SOSTIENICI
Pubblicazioni recenti - peripartum cardiomyopathy
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Peripartum Cardiomyopathy and Spouses' Experiences of Persistent Uncertainty.
MCN Am J Matern Child Nurs;47(4):207-212. doi: 10.1097/NMC.0000000000000831.
Hess Rosanna F, Donnenwirth Jo Ann,
Abstract
PURPOSE:
The purpose of this study was to explore the experiences of spouses whose wives had peripartum cardiomyopathy (PPCM).
DESIGN METHODS:
Participants were recruited for this phenomenological study through online sites Facebook and SavetheMommies. Fifteen men from four countries participated through semistructured phone interviews conducted between October 2019 and August 2020. Data were analyzed using a modified version of the constant comparison method.
RESULTS:
The overarching theme of spouses' experiences was Living with the 'what ifs' of persistent uncertainty. Four main themes were: Feeling the shock, Facing the challenge, Figuring out a new normal, and Finding meaning. Spouses had to deal with the fear of their wives' heart failure relapse or death, changed marital and parental roles, and unclear expectations of the future.
CLINICAL IMPLICATIONS:
PPCM is a rare complication of pregnancy with uncertain implications for the future that can have a profound impact on the woman's spouse and family. Our findings should alert nurses and other health care professionals to the need for emotional, spiritual, and informational support of spouses or partners of women who have PPCM. Nurses should include spouses and partners in care and communication to make sure they are as informed as possible, have their questions and concerns addressed as needed, and receive adequate follow-up support.
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Case Report: Severe Peripartum Cardiac Disease in Myotonic Dystrophy Type 1.
Front Cardiovasc Med2022 ;9():899606. doi: 10.3389/fcvm.2022.899606.
Besant Georgia, Bourque Pierre R, Smith Ian C, Chih Sharon, Lamacie Mariana M, Breiner Ari, Zwicker Jocelyn, Lochmüller Hanns, Warman-Chardon Jodi,
Abstract
Background:
Myotonic dystrophy type 1 (DM1) is a hereditary muscular dystrophy affecting ?2.1-14.3/100,000 adults. Cardiac manifestations of DM1 include conduction disorders and rarely cardiomyopathies. DM1 increases the risk of obstetric complications, however, little is known about the relationship between pregnancy and cardiomyopathy in DM1 due to disease rarity.
Case:
A 23-year-old with DM1 developed cardiomyopathy during pregnancy. Despite initial medical stabilization, she subsequently developed multiple spontaneous coronary artery dissections postpartum, worsening cardiomyopathy and multiorgan failure. She died 5 months postpartum.
Conclusion:
Though cardiomyopathy and arterial dissection are both known complications of pregnancy, this case suggests individuals with myotonic dystrophy type 1 may be at heightened risk for cardiac disease during the peripartum period. Physicians caring for women with suspected or proven DM1 should offer counseling and be alerted to the risk of cardiac complications with pregnancy and in the peripartum period. Pregnant and peripartum women with DM1 are likely to benefit from more frequent assessments of cardiac function including echocardiograms and early institution of heart failure management protocols when symptoms of cardiomyopathy present.
Copyright © 2022 Besant, Bourque, Smith, Chih, Lamacie, Breiner, Zwicker, Lochmüller and Warman-Chardon.
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Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy.
BMC Pregnancy Childbirth2022 Jun;22(1):497. doi: 10.1186/s12884-022-04814-9.
Ng Kwok-On, Chow Lok-Hi, Yeh Chun-Chang, Huang Eagle Yi-Kung, Liu Wei-Cheng, Tan Ping-Heng,
Abstract
BACKGROUND:
Peripartum cardiomyopathy (PPCM) is defined as an idiopathic cardiomyopathy occurring in the last month of pregnancy or the first 6 months postpartum without an identifiable cause. PPCM is suspected to be triggered by the generation of a cardiotoxic fragment of prolactin and the secretion of a potent antiangiogenic protein from the placental, but no single factor has been identified or defined as the underlying cause of the disease. Influenza virus can cause PPCM through immune-mediated response induced by proinflammatory cytokines from host immunity and endothelial cell dysfunction. We report a case in a parturient woman undergoing a cesarean delivery, who had influenza A pneumonia and PPCM.
CASE PRESENTATION:
A parturient woman at 40 weeks and 1 day of gestation who had experienced gestational hypertension accompanied by pulmonary edema developed hypotension after undergoing an emergency cesarean delivery. An elevation of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was noted, and echocardiography revealed a left ventricular ejection fraction of 20%. She underwent a nasopharyngeal swab test, in which influenza A antigen was positive. She was diagnosed as having PPCM and received anti-viral treatment. After antiviral treatment, hemodynamic dysfunction stabilized. We present and discuss the details of this event.
CONCLUSION:
PPCM is a heart disease that is often overlooked by medical personnel. Rapid swab tests, serum creatine kinase measurement, and echocardiography are imperative diagnostic approaches for the timely recognition of virus-associated cardiomyopathy in peripartum women with influenza-like disease and worsening dyspnea, especially during the epidemic season. Prompt antiviral treatment should be considered, particularly after PPCM is diagnosed.
© 2022. The Author(s).
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Early Recognition and Treatment for the Optimal Care of Individuals With Peripartum Cardiomyopathy.
Nurs Womens Health2022 Jun;():. doi: S1751-4851(22)00130-1.
LeBlanc Courtney A, Johnson Kathryn,
Abstract
Peripartum cardiomyopathy (PPCM) is a life-threatening pregnancy-associated condition that often develops within the last month of pregnancy and up to 5 months postpartum. Although it is uncommon, the incidence in the United States is on the rise, especially among Black individuals. Early recognition and treatment are crucial for long-term health and the recovery of left ventricular ejection fraction. Most people with PPCM will recover with time, but a multidisciplinary team is needed to help with long-term treatment. Informed contraception counseling is also needed to minimize the incidence of subsequent pregnancy before recovery, which could worsen conditions. The purpose of this article is to review PPCM and discuss early recognition and management options, which may minimize complications and improve outcomes.
Copyright © 2022 AWHONN. Published by Elsevier Inc. All rights reserved.
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Management of Wolff-Parkinson-White Syndrome in a Patient with Post-partum Cardiomyopathy.
J Community Hosp Intern Med Perspect2022 ;12(1):104-107. doi: 10.55729/2000-9666.1021.
Bendaram Snigdha, Elkattawy Sherif, Masood Noori Muhammad Atif, Fichadiya Hardik, Ayad Sarah, Kaur Parminder, Pullatt Raja, Shamoon Fayez,
Abstract
Wolf-Parkinson-White (WPW) syndrome is a congenital heart condition in which the atrioventricular (AV) node is bypassed by an accessory pathway that connects the atria and ventricle directly. WPW syndrome in patients with a history of peripartum cardiomyopathy (pregnancy-related cardiomyopathy) is associated with a high risk of morbidity and mortality secondary to failure of the pump and the conduction system of the heart. Management of these cases deals with arrhythmia and systolic heart failure, which becomes more challenging in pregnant patients as it requires treatment methods that minimize risks to the fetus. We report a case of a young female patient with WPW syndrome and postpartum cardiomyopathy presenting with symptomatic arrhythmias (tachycardia).
© 2022 Greater Baltimore Medical Center.
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Trends, Predictors, and Outcomes of Cardiovascular Complications Associated With Polycystic Ovary Syndrome During Delivery Hospitalizations: A National Inpatient Sample Analysis (2002-2019).
J Am Heart Assoc2022 Jun;():e025839. doi: 10.1161/JAHA.121.025839.
Zahid Salman, Khan Muhammad Zia, Gowda Smitha, Faza Nadeen N, Honigberg Michael C, Vaught Arthur Jason, Guan Carolyn, Minhas Anum S, Michos Erin D,
Abstract
Background Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy-associated complications. However, data on peripartum cardiovascular complications remain limited. Hence, we investigated trends, outcomes, and predictors of cardiovascular complications associated with PCOS diagnosis during delivery hospitalizations in the United States. Methods and Results We used data from the National Inpatient Sample (2002-2019). (), or (), codes were used to identify delivery hospitalizations and PCOS diagnosis. A total of 71?436?308 weighted hospitalizations for deliveries were identified, of which 0.3% were among women with PCOS (n=195?675). The prevalence of PCOS, and obesity among those with PCOS, increased during the study period. Women with PCOS were older (median, 31 versus 28?years;
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Animal Models of Cardiovascular Complications of Pregnancy.
Circ Res2022 Jun;130(12):1763-1779. doi: 10.1161/CIRCRESAHA.122.320395.
Arany Zolt, Hilfiker-Kleiner Denise, Karumanchi S Ananth,
Abstract
Cardiovascular complications of pregnancy have risen substantially over the past decades, and now account for the majority of pregnancy-induced maternal deaths, as well as having substantial long-term consequences on maternal cardiovascular health. The causes and pathophysiology of these complications remain poorly understood, and therapeutic options are limited. Preclinical models represent a crucial tool for understanding human disease. We review here advances made in preclinical models of cardiovascular complications of pregnancy, including preeclampsia and peripartum cardiomyopathy, with a focus on pathological mechanisms elicited by the models and on relevance to human disease.
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Preeclampsia and Its Maternal and Perinatal Outcomes in Pregnant Women Managed in Bahrain's Tertiary Care Hospital.
Cureus2022 May;14(5):e24637. doi: 10.7759/cureus.24637.
Tabassum Shazia, AlSada Abeer, Bahzad Noora, Sulaibeekh Noora, Qureshi Abida, Dayoub Nawal,
Abstract
OBJECTIVE:
Hypertensive disorders during pregnancy being the leading causes of maternal and fetal morbidity and mortality remains a serious health issue worldwide due to the high rate of adverse maternal outcomes and close association with neonatal morbidity and mortality. The purpose of our study was to ascertain the perinatal outcomes of preeclampsia (PE) in a tertiary care hospital in Bahrain.
METHODS:
A retrospective cohort study was conducted from January 2018 to December 2019 in the department of Gynecology and Obstetrics in Bahrain Defense Hospital. The process of data collection included a baseline review of all women who had delivered during the study period in order to identify those with PE. Additionally, the postdelivery records of the mothers and newborns were reviewed to identify relevant maternal and neonatal outcomes.
RESULTS:
During the research period, records revealed 142 patients with PE with a rate of 1.95%. The mean gestational age at diagnosis was 35.61 (± 3.69) weeks, ranging between 20 and 42 weeks. The mean birth weight was 2.64 ± 0.79 kg, ranging from 0.5-4.5 kg. Furthermore, most babies had an Apgar score of 9 at 5 minutes. The preterm delivery rate was (16.3%) and intrauterine growth restriction (IUGR) was seen in 19 patients (13.5%) and it was significantly higher in patients who presented between 30 and 34 gestational weeks P
CONCLUSION:
Preeclampsia causes a remarkable increase in adverse maternal and perinatal outcomes as compared to the normotensive pregnant population. A regular goal-oriented clinical audit into perinatal morbidity and mortality associated with this condition and an active multidisciplinary approach to the management of pre-eclampsia patients in the hospital might improve the clinical outcomes.
Copyright © 2022, Tabassum et al.
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[Incidental Diagnosis of Giant Cell Myocarditis at Open Heart Surgery:Report of Case].
Kyobu Geka2022 Jun;75(6):472-475.
Ozawa Tatsuya, Kawasaki Yusuke, Nakatsu Taro, Suenaga Etsuro,
Abstract
Giant cell myocarditis (GCM) is one of the rare diseases that cause fatal heart failure and suspected to be associated with autoimmune disorder. There are few reports that the patients of GCM live long because of their progressive heart failure. We report a rare case of patient who was suspected two long hospitalizations due to heart failure in her childhood and peripartum period, and incidentally diagnosed with GCM by myocardial biopsy performed at the aortic valve replacement and mitral annuloplasty for severe aortic valve regurgitation and moderate mitral regurgitation.
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Critical Care Management of the Parturient with Cardiac Disease.
Indian J Crit Care Med2021 Dec;25(Suppl 3):S230-S240. doi: 10.5005/jp-journals-10071-24068.
Garg Rakesh, Hariharan Uma R, Malik Indira,
Abstract
Parturient with heart disease forms a challenging group of patients and requires specialized critical care support in the peripartum period. Maternal heart disease may remain undiagnosed till the second trimester of pregnancy, presenting frequently after 20 weeks of gestation, due to increased demands imposed on the cardiovascular system and pose a serious risk to the life of mother and fetus. Management of critically ill parturient with heart disease must be tailored according to individual assessment of the patient and requires a strategic, multidisciplinary, and protocol-based approach. A dedicated obstetric intensive care unit (ICU) and team effort are the need of the hour.
How to cite this article:
Garg R, Hariharan UR, Malik I. Critical Care Management of the Parturient with Cardiac Disease. Indian J Crit Care Med 2021;25(Suppl 3):S230-S240.
Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.
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Peripartum cardiomyopathy - challenges of diagnosis and management. Stay alert and implement BOARD treatment.
Kardiol Pol2022 May;():. doi: 10.33963/KP.a2022.0135.
Cieplucha Wiktoria, Cieplucha Aleksandra, Walgamage Thilini, Subramaniapillai Mehala, Walgamage Malsha, Klotzka Aneta, Katarzy?ska-Szyma?ska Agnieszka, Gwizda?a Adrian, Keller Daria, Lesiak Maciej,
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Covid-19 Infection During Pregnancy With Acute Heart Failure, Venous Thrombosis And Pneumonia.
J Ayub Med Coll Abbottabad;34(2):369-374. doi: 10.55519/JAMC-02-9305.
Soofi Muhammad Adil, Shah Muhammad Azam, Mhish Olaa Hassan, AlSamadi Faisal,
Abstract
The COVID-19 infection has spread rampantly, attaining pandemic status within three months of its first appearance. It has been classically associated with respiratory signs and symptoms. However, unusual presentations have also been reported in multiple literatures. We are reporting a case of acute heart failure in a pregnant patient diagnosed with Covid-19 infection. Her hospital course has been complicated by pneumonia and venous thrombosis during the postpartum period. Her laboratory investigations showed evidence of myocardial injury, acute heart failure, and COVID-19 infection in second PCR sample taken during postpartum period. Echocardiography exhibited features of severe left ventricle systolic dysfunction. She had successful delivery through caesarean-section, nevertheless, her postpartum period was complicated by pneumonia and right femoral venous thrombosis. CT scan of the chest and pulmonary arteries revealed infiltrations in the left lower lobe and right middle lobe, suggestive of consolidation, with no evidence of pulmonary embolism. Cardiac MRI displayed severe global LV and RV systolic dysfunction, but no evidence of myocardial infarction, myocardial infiltration, or abnormal myocardial delayed enhancement. Her condition improved and she was discharged on heart failure medications. During follow-up at the heart failure clinic, her symptoms continued to ameliorate, except the LV and RV systolic dysfunction which persisted. Multiple unusual presentations of Covid-19 infection have been reported in various literatures and screening of the COVID-19 infection should be practiced on regular basis especially among high-risk patients. Prompt identification of COVID-19 infection will lead to proper isolation and mitigation of infection spread among hospitalized patients and health care workers. Covid-19 PCR should be repeated in cases having clinical indication and negative first sample. A proper history and cardiac MRI can differentiate between different aetiologies of heart failure during pregnancy and peripartum COVID-19 infection. Adequate anticoagulation should be considered in COVID-19 patients due to the high risk of thromboembolism. Among patients with COVID-19 infection, CT chest helps demonstrate the extent of pulmonary involvement.
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High prevalence of reduced fertility and use of assisted reproductive technology in a German cohort of patients with peripartum cardiomyopathy.
Clin Res Cardiol2022 May;():. doi: 10.1007/s00392-022-02034-x.
Pfeffer Tobias J, List Manuel, Schippert Cordula, Auber Bernd, Ricke-Hoch Melanie, Abou-Moulig Valeska, Berliner Dominik, Bauersachs Johann, Hilfiker-Kleiner Denise,
Abstract
BACKGROUND:
Over the past decades the use of assisted reproduction technology (ART) increased worldwide. ARTs are associated with an elevated risk for cardiovascular complications. However, a potential relation between subfertility/ARTs and the heart disease peripartum cardiomyopathy (PPCM) has not been systematically analyzed yet.
METHODS:
A retrospective cohort study was carried out, including n?=?111 PPCM patients from the German PPCM registry. Data from PPCM patients were compared to those from postpartum women in the German general population.
RESULTS:
The prevalence of reported subfertility was high among PPCM patients (30%; 33/111). Most of the subfertile PPCM patients (55%; 18/33) obtained vitro fertilizations (IVF) or intracytoplasmic sperm injections (ICSI). PPCM patients were older (p?0.0001), the percentage of born infants conceived by IVF/ICSI was higher (p?0.0001) with a higher multiple birth (p?0.0001), C-section (p?0.0001) and preeclampsia rate (p?0.0001), compared to postpartum women. The cardiac outcome was comparable between subfertile and fertile PPCM patients. Whole exome sequencing in a subset of n?=?15 subfertile PPCM patients revealed that 33% (5/15) carried pathogenic or likely pathogenic gene variants associated with cardiomyopathies and/or cancer predisposition syndrome.
CONCLUSIONS:
Subfertility occurred frequently among PPCM patients and was associated with increased age, hormonal disorders, higher twin pregnancy rate and high prevalence of pathogenic gene variants suggesting a causal relationship between subfertility and PPCM. Although this study found no evidence that the ART treatment per se increases the risk for PPCM or the risk for an adverse outcome, women with subfertility should be closely monitored for signs of peripartum heart failure.
© 2022. The Author(s).
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Extracorporeal membrane oxygenation during pregnancy and peripartal. An international retrospective multicenter study.
Perfusion2022 May;():2676591221090668. doi: 10.1177/02676591221090668.
Malfertheiner S Fill, Brodie D, Burrell A, Taccone F S, Broman L M, Shekar K, Agerstrand C L, Serra A L, Fraser J, Malfertheiner M V,
Abstract
INTRODUCTION:
Extracorporeal Membrane Oxygenation (ECMO) may be used in the setting of pregnancy or the peripartal period, however its utility has not been well-characterized. This study aims to give an overview on the prevalence of peripartel ECMO cases and further assess the indications and outcomes of ECMO in this setting across multiple centers and countries.
METHODS:
A retrospective, multicenter, international cohort study of pregnant and peripartum ECMO cases was performed. Data were collected from six ECMO centers across three continents over a 10-year period.
RESULTS:
A total of 60 pregnany/peripartal ECMO cases have been identified. Most frequent indications are acute respiratory distress syndrome ( = 30) and pulmonary embolism ( = 5). Veno-venous ECMO mode was applied more often (77%). ECMO treatment during pregnancy was performed in 17 cases. Maternal and fetal survival was high with 87% ( = 52), respectively 73% ( = 44).
CONCLUSIONS:
Various emergency scenarios during pregnancy and at time of delivery may require ECMO treatment. Peripartal mortality in a well-resourced setting is rare, however emergencies in the labor room occur and knowledge of available rescue therapy is essential to improve outcome. Obstetricians and obstetric anesthesiologists should be aware of the availability of ECMO resource at their hospital or region to ensure immediate contact when needed.
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First Trimester Cardiac Biomarkers among Women with Peripartum Cardiomyopathy: Are There Early Clues to This Late-Pregnancy Phenomenon?
Am J Perinatol2022 May;():. doi: 10.1055/s-0042-1748159.
Sarma Amy A, Hsu Sarah, Januzzi James L, Goldfarb Ilona T, Thadhani Ravi, Wood Malissa J, Powe Camille E, Scott Nandita S,
Abstract
INTRODUCTION:
?Whether biomarkers may enable early identification of women who develop peripartum cardiomyopathy (PPCM) prior to disease onset remains a question of interest.
METHODS:
?A retrospective nested case-control study was conducted to determine whether first trimester -terminal pro-B type natriuretic peptide (NT-proBNP) or high sensitivity cardiac troponin I (hs-cTnI) differed among women who developed PPCM versus unaffected pregnancies. Cases were matched to unaffected women by age, race, parity, and gestational age of sample (control A) and then further by blood pressure and pregnancy weight gain (control B).
RESULTS:
?First trimester NT-proBNP concentrations were numerically higher among women who subsequently developed PPCM (116 pg/mL [83-177]) as compared with women in control A (56.1 pg/mL [38.7-118.7], ?=?0.3) or control B (37.6 [23.3?-?53.8],
CONCLUSION:
?There were differences in first trimester NT-proBNP and hs-cTnI concentrations between women who subsequently developed PPCM and those who did not, raising the possibility the early pregnancy subclinical myocardial dysfunction may be associated with this late-pregnancy disease.
KEY POINTS:
· 1st trimester NT-proBNP is numerically higher among women who subsequently develop PPCM.. · 1st trimester hs-cTnI was nominally higher among women who developed PPCM versus those who did not.. · A significant proportion of normal pregnant women have undetectable hs-cTnI..
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The Relationship Between Peripartum Cardiomyopathy and Preeclampsia - Pathogenesis, Diagnosis and Management.
J Multidiscip Healthc2022 ;15():857-867. doi: 10.2147/JMDH.S357872.
Ku? Aleksandra, Kubik Daria, Ko?cielecka Klaudia, Szymanek Wojciech, M?cik-Kronenberg Tomasz,
Abstract
Peripartum cardiomyopathy (PPCM) is a condition with an incompletely understood etiology, although many risk factors for this disorder have been mentioned. Preeclampsia (PE) is a rare but undoubtedly very important cause of PPCM. Early recognition and prompt treatment of preeclampsia and peripartum cardiomyopathy are essential to optimize pregnancy outcomes. An extensive manual search of major electronic databases was conducted in November 2021. The following literature review provides a comprehensive discussion of peripartum cardiomyopathy and preeclampsia and quantifies the prevalence of PE in women with PPCM. The authors highlighted aspects such as epidemiology, risk factors, cardiovascular changes, diagnosis and clinical presentation, and management and complications. Accumulating data indicate that both conditions have a similar pathogenesis characterized by vascular abnormalities. In both conditions we can observe an increase in interleukin-6 and gamma interferon, CCL2/MCP1, and decreased SOD activity. sFLT1 (a soluble form of fms-like tyrosine kinase 1), a substance with antiangiogenic and probably cardiotoxic effects, may be important. Preeclampsia and peripartum cardiomyopathy are characterized by recurrence rates that follow a similar pattern in subsequent pregnancies, and mortality remains a concern. Our analysis highlights the need to better understand the co-morbidity of PE and PPCM, and the need to qualify patients for the same clinical trials because of the common origin of these conditions.
© 2022 Ku? et al.
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Racial Differences in Delivery Outcomes Among Women With Peripartum Cardiomyopathy.
CJC Open2022 Apr;4(4):373-377. doi: 10.1016/j.cjco.2021.12.004.
Gambahaya Ellise T, Minhas Anum S, Sharma Garima, Vaught Arthur J, Adamo Luigi, Zakaria Sammy, Michos Erin D, Hays Allison G,
Abstract
Background:
Peripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy associated with pregnancy that occurs more frequently among Black women. However, less is known about the association of race/ethnicity with outcomes at the time of delivery in women with PPCM.
Methods:
We used data from the 2016-2018 National Inpatient Sample (NIS) database to identify women with a diagnosis of PPCM based on International Classification of Diseases, 10th revision (ICD-10) codes. Using adjusted logistic regression, the association of race with PPCM and adverse cardiovascular (CV) outcomes with PPCM was evaluated across racial/ethnic groups (White, Black, Hispanic, Asian/Pacific Islander).
Results:
Among 11,304,996 delivery hospitalizations, PPCM was present in 8735 (0.08%). After adjusting for CV risk factors (chronic hypertension, diabetes, and obesity) and socioeconomic factors (insurance status, hospital income, and residential income), Black and Native American women had greater adjusted odds of developing PPCM (adjusted odds ratio [aOR] 1.89; 95% confidence interval [CI] 1.66-2.15; aOR 1.60; 95% CI 1.02-2.50, respectively), compared with White women. In stratified analysis of CV events, however, Asian/Pacific Islander women with PPCM were the most likely to have CV complications (aOR 98; 95% CI 29-333 for pulmonary edema).
Conclusions:
In the US, at the time of delivery hospitalization, Black and Native American women are the most likely to develop PPCM, despite adjustment for CV and socioeconomic risk factors, but Asian women have higher odds of having CV complications.
© 2021 The Authors.
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Large Biventricular Thrombi Associated With Peripartum Cardiomyopathy.
CJC Open2022 Apr;4(4):439-440. doi: 10.1016/j.cjco.2022.01.006.
Al Habsi Marwa, Al Lawati Hatim A,
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Pre-pregnancy obesity and the risk of peripartum cardiomyopathy: A systematic review and meta-analysis.
Indian Heart J;74(3):235-238. doi: S0019-4832(22)00070-0.
Putra Iwan Cahyo Santosa, Irianto Christian Bobby, Raffaello Wilson Matthew, Suciadi Leonardo Paskah, Prameswari Hawani Sasmaya,
Abstract
The outcome of this review is to assess the association between pre-pregnancy obesity and PPCM incidence. There were a total of 5.373.581 participants were included in this study. Pre-pregnancy obesity was significantly associated with PPCM incidence compared to normal-weight subjects (OR = 1.79 (1.16,2.76); p = 0.008; I = 59%, P = 0.04). The sub-group analysis showed that pre-pregnancy women with obesity class I (OR = 1.58 (1.20,2.07); p = 0.001; I = 0%, P = 0.64) and class II and III (OR = 2.65 (2.04,3.45); p
Copyright © 2022 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.
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Pregnancy and Progression of Cardiomyopathy in Women With LMNA Genotype-Positive.
J Am Heart Assoc2022 04;11(8):e024960. doi: 10.1161/JAHA.121.024960.
Castrini Anna I, Skjølsvik Eystein, Estensen Mette E, Almaas Vibeke M, Skulstad Helge, Lyseggen Erik, Edvardsen Thor, Lie Øyvind H, Picard Kermshlise C I, Lakdawala Neal K, Haugaa Kristina H,
Abstract
Background We aimed to assess the association between number of pregnancies and long-term progression of cardiac dysfunction, arrhythmias, and event-free survival in women with pathogenic or likely pathogenic variants of gene encoding for Lamin A/C proteins ( LMNA+). Methods and Results We retrospectively included consecutive women with LMNA+ and recorded pregnancy data. We collected echocardiographic data, occurrence of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, and implantation of cardiac electronic devices (implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator). We analyzed retrospectively complications during pregnancy and the peripartum period. We included 89 women with LMNA+ (28% probands, age 41±16 years), of which 60 had experienced pregnancy. Follow-up time was 5 [interquartile range, 3-9] years. We analyzed 452 repeated echocardiographic examinations. Number of pregnancies was not associated with increased long-term risk of atrial fibrillation, atrioventricular block, sustained ventricular arrhythmias, or implantable cardioverter defibrillator/cardiac resynchronization therapy defibrillator implantation. Women with previous pregnancy and nulliparous women had a similar annual deterioration of left ventricular ejection fraction (-0.5/year versus -0.3/year, =0.37) and similar increase of left ventricular end-diastolic diameter (0.1/year versus 0.2/year, =0.09). Number of pregnancies did not decrease survival free from death, left ventricular assist device, or need for cardiac transplantation. Arrhythmias occurred during 9% of pregnancies. No increase in maternal and fetal complications was observed. Conclusions In our cohort of women with LMNA+, pregnancy did not seem associated with long-term adverse disease progression or event-free survival. Likewise, women with LMNA+ generally well-tolerated pregnancy, with a small proportion of patients experiencing arrhythmias.
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