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magalhaes_cg_dr_botfm.pdf: 216705 bytes, checksum: 881a08a914c86cba7e794e4008028006 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Fundação para o Desenvolvimento da UNESP (FUNDUNESP) / Verificar se o coração é órgão-alvo da pré-eclâmpsia (PE) e identificar as alterações hemodinâmicas, estruturais e de função diastólica e sistólica do ventrículo esquerdo, por estudos Doppler-ecocardiográficos. Sujeitos e métodos: Foram avaliadas 29 gestantes com PE e 29 normotensas, pareadas por idades materna e gestacional, e paridade. O exame foi realizado no momento diagnóstico de PE, antes da administração de anti-hipertensivos, avaliando-se as variáveis: resistência periférica (RP), rigidez vascular (RV), diâmetro do átrio esquerdo (AE), diâmetro diastólico do ventrículo esquerdo (VE) (DDVE), diâmetro sistólico do VE (DSVE), septo interventricular (SIVd), parede posterior do VE (PPVEd), espessura relativa da parede posterior do VE (ERP), massa do VE (MVE), índice de massa do VE (iMVE), débito cardíaco (DC), volume sistólico (VS), fração de ejeção (FE%), porcentagem de variação do diâmetro VE (%HD), onda E (E), Onda A (A), relação E/A, tempo de relaxamento isovolumétrico do VE (TRIV). Os dados foram avaliados por média ± desvio-padrão e a análise estatística, pelo teste t de Student, considerando-se p < 0,05. Resultados: Gestantes com PE apresentaram aumento significativo de RV (0.86 ± 0.34 v 0.65 ± 0.17mmHg/mL, p = 0.006), RP (1900.75 ± 439.53 v 1388.14 ± 336.90dyn/s/cm-5, p < 0.001) , SIVd (9.66 ± 1.67 v 7.40 ± 0.86mm, p < 0.001), PPVEd (9.45 ± 1.63 v 7.52 ± 0.81mm, p < 0.001), ERP (0.40 ± 0.09 v 0.31 ± 0.04, p < 0.001),MVE (187.36 ± 43.89 v 132.78 ± 32.66g, p < 0.001), iMVE (52.01 ± 11.29 v 45.33 ± 11.69g/m2,7, p < 0.001), FE% (0.79 ± 0.04 v 0.74 ± 0.06%, p = 0.001), %HD (40.73 ± 4.43 v 36.69 ± 5.27%, p = 0.002) e A (62.34 ± 18.78 v 50.37 ± 10.93cm/s, p < 0.004). Gestantes normotensas apresentaram significativamente maiores valores de DSVE (30.61 ± 3.39 v 28.48 ± 4.09mm, p = 0.032) e relação E/A (1.71 ± 0.50 v 1.42 ± 0.40, p = 0.018). / Being PE a systemic disease which affects multiple organs, it is possible to infer that it also affects the heart, even in the absence of symptoms. This study proposed to verify if the heart is a target organ in PE by analyzing structural and functional variables. Methods: Left ventricular geometry and function were compared among 29 PE women and 29 normotensive pregnant women (grouped according to maternal and gestational age and parity) using Doppler-echocardiography performed when PE was diagnosed. The parameters included systemic vascular resistance (SVR), Stiffness (S), left atrial dimension (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septal thickness in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD), relative wall thickness (RWT), left ventricular mass (LVM), left ventricular mass index (LVMi), cardiac output (CO), stroke volume (SV), ejection fraction (EF), fractional shortening (FS), peak velocity of the mitral E wave (E), peak velocity of the mitral A wave (A), E/A ratio and isovolumetric relaxation time (IVRT). Data were expressed as mean ± SD. Comparison between groups was made using the Student’s t-test. A p value of < 0.05 was considered as significant. Results: PE women showed increased: Stifnness (0.86 ± 0.34 mmHg/mL v 0.65 ± 0.17mmHg/mL, p = 0.006), SVR (1900.75 ± 439.53dyn/s/cm-5 v 1388.14 ± 336.90dyn/s/cm-5, p < 0.001), IVSD (9.66 ± 1.67 mm v 7.40 ± 0.86mm, p < 0.001), LVPWD (9.45 ± 1.63mm v 7.52 ± 0.81mm, p < 0.001), RWT (0.40 ± 0.09 v 0.31 ± 0.04, p < 0.001), LVM (187.36 ± 43.89g v 132.78 ± 32.66g, p < 0.001), LVMi (52.01 ± 11.29g/m2,7 v 45.33 ± 11.69g/m2,7, p < 0.001), EF (0.79 ± 0.04% v 0.74 ± 0.06%, p = 0.001), FS (40.73 ± 4.43% v 36.69 ± 5.27%, p = 0.002) A (62.34 ± 18.78 v 50.37 ± 10.93, p < 0.004) Normotensive women showed increased:...(Complete abstract click electronic access below)
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unesp.br:11449/104164 |
| Date | 18 July 2008 |
| Creators | Magalhães, Claudia Garcia [UNESP] |
| Contributors | Universidade Estadual Paulista (UNESP), Peraçoli, José Carlos [UNESP], Borges, Vera Therezinha Medeiros [UNESP] |
| Publisher | Universidade Estadual Paulista (UNESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 48 f. |
| Source | Aleph, reponame:Repositório Institucional da UNESP, instname:Universidade Estadual Paulista, instacron:UNESP |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -1, -1, -1 |
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