Disruption of cardiac electrical activity resulting in palpitations and syncope is often an early symptom of pregnancy. Pregnancy is a time of dramatic and dynamic physiological and hormonal changes during which numerous demands are placed on the heart. These changes result in electrical remodelling which can be detected as changes in the electrocardiogram (ECG). This gestational remodelling is a very under-researched area. There are no systematic large studies powered to determine changes in the ECG from pre-pregnancy, through gestation, and into the postpartum period. The large variability between patients and the dynamic nature of pregnancy hampers interpretation of smaller studies, but some facts are consistent. Gestational cardiac hypertrophy and a physical shift of the heart contribute to changes in the ECG. There are also electrical changes such as an increased heart rate and lengthening of the QT interval. There is an increased susceptibility to arrhythmias during pregnancy and the postpartum period. Some changes in the ECG are clearly the result of changes in ion channel expression and behaviour, but little is known about the ionic basis for this electrical remodelling. Most information comes from animal models, and implicates changes in the delayed-rectifier channels. However, it is likely that there are additional roles for sodium channels as well as changes in calcium homoeostasis. The changes in the electrical profile of the heart during pregnancy and the postpartum period have clear implications for the safety of pregnant women, but the field remains relatively undeveloped.
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May 2016
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Paraffin section of knee joint from CIA mouse model. Safranin-O/fast green staining showed significant cartilage degeneration and bone erosion in femorotibial joint. For further details see pp. 667-681. Image kindly provided by Dr. Chih-Hsin Tang.
Review Article|
April 01 2016
Hormones and sex differences: changes in cardiac electrophysiology with pregnancy
Glenna C.L. Bett
*Center for Cellular and Systems Electrophysiology, University at Buffalo, State University of New York, Buffalo, NY 14214, U.S.A.
†Department of Obstetrics and Gynecology, University at Buffalo, State University of New York, Buffalo, NY 14214, U.S.A.
‡Department of Physiology and Biophysics, University at Buffalo, State University of New York, Buffalo, NY 14214, U.S.A.
Correspondence: Dr Glenna C.L. Bett (email bett@buffalo.edu).
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Publisher: Portland Press Ltd
Received:
October 05 2015
Revision Received:
January 19 2016
Accepted:
February 01 2016
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2016 Authors; published by Portland Press Limited
2016
Clin Sci (Lond) (2016) 130 (10): 747–759.
Article history
Received:
October 05 2015
Revision Received:
January 19 2016
Accepted:
February 01 2016
Citation
Glenna C.L. Bett; Hormones and sex differences: changes in cardiac electrophysiology with pregnancy. Clin Sci (Lond) 1 May 2016; 130 (10): 747–759. doi: https://doi.org/10.1042/CS20150710
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