Abstract des Autors

During pregnancy the cardiovascular apparatus goes through an important process of morphofunctional adjustment. However, the precise moment this happens is not very well known. We observed twelve patients during the various GIFT phases (Gamete Intrafallopian Transfer) that consist the intratube transfer of male and female gametes and that also represent an ideal model for the study of pregnancy in the early phases. With the eco-Doppler technique morphological and functional parameters of the left ventricle have been evaluated and at the same time estradiol and progesterone haematic variations have been determined. In all twelve patients the increase in E2 corresponds to a significant increment of telediastolic (Dd) and telesystolic (De) diameter and of systolic index (SI) and cardiac index (CI). At the same time a significant reduction of the mean arterial pressure and of the index of systemic vascular resistance has been observed. These data say that systolic flow increment is not due to an increase in the ejection fraction but to an increase in diastolic filling. The utilised mechanism has nothing to do with inotropism but the preload reserve according to the Starling principle. The increase in systolic output is the almost sole cause of the cardiac capacity increment because there is only a light increase in heart rate. In those patients in which GIFT gave a positive result these variations are sustained while in the group of non pregnant patients one can see a rapid return to basic values of the various parameters (except the presence of a significant Dd increment) together with the reduction of plasma E2. In conclusion our work results show that significant cardiovascular adjustments are evident from the earliest pregnancy phases and that these changes can be related to E2 plasma variations. Verf.-Referat