Evaluation of the effects of cigarette smoking on fetal cardiac function: using the doppler Tei index

This prospective study involved 40 pregnant women [20 as pregnant smoking women and 20 as a control group] randomly selected with uncomplicated pregnancies and without risk factors for fetal heart disease. Patients underwent complete fetal echocardiographic examinations and Tei index was calculated. The mean maternal heart rate was elevated as was the mean fetal heart rate. A decrease occurred in the systolic/diastolic ratio in the umbilical artery. Ductal flow was significantly increased and Tei index [IRT+ICT]/ET was significantly increased for right ventricle [RV] compared with the control group [0.71 +/- 0.04 vs 0.36 +/- 0.05, respectively]. The other hemodynamic variables remained unchanged. Smoking was associated with increase in maternal and fetal heart rate. Tei index was significantly increased for right ventricle

Combined systolic and diastolic performance, aortic root, left atrial dimensions and carotid intima-media thickness in pregnancy-induced hypertension: relation to parity and lipids

Pregnancy-induced hypertension offers a natural model of transient hypertension. This study aimed to assess the ability of echocardiographic Doppler to unmask left ventricular function impairment as well as both left atrium and aortic root dimensions and carotid intma-media thickness as echocardiographic markers. Forty-eight women aged 29.6 +/- 4.42 years with pregnancy-induced hypertension defined as blood pressure higher than 140/90 mm Hg after 20 weeks gestation without a history of hypertension. Forty-eight normal pregnant women, aged 26.37 +/- 4.94 years, were the controls. Left ventricular diastolic and systolic diameters, ejection fraction, interventrical septum, posterior wall, relative wall thickness, left ventricular mass index, E velocity, A velocity, E/A ratio, isovolumetric relaxation time [IRT], isovolumetric contraction time [ICT], ejection time [ET], and the combined index of myocardial performance [Tei index = IRT + ICT/ET], were calculated by echocardiography Doppler 2 to 4 days postpartum. Left atrium and aortic root dimensions and carotid intima-media thickness were also assessed. Lipid profile was compared and the relation to parity and pregravid bodymass index were also assessed. There were statistically significant differences between groups in the all parameters apart from both diastolic and systolic diameters, ejection fraction, left atrium and aortic root dimensions. Highly significant differences existed in the Tei-Index andIRT and less significant relation regarding carotid intima-media thickness and E/A ratio. A highly positive association with pregravid body mass index, cholesterol, LDL, triglycerides and not HDL was found. A less positive relationship between parity was noticed. Pregnancy-induced hypertension evaluated 2 to 4 days after delivery showed left ventricular dysfunction, mainly diastolic. The Tei index is a useful parameter to unmask left ventricular dysfunction. Carotid intima-media thickness as well as E/A ratio are also ot value. Obesity and of a lesser extent parity are also predictors

Prediction of risk of hypertension in offspring of hypertensive subjects

The offspring of hypertensive patients has a tendency to develop hypertension, so the question of prediction of susceptible individuals is unclear. This Cross-sectional comparative study was designed to clarify some predictors of hypertension in offspring of hypertensive patients. The study included 100 subjects [12 to 18 year old, male and female]; 50 offspring of hypertensive parents [group I] and 50 offspring of normotensive parents [Group II]. They were subjected to full medical history and clinical examination including blood pressure record at rest and after exercise. Also anthropometric assessment was performed. Biochemical assessment for fasting C-peptide insulin level, and plasma level of norepinephrin [NE] were recorded. In group I. the mean resting systolic blood pressure [SBP] was 101.8 +/- 9mmHg, the mean peak SBP 197.2 +/- 27mmHg, the mean resting distolic blood pressure [DBP] was 76.5 +/- 7.5mmHg, the mean peak DBP 71 +/- 9.5mmHg. The mean resting heart rate [HR] was 83.6 +/- 8.7 Beat/min. the mean peak HR was 193.5 +/- 9.I Beat/min. The mean metabolic equivalent [METs] was 12.5 +/- 1.8 MEq. The mean body mass index [BMI] was 30 +/- 5.1 kg/m2. The mean serum insulin level was 23.5 +/- 15.7 micro U/dl and the mean serum NE level was 344.7 +/- 57.1 ng/dl. In group II, the mean resting SBP was 95.1 +/- 16.22mmHg, the mean peak SBP was 172.5 +/- 17.8mmHg; the mean resting DBP was 66.7 +/- 7.7mmHg, the mean peak DBP was 63.4 +/- 6.9mmHg. The mean resting HR was. 80.1 +/- 11.4 Beat/min, the mean peak HR was 188.7 = 6.2 Beat/min. The mean METs was 13.2 +/- 1.8 MEq. The mean BMI was 26.8 +/- 3.6 +/- 5.8 kg/m[2]. The mean serum insulin was 14.7 +/- 15.7 micro U/dl, and mean serum NE was 286.3 +/- 57.1 ng/dl. Both SBP and DBP were within normal limits but were significantly greater in group I than group II. Function capacity was significantly lesser in group I than group II. BMI was significantly greater in group 1 than group II. Serum insulin and NE were significantly increased in group I than group II. However the long-term effect of these risk factors on the cardiovascular system including the coronary arteries need more research