[Compensatory hypertension and fetal heart remodeling: from adaptation to pathology].
Left ventricular (LV) isovolumetric relaxation time (IRT), shape and LV wall movement uniformity were assessed in 102 appropriate for gestational age (AGA) human fetuses and 36 fetuses with intrauterine growth retardation (IUGR). In 28 AGA newborns and 26 IUGR infants rennin and angiotensin 1 concentrations were assessed in umbilical cord blood by radioimmunoassay. Systolic blood pressure (BP) was also measured in these infants. The IRT in IUGR fetuses was more (50.9+/-8.6 ms) than in the AGA fetuses (42.8+/-6.7 ms, p < 0.01). The mean BP in the IUGR newborns was greater (76+/-5 mm Hg vs 60+/-6 mm Hg, p < 0.01) than in the AGA fetuses. Rennin and angiotensin 1 concentrations were 1.61- and 1.56-fold greater in the blood of the IUGR newborns than in the AGA infants. A chronic hypertension in placenta perfusion increase in the IUGR fetuses was proposed. The changes in LV shape and uniformity of wall movement (remodeling) are considered to be the result of chronic increase in afterload. Rennin-angiotensin activation and LV remodeling as an adaptive reactions of antenatal period could promote the arterial hypertension development in later life.