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Pregnancy as a Model to Explore Stretch-Induced Compliance mechanism in Physiological Hypertrophy
Session:
Sessão de Posters 57 - Diferenças de género em Cardiologia
Speaker:
Ana Filipa da Silva Ferreira
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Ana Filipa Ferreira; Maria João Azevedo; Juliana Morais; João Almeida-Coelho; André Mendes Leite-Moreira; Francisca Almeida Saraiva; Carla Sousa; Benedita Sampaio-Maia; Carla Ramalho; Adelino Leite-Moreira; António Sousa Barros; Inês Falcão-Pires
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Considering that pressure-overload-induced cardiac hypertrophy compromises stretch-induced compliance (SIC) following acute volume overload (AVO), we hypothesized that SIC might change in physiological hypertrophy induced by pregnancy’s chronic volume overload. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aim:</strong> To compare the SIC-mechanism between 1<sup>st</sup> and 3<sup>rd</sup> trimesters (1<sup>st</sup>T versus 3<sup>rd</sup>T) of pregnancy (that showed distinct basal hemodynamic preload and cardiovascular remodeling); as well as to explore the impact of cardiovascular risk factors (CRF), parity, and age in SIC. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> Thirty-seven and thirty-one women independently recruited in 1<sup>st</sup>T and 3<sup>rd</sup>T, respectively, prospectively underwent echocardiography’s before (T0), immediately after (T1), and 15 minutes (15min) after AVO induced by passive leg elevation (T2). Blood samples were collected before and after the AVO, and plasmatic NT-proBNP (DY3604-05, R&D Systems) was quantified using ELISA Assay Kit. Mixed-effects models was applied to explore the impact of CRF, parity and age in SIC.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> A significant increase in the inferior vena cava diameter (p<0.001) and stroke volume (1<sup>st</sup> T: p=0.009, 3<sup>rd</sup>T: p=0.010) from T0 to T1 in both trimesters confirmed an effective AVO. A significant increase in the left ventricle (LV) end-diastolic volume (LVEDV, p<0.001) and E/e’ (1<sup>st</sup> T: p=0.005, 3<sup>rd</sup>T: p=0.008) was observed immediately after AVO in the 1<sup>st</sup>T and 3<sup>rd</sup>T groups. SIC (15min after AVO) was characterized by a significant decrease of E/e’ in both trimesters (1<sup>st</sup> T: p=0.005, 3<sup>rd</sup>T: p=0.020), counterbalanced with additional expansion of LVEDV only in the 1<sup>st</sup>T (p=0.006). During the entire AVO period, LV stiffness decreased significantly in both trimesters (1<sup>st</sup> T: p=0.005, 3<sup>rd</sup>T: p=0.020). NT-proBNP concentration increased slightly after AVO only in the 1<sup>st</sup>T (<span style="color:black">102±10pg/mL to 106±15pg/mL, p=0.160 vs </span>3<sup>rd</sup>T: <span style="color:black">109±15pg/mL to 107±13pg/mL, p=0.510)</span>. <span style="color:black">The presence of CRF significantly impacted SIC (in all echocardiographic variables included p<0.005), contrasting with the non-significant effect of parity and age.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> A distinct functional response to SIC was observed between 1<sup>st</sup>T and 3<sup>rd</sup>T, influenced by CRF. Despite the LV of 3<sup>rd</sup>T pregnant women showing a structural limitation to dilate and accommodate increased volume upon AVO, its physiological hypertrophy did not compromise the SIC-mechanism, suggesting it is exacerbated.</span></span></p>
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