Pregnancy-related changes in Doppler gradients and left ventricular
mechanics in women with subvalvular or valvular aortic stenosis.
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 2 consecutive echocardiograms between 1 year pre-conception
up to 1 year postpartum, with at least 2 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) vs.