ESTUDO DE ANÁLISE DA DEFORMAÇÃO MIOCÁRDICA DURANTE A GESTAÇÃO DE PACIENTES HIPERTENSAS

Abstract

MARQUES, Mayara Hannah Gomes da Silva. Myocardial strain analysis study during pregnancy in hypertensive patients. 2022. Course Conclusion Paper (Medicine) - Universidade Federal da Paraíba, João Pessoa, 2022. Introduction: hypertensive disorders in pregnancy are associated with cardiovascular events linked to high morbidity and mortality. Assessment of myocardial strain (strain) can detect ventricular dysfunction early, even with normal ejection fraction (EF), and be useful for early management of this audience. Objective: to evaluate the behavior of the Longitudinal Global Strain (LGS) in the first and third trimesters of pregnancy of healthy and chronically hypertensive women. Method: this is a prospective observational study, at Hospital Universitário Lauro Wanderley, from August/2019 to March/2022, with echocardiography in the first and third trimesters of 09 pregnant women with chronic SAH and 21 healthy women. Confidence interval of 95%, p < 0,05. Categorical variables described by absolute and relative frequency. Mean and median as measures of central tendency, standard deviation and interquartile range as measures of dispersion, depending on the sample distribution by the Kolmogorov-Smirnov test. Two-way ANOVA, followed by Tukey's post-hoc test to compare LGS behavior according to gestational period and chronic SAH. Results: median age 27.5 (IIQ 11) years. All with preserved EF, in the first and third trimesters. Increased myocardial thickness in the third trimester, in detriment of the first, only in chronic hypertensive women. Alteration of relaxation in the analysis of ventricular diastolic function in the third trimester, in the chronic SAH group, with no change in the first. There is an effect of diagnosis of chronic SAH on LGS (p=0.008), but no effect of gestational period (p=0.214) or interaction between these two factors (p=0.259). Tukey's post-hoc test showed that in the first trimester previously hypertensive pregnant women had a lower LGS than the control group (p=0.045), which was not significant when these groups were compared in the third trimester (p=0.655). In the temporal analysis, there was no significant difference in LGS throughout gestation in either the control group (p=0.126) or the hypertensive group (p=0.999). Conclusion: the gestation period did not significantly influence the LGS, comparing the first and third trimesters within each group. Chronic SAH can influence the LGS, decreasing its value, before the effects of pregnancy, so there was no interaction between the period of gestation and presence of SAH on LGS. During the third trimester, there was no significant difference in LGS measurements between the groups.