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PubMed1984

Symptoms, exercise capacity and exercise hemodynamics: interrelationships and their role in quantification of the valvular lesion.

To compare the symptoms with the objectively-determined exercise capacity, the symptoms as well as the exercise capacity with the exercise hemodynamics and the symptoms, exercise capacity and exercise hemodynamics with the severity of the valvular lesion, in 154 patients with aortic regurgitation, mitral regurgitation, aortic stenosis or mitral stenosis, the symptoms were classified according to the New York Heart Association and the exercise capacity was determined by means of bicycle ergometry with simultaneous measurement of heart rate, blood pressure, pulmonary artery pressure, cardiac output and the left ventricular ejection fraction. Among the parameters studied, no relationships could be established; to a certain degree, the exercise hemodynamics correlated with the severity of the valvular lesion in that a markedly pathologic response was associated with the presence of a high-grade valvular lesion. Since the symptoms were not indicative of the exercise capacity, nor the symptoms or the exercise capacity of either the exercise hemodynamics, the exercise ejection fraction or the severity of the valvular lesion, the symptoms and the exercise capacity should be evaluated on the basis of the exercise hemodynamics before they are taken into consideration for meaningful decision-making processes such as establishment of the indication for surgery.

Adolescent↗
PubMed1982

[Pulmonary and hemodynamic changes in endotoxic shock].

With help of an endotoxin-infusion-model an endotoxic shock was induced. It was possible with the demonstrated parameters to display in different ways the pulmonary and hemodynamic changes. The pathophysiology of the pulmonary hemodynamic was characterized by a marked rise in the difference of the alveolar-arterial oxygen partial pressure, of the pulmonary resistance and of the intrapulmonary right to left shunt immediately at the beginning of the experiment. The influence on the hemodynamic changes of the systemic circulation was manifested at a later time and was characterized by a hypodynamic change in the circulation. Essential pathognomonic signs were, besides the reduction in cardiac output and the increase in total peripheral resistance a continuous decrease in colloid osmotic pressure. Measurement of PaO2 and PaCO2 plays an important role in the overall clinical diagnosis of septic shock. In this experiment this reduction reflects however much less the true measure of the disturbed respiratory-hemodynamic function than the above mentioned findings and the metabolic changes. Here the lactate level of blood is a more meaningful indicator of disturbed cell function. The hemodynamic, hematological and x-ray findings are confirmed by light- and electron microscope findings. Here a characteristic train of events can be demonstrated some of which were typified by capillary endothelial damage, fluid- and cell permeation into the interstitium, intravascular thrombosis and the consequences of cell hypoxia. The differential consideration of the results of the experiment gives an early indication of the further trend as regards those animals which died early and those which survived. Only by early diagnosis with corresponding therapy can the prognosis of endotoxic shock be improved.

Animals↗
PubMed1983

Transient hemodynamic dysfunction after myocardial revascularization. Temperature dependence.

We studied hemodynamics and the effects of right atrial pacing (110 beats/min) following complete myocardial revascularization and hypothermic multidose potassium crystalloid cardioplegia in 12 patients with a normal preoperative left ventricular ejection fraction (LVEF). Measurements were made immediately preoperatively, postoperatively at specified temperatures during the rewarming period (90 degrees F, 94 degrees F, and 98 degrees F), and at 24 hours. No patient had a perioperative myocardial infarction. At 90 degrees F, hemodynamics were characterized by significant decreases in cardiac index, stroke volume index, and left ventricular stroke work index (LVSW) and an increase in systemic vascular resistance index (SVRI) compared to preoperative values (p less than 0.05). Right atrial pacing significantly increased cardiac index preoperatively and 24 hours postoperatively, but not during the rewarming period. Over the entire rewarming period (90 degrees F to 98 degrees F), each of the following variables correlated with temperature: cardiac index (r = 0.71 in sinus rhythm and r = 0.66 with right atrial pacing); stroke volume index (r = 0.33 and 0.66); SVRI (r = -0.80 and -0.64); LVSW (r = 0.37 and 0.73); and heart rate in sinus rhythm (r = 0.51). During the rewarming period, there was an inverse relationship between cardiac index and SVRI (r = -0.87). In conclusion, after myocardial revascularization: (1) transient hemodynamic dysfunction occurs during the rewarming period (90 degrees F to 98 degrees F); (2) this dysfunction is temperature-dependent; and (3) right atrial pacing at 110 beats/min does not improve hemodynamic function during the rewarming period. Temperature must be considered in the evaluation of left ventricular and hemodynamic function following myocardial revascularization.

Adult↗
PubMed1981

[New approach to understanding the hemodynamic norm].

Hemodynamic values were studied by rheography and tachooscillography in 114 healthy individuals whose ages ranged from 15 to 34 years. According to the cardiac index value, all individuals examined were divided into 3 groups: with hyperkinetic type hemodynamics (cardiac index 5.67--4.32 l/min/m2 in males and 6.06--4.70 l/min/m2 in females), eukinetic (4.31--2,96 and 4.69--3.33 l/min/m2, respectively), and hypokinetic (2.95--1,59 and 3.32--1.95 l/min/m2, respectively). The first type was encountered in 23.7% of cases, the second in 46.5%, and the third in 29.8%. The information yielded by the study is used as evidence in favour of the assumption concerning the heterogeneous character of the hemodynamic norm among the healthy population. It is suggested that the criterion of the initial hemodynamic heterogeneity of the human population is employed in the analysis of the heterogeneity of hemodynamics in individuals with arterial hypertension.

Adult↗
PubMed1981

[Natural history of chronic aortic valve. Significance of hemodynamic findings (author's transl)].

The natural history of chronic aortic valve disease is well known from non-invasive data, but invasive data documenting the natural course of this disease are lacking. We studied hemodynamic data of 45 patients who had chronic aortic valve disease and were in functional class III or IV. All patients were candidates for prosthetic aortic valve replacement, but refused operation. These patients document the natural course of aortic valve disease. Invasive hemodynamic data were obtained by heart catheterization. Patients with aortic stenosis who died during the observation period had a transvalve gradient of 83 +/- 40 mm Hg, which was comparable to the gradient of survivors (70 +/- 16 mm Hg, p greater than 0.05), but left ventricular end-diastolic pressure, mean left atrial pressure and pulmonary artery pressure were higher indicating impaired left ventricular function. Patients with aortic stenosis who were repeatedly studied with heart catheterization (n = 7, average interval between studies 3.3 years) showed a significant increase of left ventricular filling pressure and of pulmonary arteriolar resistance and a fall of cardiac index. Patients with aortic insufficiency who died during the observation period had higher left ventricular filling pressures than survivors. Patients with aortic insufficiency who were repeatedly studied with heart catheterization (n = 5, average interval 2.9 years) showed no change of hemodynamic parameters. The latter group showed symptomatic deterioration although hemodynamics were unchanged. We conclude, in chronic aortic valve disease hemodynamic parameters regarding left ventricular function have prognostic implications.

Adult↗
PubMed1981

Cerebral hemodynamics evaluation.

The cerebral hemodynamic evaluation is the embodiment of a system approach to the hemodynamic factors that affect brain blood flow. The stresses employed are those encountered in everyday living. The instruments are simple and the method is basic. The importance of the cardiovascular response to the upright position and of brain perfusion to head motion deserves close attention in the clinical setting. The CHE complements the angiogram, the CT scan, and CT-rBBC studies by addressing the system and arterial hemodynamic factors affecting brain circulation. The CT-rBBC studies have given greater validity and direction to noninvasive and electrophysiologic testing because the ultimate concern is brain perfusion and function and not the angiogram. This combination of techniques has defined the role of the dynamic arterial obstruction and the vertebral artery in the hemodynamics of the brain. The cerebral hemodynamic evaluation is an integral part of the physiologic approach to the diagnosis and treatment of brain ischemia.

Aged↗
PubMedDate not supplied

Hemodynamic effects of long term feeding of sympathomimetic amines to swine.

The hemodynamic effects of long term feeding of sympathomimetic amines (SPMA) to swine were studied. Three groups of female swine (N = 20 for each group) were fed either aminorex fumarate, d-amphetamine sulfate, or dextrose (control) for as long as 8 months in dosages up to 15 mg/kg/day. After 4 months of this feeding regiment, the weight gain of the pigs fed either aminorex or amphetamine was significantly less than the control animals. Hemodynamic measurements on awake swine indicated no elevation of pulmonary arterial blood pressure in the pigs fed SPMA. Measurement of systemic hemodynamics revealed that cardiac index was lower in the treated pigs than in control animals, but that heart rate and systemic arterial blood pressure were not altered by the drugs. In addition to baseline measurements of hemodynamic variables, the animals were exposed to acute hypoxia (12 percent O2 in N2) for 5 minutes. Although pulmonary arterial blood pressure increased similarly in the 3 groups of pigs, total pulmonary resistance increased to a greater extent in the pigs fed SPMA, indicating perhaps an enhancement of the hypoxic pulmonary pressor response after chronic ingestion of either amphetamine or aminorex. In a limited number of pigs, SPMA were fed for a period of 8 months, of which the last 3 months were during pregnancy. Hemodynamic measurements on sedated (metomidate, IV) swine revealed no difference in pulmonary arterial blood pressures between treated and control animals. We conclude that chronic ingestion of large doses of aminorex or amphetamine in swine does not lead to pulmonary arterial hypertension, but that slight reductions in cardiac output and subtle alterations in the pulmonary pressor response to acute hypoxia may occur.

Aminorex↗
PubMed1981

[Acute myocardial infarction of the right ventricle: hemodynamic and electrocardiographic correlation (author's transl)].

The electrocardiogram as a diagnostic aid in acute myocardial infarction of the right ventricle (AMI-RV) was studied prospectively in a group of 66 patients in our coronary unit. Diagnosis was AMI in all cases, divided into 29 (44%) with posterior-descending and 35 (53%) with anterior location. Electrocardiography was practiced with standard and special modes: CRnR, CR and VR. Thirty-nine patients were hemodynamically monitored. In 13 patients with posterior-descending location (19.6%) the hemodynamic pattern disclosed AMI. Right ventricular dysfunction was found in 17%, left ventricular dysfunction in 9% and biventricular dysfunction in 20%. In 30 patients (45.5%) ST increased to greater than 1 mm CR3R-CR6R of which 77% were false positive and 46% false negative. No improvement in these proportions was observed with the use of special mode, special in infarctions with anterior location. The correlation between hemodynamics-site of necrosis was better than that between hemodynamics-increase in ST in CRnR. The authors draw the conclusion that special modes as an aid to diagnosis are of limited value, sensitivity is 54% and specificity is 23%, which rises to 50% in posterior-descending infarctions. At present hemodynamics are the choice diagnostic procedure for AMI-RV which must be suspected if serial studies disclose PVC of more than 9 mm Hg.

Electrocardiography↗
PubMed1981

Hemodynamic assessment of transluminal angioplasty for lower extremity ischemia.

The results of percutaneous transluminal angioplasty (PTA) for 56 ischemic lower extremities in 51 patients were analyzed. Indications for balloon catheter dilatation were intermittent claudication in 46 limbs (82.1%), rest pain in five (8.9%), and ischemic ulceration in five (8.9%). Balloon dialation was technically successful in 16 of 17 iliac segment lesions (94.1%) with symptomatic improvement in each instance. Nine of the 16 limbs were hemodynamically improved with a significant increase (less than 0.15) in ankle systolic pressure index. Four additional limbs had improvement in the thigh index. The remaining three limbs were hemodynamically unimproved. During average follow-up of 7.1 months, the 13 initially improved limbs remained hemodynamically improved. Thirty-one of 42 femoropopliteal dilatations (73.8%) were technically successful, with uniform symptomatic improvement. Of these 31 limbs, 26 had a significant initial increase in ankle index, one had improvement in distal thigh index only, and the remaining four limbs were hemodynamically unimproved. During mean follow-up of 8.4 months in the 27 limbs that initially were improved after femoropopliteal dilation, the pressure index returned to the pre-PTA level in 12 instances (44.4%). These results indicate that PTA is useful in selected short-segment iliac lesions. Balloon dilation of femoropopliteal lesions was less successful and its application requires further evaluation. This study demonstrates the need for close monitoring of the objective hemodynamic response, as well as symptomatic and angiographic results, in establishing the proper role of PTA in the treatment of lower extremity ischemia.

Adult↗
PubMed1995

[Short-term survival after heart transplantation: the relationships between preoperative hemodynamics, organ function and postoperative clinical events].

AIM OF THE STUDY: Pulmonary hypertension is known to affect prognosis of cardiac allograft recipients. Aim of this study is to elucidate the mechanisms relating preoperative hemodynamics to early post-transplant mortality. METHODS: Hemodynamic and pre- and postoperative clinical data of 122 heart transplant recipients were reviewed with respect to early mortality (within 1 month or in-hospital). The relationships between hemodynamics and mortality were studied by means of univariate and multivariate analysis of absolute data and at different cut-off values of hemodynamic parameters. RESULTS: The following hemodynamic parameters were significantly different between survivors (n = 107) and non-survivors (n = 15): right atrial pressure (7.7 +/- 4.7 vs. 12.1 +/- 8.6 mm Hg, p < 0.004), pulmonary vascular resistance (2.57 +/- 1.44 vs. 3.72 +/- 1.88 Wood units, p < 0.007), pulmonary vascular resistance index (4.43 +/- 2.53 vs. 6.53 +/- 3.28 Wood units x m2, p < 0.005), and transpulmonary gradient (8.8 +/- 4.8 vs. 12.3 +/- 6.4 mm Hg, p < 0.02). Right atrial pressure and pulmonary vascular resistance index showed an independent value at stepwise multiple logistic regression analysis (p < 0.008 and < 0.03 respectively). When mortality was tested using cut-off values, it was significantly higher with right atrial pressure > or = 12 (7/28 vs 8/94, p < 0.05), pulmonary vascular resistance index > or = 8 (6/13 vs 9/109, p < 0.0005), and transpulmonary gradient > or = 15 (5/13 vs 10/109, p < 0.01). High right atrial pressure, pulmonary vascular resistance index, and transpulmonary gradient were associated with higher preoperative bilirubin (p < 0.03), which was significantly superior in non-survivors (1.44 +/- 1.53 vs. 0.83 +/- 0.61 mg/dl, p < 0.02). Postoperatively, severe right ventricular failure, severe renal failure and infections within 1 month were all strongly associated with an increased mortality (p < 0.00003); they were more common in patients with high preoperative right filling pressure (9% vs. 43%, p < 0.00002) and/or high pulmonary vascular resistance index (14% vs. 38%, p < 0.03), in those with high right atrial pressure (9% vs. 35%, p < 0.0009), and in those with high pulmonary vascular resistance index (17% vs. 58%, p < 0.002) respectively. Mortality after acute rejection within 1 month was significantly higher in patients with high preoperative right atrial pressure (8% vs. 57%, p < 0.006). CONCLUSIONS: Besides pulmonary hypertension, elevated preoperative right filling pressure appears to indicate an increased risk of early death after transplantation; pre- and postoperative end-organ dysfunction and post-transplant complications are more common or more threatening in this setting.

Adult↗
PubMed1995

Beneficial effects of intravenous albumin infusion on the hemodynamic and humoral changes after total paracentesis.

The study investigated the hemodynamic and neurohumoral effects of albumin infusion after total paracentesis in 18 patients with cirrhosis and tense ascites. Measurements of systemic and splanchnic hemodynamics, and vasoactive neurohumoral systems were performed before and immediately after total paracentesis. The patients were then randomized to receive albumin or not, and hemodynamic and humoral measurements were repeated at 24 hours. Hemodynamic and humoral changes just after paracentesis were similar in patients later randomized to receive albumin infusion or not. Twenty-four hours after total paracentesis, patients nor receiving albumin had total significant reductions in cardiac index (-13%; P = .005), femoral blood flow (-17%; P = .004), and pulmonary capillary pressure (-16%; P = .02), which were accompanied by significant increases in plasma renin activity (PRA) and plasma aldosterone (PA) and by significant decreases in atrial natriuretic factor (ANF) and plasma sodium. By contrast, there was no significant changes in patients receiving albumin, except for an increase in ANF and a further decrease in PA. In both groups, hepatic venous pressure gradient (HVPG) and azygos blood flow decreased just after paracentesis returning to baseline at 24 hours. This study shows that albumin infusion prevents the impairment in systemic hemodynamics, vasoactive neurohumoral systems, and plasma sodium after a large-volume paracentesis, without detrimental effects on portal pressure and portocollateral blood flow.

Aged↗
PubMed1994

[Hemodynamic changes in orthotopic transplantation of the liver].

OBJECTIVE: To evaluate the hemodynamic changes during orthotopic liver transplantation (OLT). DESIGN: Retrospective analysis of the hemodynamic data during OLT. SETTING: National Cancer Hospital. PATIENTS: Thirty-two patients with hepatic neoplasia and various degrees of cyrrhosis classified according to Child-Pugh. INTERVENTIONS: Orthotopic liver transplantation. MEASUREMENTS AND MAIN RESULTS: For each of the six phases of the operation a complete hemodynamic profile was reported as general mean and as mean of each Child class. The catecholamins given were also reported. At baseline the Child C showed a cardiac index (CI) and heart rate higher than others. At the end of first phase the blood pressure (BP) of the Child C lowered more than the others'. The anhepatic phase was stable. At reperfusion CI increased, the systemic resistances and BP decreased in all the classes. The Child C needed more catecholamins at this time. In the last profile all tended to return to baseline values. CONCLUSIONS: The baseline hemodynamic was the more hyperdynamic the more sever was the cyrrhosis. The Child C, despite a meticolous fluid therapy, were prone to hypotension in response to even minimal decreases of filling pressures. At reperfusion an hemodynamic disturbance featured by systemic vasodilation occurred. It was more severe in the hyperdynamic patients and it was time limited. The causes of this disturbances have not yet been fully elucidated.

Adult↗
PubMed1994

[Role of nitric oxide in alterations of the systemic and splanchnic hemodynamics in a experimental model of portal hypertension].

Recent experimental studies have suggested that an increase in the synthesis of nitric oxide, a powerful vasodilator secreted by endothelial cells, plays a role in the hemodynamic disturbances associated to portal hypertension. The present study was addressed to investigate the effects of L-NNA (a specific inhibitor of nitric oxide) on systemic and splanchnic hemodynamics in portal hypertensive rats, induced by partial portal vein ligation. Intravenous infusion of L-NNA (50 ug/kg/min) significantly increased systemic blood pressure and decreased cardiac output as measured by radiolabeled microspheres. A significant increase in systemic and splanchnic vascular resistance was also observed in L-NNA-treated rats; whereas portal blood flow decreased significantly, L-NNA did not modify portal pressure. Pretreatment with L-arginine (300 mg/Kg, i.v.) prevented the hemodynamic changes induced by L-NNA. Similar values of endotoxin levels were detected in both groups of animals. In the control group, L-NNA caused a mild but significant increase of mean arterial pressure; no significant changes on the other hemodynamic parameters were observed. These results suggest that an increase in endogenous synthesis of nitric oxide may play an important role in hemodynamic disturbances associated with chronic portal hypertension.

Animals↗
PubMed1993

[Hemodynamic study with Swan-Ganz catheterization, concomitant to endomyocardial biopsy in heart transplantation patients. Importance in the early diagnosis of rejection].

PURPOSE: To evaluate the role of hemodynamic parameters in the diagnosis of acute rejection who underwent orthotopic cardiac transplantation. METHODS: A protocol was carried out in 19 patients who underwent heart transplantation and in whom Swan-Ganz hemodynamics was performed immediately prior to routine endomyocardial biopsy in the first few months postoperatively. The results of 28 biopsies were divided in group I--severe rejection who needed pulse-therapy (n = 10) and group II--No or mild/moderate rejection who did not need any pulse (n = 18). Hemodynamic parameters were compared between both groups. RESULTS: There were significant differences among hemodynamic parameters in groups I and II. Group I had higher mean right atrial pressures (13.0 x 7.3 mmHg), mean pulmonary pressure (26.3 x 20.4 mmHg), mean wedge pressure (14.4 x 10.9 mmHg) and lower cardiac index (2.57 x 3.10 l/min/m2). CONCLUSION: In a routine situation, hemodynamic measurements, as obtained with Swan-Ganz catheter, simultaneously with endomyocardial biopsies, show significant alterations in transplanted patients who develop acute rejection. This information, obtained earlier than the biopsy results, could shorten the time to initiate pulse-therapy in patients with severe rejection.

Adult↗
PubMed1994

Early hemodynamic and renal effects of tumor necrosis factor alpha: role of thromboxane.

TNF alpha is an early mediator of endotoxemic shock. Its acute effect on renal hemodynamics is not known. In this study, the early hemodynamic and renal effects of TNF alpha were investigated in a rabbit model of shock, in which the measurement of the aortic blood flow before the bifurcation of the renal arteries allows one to differentiate between prerenal factors and hemodynamic renal response. Six groups of rabbits were studied, receiving either: (1) endotoxin, (2) endotoxin + thromboxane inhibitor Dazmegrel, (3) TNF alpha, (4) TNF alpha + Dazmegrel, (5) TNF alpha+indomethacin, or (6) placebo. Between 60 min and 3 hr after the injection, endotoxin induced a mean fall in arterial pressure of 32% (P < 0.01) and TNF alpha of 16% (P < 0.01). After endotoxin, the aortic blood flow decreased by 27% (P < 0.01) and after TNF alpha by 18% (P < 0.001). Both specific thromboxane inhibition and indomethacin abolished the TNF alpha central hemodynamic effect. The renal blood flow (-53%), the renal fraction of the aortic blood flow (-38%), and the glomerular filtration rate (-47%, P < 0.05) decreased 1 hr after endotoxin injection. In contrast, TNF alpha induced only a slight fall of the renal fraction of the aortic blood flow (-19%) after 2.5 hr. Glomerular filtration was not modified after TNF alpha injection most likely because of a 17% mean increase of filtration fraction in this group (P < 0.001). These data indicate that TNF alpha is implicated in the early hemodynamic changes of endotoxemic shock.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Posttransplantation hemodynamics and exercise function are not affected by body-size matching of donor and recipient.

Because the number of heart transplantations performed is limited by the number of available donor hearts, many centers have expanded the acceptable criteria for donor hearts in an attempt to provide a sufficient number of donors for the number of patients awaiting heart transplantation. Traditionally, body-size matching has been an important criteria for matching donors with potential heart transplant recipients. Although initially thought to be detrimental, studies have shown no difference in survival of patients who receive hearts from smaller donors, but heart performance in this subset of patients who receive undersized hearts has not been extensively examined. We assessed exercise capacity and 1-year posttransplantation hemodynamics in 72 consecutive adult orthotopic heart transplant recipients, grouped according to donor-recipient weight ratio and the ratio of donor to recipient body surface area. Total exercise time and relative oxygen consumption were not significantly different among three groups of patients grouped according to donor-recipient body weight ratio as follows: low, 0.60 to 0.79; mid, 0.80 to 1.0; high, more than 1.0. No difference was noted among the three donor-recipient weight ratio groups with respect to 1-year posttransplantation hemodynamics. Similarly, 1-year posttransplantation hemodynamics were not different between patients with a body surface area ratio of less than 1.0 versus those with a body surface area ratio of 1.0 or more. Differences in pretransplantation hemodynamics or graft preservation did not affect our results. Neither donor-recipient weight ratio nor body surface area ratio correlated with any posttransplantation hemodynamic measurement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Effect of hemodynamics on transdiaphragmatic central venous pressure: experiments with rapid bleeding and rapid infusion].

Effects of hemodynamics which would be a possible problem in monitoring diaphragm function through transdiaphragmatic central venous pressure were studied experimentally. Mongrel dogs were anesthetized and allowed to breath spontaneously. (1) Rapid exsanguination (30 ml/kg. body), (2) rapid infusion (15 ml/kg. body) were performed. Superior vena cava mean pressure (PSVC) and inferior vena cava mean pressure (PIVC) were measured and pressure changes during respiration (delta P) were recorded. Changes in the transdiaphragmatic central venous pressure (delta PDI = delta PIVC - delta PSVC) were calculated. And hemodynamic parameters (heart rate, cardiac output, mean arterial pressure, PSVC, PIVC) were measured simultaneously. The delta P and hemodynamic parameters were measured before and after (1) or (2). As the results, no significant changes were observed in delta PDI even if hemodynamics changed. The results suggest that measurement of transdiaphragmatic central venous pressure can be employed clinically as a parameter for monitoring diaphragm function to detect hemodynamic changes which are less serious than those appeared by mass bleeding or excess fluid transfusion.

Animals↗
PubMed1993

[The hemodynamic characteristics of mother and fetus in EPH gestosis].

Maternal and fetal hemodynamics was examined by echocardiography and dopplerometry in 104 pregnant women with EPH [correction of OPH] gestosis of various severity and in 30 women with a normal course of pregnancy in the third trimester. A relationship between incidence and severity of the detected hemodynamic disorders and severity of gestosis clinical manifestations was revealed. Renal blood flow disorders were detected at earlier stages of EPH [correction of OPH] gestosis than deterioration of uteroplacental and fetoplacental hemodynamics. Central hemodynamics parameters were more stable. The detected changes in uteroplacental circulation were less liable to positive dynamic shifts under the effect of therapy than those in the fetoplacental component. Hence, dopplerometric parameters of hemodynamics may serve the criteria of therapy efficacy, and the critical condition of fetoplacental blood flow dictates the necessity of an urgent delivery.

Adolescent↗