Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position
Author(s)
Type
Journal Article
Abstract
Background: There are physiological reasons for the effects of positioning on hemodynamic variables and cardiac
dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in
pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study
was to investigate the effect of postural changes on cardiac dimensions and function during mid and late
pregnancy using cardiovascular magnetic resonance (CMR).
Methods: Healthy non-pregnant women, pregnant women at 20th week of gestation and at 32nd week of
gestation without history of cardiac disease were recruited to the study and underwent CMR in supine and left
lateral positions. Cardiac hemodynamic parameters and dimensions were measured and compared between both
positions.
Results: Five non-pregnant women, 6 healthy pregnant women at mid pregnancy and 8 healthy pregnant women
at late pregnancy were enrolled in the study. In the group of non-pregnant women left ventricular (LV) cardiac
output (CO) significantly decreased by 9% (p = 0.043) and right ventricular (RV) end-diastolic volume (EDV)
significantly increased by 5% (p = 0.043) from the supine to the left lateral position. During mid pregnancy LV
ejection fraction (EF), stroke volume (SV), left atrium lateral diameter and left atrial supero-inferior diameter
increased significantly from the supine position to the left lateral position: 8%, 27%, 5% and 11%, respectively (p <
0.05). RV EDV, SV and right atrium supero-inferior diameter significantly increased from the supine to the left lateral
position: 25%, 31% and 13% (p < 0.05), respectively. During late pregnancy a significant increment of LV EF, EDV,
SV and CO was observed in the left lateral position: 11%, 21%, 35% and 24% (p < 0.05), respectively. Left atrial
diameters were significantly larger in the left lateral position compared to the supine position (p < 0.05). RV CO
was significantly increased in the left lateral position compared to the supine position (p < 0.05).
Conclusions: During pregnancy positional changes affect significantly cardiac hemodynamic parameters and
dimensions. Pregnant women who need serial studies by CMR should be imaged in a consistent position. From as
early as 20 weeks the left lateral position should be preferred on the supine position because it positively affects
venous return, SV and CO.
dimensions related to altered intra-abdominal and intra-thoracic pressures. This problem is especially evident in
pregnant women due to the additional aorto-caval compression by the enlarged uterus. The purpose of this study
was to investigate the effect of postural changes on cardiac dimensions and function during mid and late
pregnancy using cardiovascular magnetic resonance (CMR).
Methods: Healthy non-pregnant women, pregnant women at 20th week of gestation and at 32nd week of
gestation without history of cardiac disease were recruited to the study and underwent CMR in supine and left
lateral positions. Cardiac hemodynamic parameters and dimensions were measured and compared between both
positions.
Results: Five non-pregnant women, 6 healthy pregnant women at mid pregnancy and 8 healthy pregnant women
at late pregnancy were enrolled in the study. In the group of non-pregnant women left ventricular (LV) cardiac
output (CO) significantly decreased by 9% (p = 0.043) and right ventricular (RV) end-diastolic volume (EDV)
significantly increased by 5% (p = 0.043) from the supine to the left lateral position. During mid pregnancy LV
ejection fraction (EF), stroke volume (SV), left atrium lateral diameter and left atrial supero-inferior diameter
increased significantly from the supine position to the left lateral position: 8%, 27%, 5% and 11%, respectively (p <
0.05). RV EDV, SV and right atrium supero-inferior diameter significantly increased from the supine to the left lateral
position: 25%, 31% and 13% (p < 0.05), respectively. During late pregnancy a significant increment of LV EF, EDV,
SV and CO was observed in the left lateral position: 11%, 21%, 35% and 24% (p < 0.05), respectively. Left atrial
diameters were significantly larger in the left lateral position compared to the supine position (p < 0.05). RV CO
was significantly increased in the left lateral position compared to the supine position (p < 0.05).
Conclusions: During pregnancy positional changes affect significantly cardiac hemodynamic parameters and
dimensions. Pregnant women who need serial studies by CMR should be imaged in a consistent position. From as
early as 20 weeks the left lateral position should be preferred on the supine position because it positively affects
venous return, SV and CO.
Date Issued
2011-06-27
Date Acceptance
2011-06-27
Citation
Journal of Cardiovascular Magnetic Resonance, 2011, 13 (1)
ISSN
1097-6647
Publisher
BioMed Central
Journal / Book Title
Journal of Cardiovascular Magnetic Resonance
Volume
13
Issue
1
Copyright Statement
© 2011 Rossi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Identifier
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Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Radiology, Nuclear Medicine & Medical Imaging
Cardiovascular System & Cardiology
LEFT-VENTRICULAR ANALYSIS
CONGENITAL HEART-DISEASE
CARDIAC-OUTPUT
LATERAL POSITIONS
INTRACARDIAC PRESSURES
POSTURE
INFORMATION
DYNAMICS
Publication Status
Published
Article Number
31
Date Publish Online
2011-06-27