The aim of the study is to evaluate left ventricular cardiac mechanics via speckle tracking echocardiography in a population of healthy pregnant women and women after in vitro fertilisation (IVF) during different stages of pregnancy.Design and Method:
We included 22 normal pregnant women, 40 after IVF, 10 of them with multiple pregnancy (46.5 ± 3 years) and 20 healthy non pregnant women (33 ± 4years). 2D images were acquired (65 ± 7 frames/s) during the first, second and third trimester, as well as up to two months postpartum.Results:
Peak LVT and LVUR increased significantly in the 3rd trimester in both pregnancy groups (13.48 ± 2.90°, 13.12 ± 3.30°, 16.83 ± 3.61°,P < 0.001; and −111.52 ± 23.54°/sec, −107.40 ± 26.58°/sec, −144.30 ± 45.14°/sec, P < 0.001). The pregnants with twins have highest value for LVT and LVUR (p < 0.01), and the time to peak LVUR is more prolonged. An independent correlation was found between the change in LVT and LV end-systolic volume in 1st and 3rd trimester (r = 0.56). Peak LVUR at the 3rd trimester correlated significantly with LV end-diastolic volume. Multiple regression analysis indicates that only systolic blood pressure (r = 0.394, P = 0.005) was an independent predictor for increased LV torsion. Arterial hypertension (AH) and prevalence of preeclampsia (PE) is more often in IVF group. Longitudinal strain decreased significantly (p < 0.001) during 3th trimester in women with AH and PE, but is not significantly different between the different groups in first and second trimester (GLS-20.6 ± 3.14 vs. −19,29 ± 2.17).Conclusions:
LV twist and untwisting rate increase in the 3rd trimester and correlate with end-systolic and end-diastolic volume. Blood pressure and condition of multiple pregnancy are independently associated with increased torsion during pregnancy and may predict the new onset heart failure and perinatal cardiomyopathy. GLS is the main predictor of new onset peripartum cardiomyopathy.