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Cardiomyopathy pregnancy

J Hoevelmann, C A Viljoen, K Manning, J Baard, L Hahnle, M Ntsekhe, J Bauersachs, K Sliwa
BACKGROUND: Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure, which appears in previously healthy women towards the end of pregnancy or within five months following delivery. Although the ECG is widely used in clinical practice, its prognostic value has not been established in PPCM. METHODS: We analysed 12-lead ECGs of patients with PPCM, taken at index presentation and follow-up visits at 6 and 12 months. Poor outcome was determined by the composite endpoint of death, readmission, NYHA functional class III/IV or left ventricular ejection fraction (LVEF) of ≤35% at follow-up...
November 7, 2018: International Journal of Cardiology
Anna S Herrey, Jane M Francis, Marina Hughes, Ntobeko A B Ntusi
Aims: Cardiovascular disease is the leading cause of maternal morbidity and mortality, frequently requiring cardiac imaging for diagnosis, and follow-up. This need does not change pregnancy; however, many centres do not offer cardiovascular magnetic resonance (CMR) to pregnant patients. This paper explores current practice of CMR in pregnancy in four large volume centres, its safety and its impact on patient management. Methods and results: Between 2008 and 2017, we collected consecutive pregnant patients between four centres...
November 20, 2018: European Heart Journal Cardiovascular Imaging
U Seeland, J Bauersachs, J Roos-Hesselink, V Regitz-Zagrosek
Heart diseases are the most common cause of maternal death during pregnancy in Western countries. The current ESC guidelines 2018 for the management of cardiovascular diseases during pregnancy is a guide for any physician facing the challenge of caring for pregnant women with cardiovascular diseases. Among the new concepts compared to 2011, are recommendations to classify maternal risk due to the modified World Health Organization (mWHO) classification, introduction of the pregnancy heart team, guidance on assisted reproductive therapy, specific recommendations on anticoagulation for low-dose and high-dose requirements of vitamin K antagonists and the potential use of bromocriptine in peripartum cardiomyopathy...
November 19, 2018: Herz
Kathryn J Lindley, Amanda K Verma, Lori A Blauwet
Occurring in approximately 1 in 1000 live births in the United States, peripartum cardiomyopathy (PPCM) is characterized by left ventricular ejection fraction reduced to less than 45% near the end of pregnancy or within the first 5 months after delivery. Although the cause of PPCM remains unclear, increasing evidence supports a complex interaction of genetic and environmental factors contributing to angiogenic imbalance, which may lead to myocardial dysfunction in a susceptible woman. This article reviews the progress that has been made regarding understanding of the cause, management, and natural history of PPCM...
January 2019: Heart Failure Clinics
K W Arendt, K J Lindley
Cardiovascular disease is the leading cause of maternal mortality in much of the developed world. Risk stratification models can predict which patients are at greatest risk for maternal or fetal morbidity or mortality. Particular cardiac diseases hold significant risk of mortality during pregnancy including pulmonary hypertension, aortic aneurysm, left-ventricular outflow tract obstruction, and severe cardiomyopathy. High-risk patients should deliver at high-resource hospitals under the care of experts in cardiology, obstetrics, perinatology, neonatology and anesthesiology...
September 27, 2018: International Journal of Obstetric Anesthesia
Alice Balaceanu
Pregnancy is characterized by complex physiological changes of the cardiovascular system. B-type natriuretic peptides, represented by the bioactive molecule (BNP) and its inactive amino terminal fragment (NT-proBNP) are important biomarkers used in the management of the heart failure. Besides cardiac causes, BNP can grow in other noncardiac conditions such as pregnancy. The levels of natriuretic peptides during pregnancy have been the subject of multiple studies, whether it is a normal pregnancy, or there are pre-existing or developed cardiac conditions during pregnancy...
December 2018: Medical Hypotheses
Najlae Adadi, Maryem Sahli, Grégory Egéa, Ilham Ratbi, Mohamed Taoudi, Layla Zniber, Wafaa Jdioui, Said El Mouatassim, Abdelaziz Sefiani
BACKGROUND: Pompe disease is an autosomal recessive lysosomal storage disorder characterized by progressive myopathy with proximal muscle weakness, respiratory muscle dysfunction, and cardiomyopathy. Its prevalence ranges between 1/9000 and 1/40,000. It is caused by compound heterozygous or homozygous mutations in the GAA gene, which encodes for the lysosomal enzyme alpha-glucosidase, required for the degrading of lysosomal glycogen. CASE PRESENTATION: In this study, we report the case of a Moroccan consanguineous family with hypertrophic cardiomyopathy and sudden cardiac deaths at an early age; our patient was a 7-month-old Moroccan girl...
October 29, 2018: Journal of Medical Case Reports
Anne S Ersbøll, Annemie S Bojer, Maria G Hauge, Marianne Johansen, Peter Damm, Finn Gustafsson, Niels G Vejlstrup
Background Long-term clinical studies of peripartum cardiomyopathy ( PPCM ) are few. We aimed to measure the long-term effect of PPCM on cardiac function in comparison with the long-term effects of severe preeclampsia and uncomplicated pregnancy. Methods and Results A nationwide Danish cohort of women diagnosed with PPCM from 2005 to 2014 ( PPCM group) were invited to participate in a clinical follow-up study including maximal cardiopulmonary exercise testing and cardiac magnetic resonance imaging. Matched women with previous severe preeclampsia (preeclampsia group) and previous uncomplicated pregnancies (uncomplicated pregnancies group) served as comparison groups...
October 16, 2018: Journal of the American Heart Association
Deyna Cardosa, Alexandra Ridout, Surabhi Nanda, Jo Howard, Susan E Robinson, Eugene Oteng-Ntim
OBJECTIVES: Maternal sickle cell disease (SCD) and multiple gestations are well known separately as causes of high-risk pregnancies, however, there is sparse information available on maternal and perinatal outcome when both conditions occur together. This case series describes the outcomes of women with maternal SCD and twin pregnancy in the largest single-center case series to date. METHODS: Retrospective identification of all twin pregnancies in maternal SCD patients between 2006 and 2016 at Guy's and St...
October 21, 2018: Hematology (Amsterdam, Netherlands)
Giuseppe Limongelli, Marta Rubino, Augusto Esposito, Mariagiovanna Russo, Giuseppe Pacileo
PURPOSE OF REVIEW: To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. RECENT FINDINGS: Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus...
December 2018: Current Opinion in Obstetrics & Gynecology
Z L Bao, J Zhang
Objective: To summarize and analyze the methods of termination of pregnancy in the first and second trimester of pregnancy with severe cardiovascular disease. Methods: A retrospective analysis of 27 cases of termination of pregnancy in the first and second trimester of pregnancy in Beijing Anzhen Hospital from January 1, 2016 to December 30, 2017. All of these pregnant women were pregnancy complicated with severe cardiovascular disease in grade Ⅴ pregnancy risk. Results: (1) The age of 27 pregnant women was 22-40 years, gestational age was 6-27 weeks; cardiac function grade before induced labor was: 5 cases of grade Ⅱ, 15 cases of grade Ⅲ, 7 cases of grade Ⅳ...
September 25, 2018: Zhonghua Fu Chan Ke za Zhi
Sivan Reut Shiloh, Eyal Sheiner, Tamar Wainstock, Asnat Walfisch, Idit Segal, Daniella Landau, Avi Harlev
OBJECTIVE: To determine the risk of long-term cardiovascular disease (CVD) among children born following in vitro fertilization (IVF) and compared with spontaneous pregnancies. STUDY DESIGN: A population-based cohort study including all singleton deliveries occurring between 1991and 2014 at a tertiary medical center was performed. Hospitalizations up to the age of 18 years involving CVD were evaluated in children delivered following IVF, ovulation induction, and spontaneous pregnancies...
October 2, 2018: Journal of Pediatrics
Takeshi Mikami, Hitoshi Kamiunten
Peripartum cardiomyopathy (PPCM) is an idiopathic left ventricular dysfunction in women who are in late pregnancy or the postpartum period. PPCM is a rare but sometimes fatal disease, and mechanical circulatory support is required if heart failure is refractory to conventional therapy. A 28-year-old woman in late pregnancy was admitted to our hospital due to congestive heart failure with cardiogenic shock. Her heart rate was 200 beats per minute (sinus tachycardia), and left ventricular ejection fraction (LVEF) was 10%...
June 2018: Journal of Cardiology Cases
Armaan Shaikh, Tanvir Bajwa, Michelle Bush, A Jamil Tajik
Hypertrophic cardiomyopathy is a clinically heterogeneous disease with common findings of ventricular hypertrophy, left ventricular outflow tract (LVOT) obstruction, mitral regurgitation, and diastolic dysfunction. Sometimes, the condition can lead to catastrophic cardiac events. Pregnancy can pose a larger challenge, due to medication restrictions associated with pregnancy. We report a case of a 43-year-old pregnant woman presenting with symptomatic hypertrophic obstructive cardiomyopathy (HOCM). As her pregnancy progressed, her HOCM worsened both symptomatically and by objective echocardiographic data...
May 2018: Journal of Cardiology Cases
Abigail Khan, Emmanuelle Paré, Shimoli Shah
PURPOSE OF REVIEW: This review summarizes the pathophysiology, diagnosis, and treatment of peripartum cardiomyopathy (PPCM), with a focus on recent discoveries of clinical relevance. RECENT FINDINGS: An increase in oxidative stress and anti-angiogenic activity play key roles in the pathophysiology of peripartum cardiomyopathy. Therapies that target this dysregulation may have a future role in treatment. Suppression of prolactin release using bromocriptine, a dopamine-receptor antagonist, has been associated with more favorable outcomes in small studies but more research is needed...
September 29, 2018: Current Treatment Options in Cardiovascular Medicine
Mukund Das, Anil Rathi, Ashwad Afzal, Kumudha Ramasubbu
Peripartum cardiomyopathy is a potentially life-threatening cause of heart failure (HF) that affects women toward the end of pregnancy or in months after delivery. Treatment is similar to the treatment for HF with reduced ejection fraction (EF). Most women make full myocardial function recovery within 6 months on conventional HF therapy. In rare instances, catastrophic presentations may occur with hemodynamic instability requiring the use of mechanical support. Because of the small patient population, limited information is available regarding the recovery of myocardial function in women who received mechanical support...
September 2018: Journal of Extra-corporeal Technology
Matthew Cauldwell, Philip Steer, Monique Sterrenburg, Suzanne Wallace, Gemma Malin, Gemma Ulivi, Thomas Everett, Adam Daniel Jakes, Catherine E G Head, Aarthi R Mohan, Sophie Haynes, Margaret Simpson, Janet Brennand, Mark R Johnson
OBJECTIVE: To assess median and percentile birthweight distribution in women with various groups of heart disease relative to a contemporaneous comparison group. METHODS: Data on birth weight and gestational age were collected from 1321 pregnancies ≥24 weeks' gestation in 1053 women with heart disease from seven UK maternity units. Women were assigned to one of 16 groups according to their cardiac lesion. In units where it was possible, data on two births, one delivering before and one after index cases, were collected, giving 2307 comparators...
September 21, 2018: Heart: Official Journal of the British Cardiac Society
Esa M Davis, Gregory Ewald, Michael M Givertz, Navin Rajagopalan, Leslie T Cooper, Joan Briller, G Michael Felker, Biykem Bozkurt, Mark H Drazner, Karen Hanley-Yanez, Indrani Halder, Charles F McTiernan, Dennis M McNamara
OBJECTIVE:  To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN:  This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity...
September 5, 2018: American Journal of Perinatology
Reza Masoomi, Zubair Shah, Zoltan Arany, Kamal Gupta
OBJECTIVE: Peripartum cardiomyopathy (PPCM) can present during pregnancy and up to months post-delivery. Most large-scale epidemiologic studies have reported on cases occurring during pregnancy or the first few days postpartum (termPPCM). Limited information is available on PPCM in the later postpartum period (latePPCM). We studied the incidence, predictors, and hospital outcome of peripartum cardiomyopathy (PPCM) in the prepartum and immediate post delivery period versus up to 3 months post-delivery...
July 2018: Pregnancy Hypertension
Louise Marie Kofod, Finn Lauszus
Sinus tachycardia may have a definite aetiology, but in the remaining cases inappropriate sinus tachycardia (IST) may be considered. IST is primarily treated in order to improve symptoms. During pregnancy, tachycardia-induced cardiomyopathy is rare; however, it needs urgent attention and treatment due to the risk of fast progression. In Denmark, performing an electrocardiogram is recommended in any pregnant woman, who has palpitations or a persisting heart rate > 100 beats per minute.
August 20, 2018: Ugeskrift for Laeger
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