n = 26), averaged 2nd/3rd trimester LVEF was lower (51 ± 12)% versus (58 ± 4)%, (p = 0.02) and GLS was lower (−19.5 ± 2.8) versus (21.2 ± 2.4), (p = 0.06). Pregnancy was well tolerated despite these changes. Conclusion Among pregnant women with even milder forms of LVOTO/AS, increases in cardiac volumes and AV gradients can be expected over the course of pregnancy. Significant decreases in LV function and mechanics were only observed in women with moderate or greater LVOTO/AS, although still remained in normal range.
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The hemodynamic challenges during pregnancy are similar for those with subaortic stenosis.
“The hemodynamic challenges during pregnancy are similar for those with subaortic stenosis.519”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [519]
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- Authors
- Chang, S. A., Khakh, P., Janzen, M., Kiess, M., Rychel, V., & Grewal, J.
- Affiliations
- University of British Columbia (CA)
- Corresponding author
- Grewal, Jasmine
- Venue
- Echocardiography
- Publisher
- Wiley
- Published
- 2021-10
- Volume
- 38
- Issue
- 10
- Pages
- 1754-1761
- ISSN
- 0742-2822 (ISSN-L)
- 1540-8175
- OpenAlex
- W3173367972
- Cited by
- 7
- References
- 39
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Echocardiography (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Keywords
- pregnancy, aortic stenosis, subaortic stenosis, left ventricular outflow tract obstruction, Doppler gradient, left ventricular mechanics, left ventricular ejection fraction, global longitudinal strain, left atrial volume, left ventricular volume, pregnancy outcomes
- MeSH terms
- Aortic Valve Stenosis, Echocardiography, Female, Heart Ventricles, Humans, Pregnancy, Retrospective Studies
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