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Type‐specific orthostatic hemodynamic response of hypertensive diseases in pregnancy
Author(s) -
Staelens Anneleen S,
Vonck Sharona,
Mesens Tinne,
Tomsin Kathleen,
Molenberghs Geert,
Gyselaers Wilfried
Publication year - 2015
Publication title -
clinical and experimental pharmacology and physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 103
eISSN - 1440-1681
pISSN - 0305-1870
DOI - 10.1111/1440-1681.12463
Subject(s) - medicine , orthostatic vital signs , blood pressure , supine position , cardiology , heart rate , impedance cardiography , hemodynamics , cardiac output , gestation , preeclampsia , pregnancy , stroke volume , biology , genetics
Summary Posture changes may differ between types of hypertensive disease. The aim is to evaluate the orthostatic response of impedance cardiography ( ICG ) measurements in uncomplicated and hypertensive pregnancies. Measurements were performed in supine and standing position in 202 women: 41 uncomplicated pregnancies ( UP ), 59 gestational hypertension ( GH ), 35 early‐onset ( EPE , < 34 weeks) and 67 late‐onset ( LPE , ≥ 34 weeks) preeclampsia were assessed. Measurements were recorded of heart rate, blood pressure, aortic flow parameters, cardiac output, pre‐ejection period and left ventricular ejection time. Overall, orthostatic shifts were different between all groups ( P < 0.001). UP was different from the hypertensive complicated gestations in the orthostatic change of the aortic acceleration. In contrast to patients with preeclampsia, those with GH had an increased blood pressure and Heather index, and stable pre‐ejection period after posture change. EPE differed from LPE by change in blood pressure and aortic flow parameters. In addition to static ICG ‐measurements, orthostatic shifts improved group characterization from 57.4% to 65.8%. The orthostatic response is altered in hypertensive pregnancies. ICG measurements in the upright as well as during an orthostatic test might have the potential to improve the discriminative yield between hypertensive diseases in pregnancy.