期刊
EUROPEAN HEART JOURNAL
卷 38, 期 35, 页码 2683-2690出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehx189
关键词
Pregnancy; Hypertrophic; Cardiomyopathy; Outcome
资金
- Abbott Vascular Int.
- Amgen Cardiovascular
- AstraZeneca
- Bayer
- Boehringer Ingelheim
- Boston Scientific
- Bristol Myers Squibb
- Pfizer Alliance
- Alliance Daiichi Sankyo Europe GmbH
- Eli Lilly and Company
- Edwards
- Gedeon Richter Plc.
- Menarini Int. Op.
- MSD-Merck Co.
- Novartis Pharma AG
- ResMed
- Sanofi
- SERVIER
Aims We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. non-obstructive HCM. Sixty pregnant women (mean age 30.4 +/- 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >= II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.
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