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Pregnancy and heart failure

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https://www.readbyqxmd.com/read/27904846/complete-congenital-heart-block-in-a-neonate-with-a-complex-congenital-heart-defect-in-africa
#1
Clovis Nkoke, Edvine Yonta Wawo, Liliane Kuate Mfeukeu, Larissa Makamte, Sandrine Dikosso Edie, Flore Esiene Balana
Congenital heart block (CHB) is rare disorder that has a higher mortality when associated with structural congenital heart defects. Very few cases have been reported in Sub-Saharan Africa (SSA). We present a case of complete CHB associated with a complex congenital heart defect in a neonate in Cameroon. A 1-month-old neonate in Cameroon was referred for the evaluation of bradycardia. The obstetrical ultrasound done during pregnancy revealed fetal bradycardia without further evaluation. Clinical examination showed well a developed neonate with bradycardia at 62 beats/minute, and mild cyanosis with oxygen saturation at 93% at room air...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27881700/veno-venous-ecmo-as-a-safe-bridge-to-recovery-in-a-patient-with-severe-peripartum-cardiomyopathy-learning-from-errors
#2
Christopher Ull, Thomas Armin Schildhauer, Justus T Strauch, Andreas Mügge, Justyna Swol
Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child...
November 23, 2016: Perfusion
https://www.readbyqxmd.com/read/27867530/continuous-renal-replacement-therapy-for-haemodynamic-collapse-and-rhabdomyolysis-induced-by-pheochromocytoma-crisis
#3
Xi Zhou, Chuhuan Zhao, Xiafei Feng, Anweshan Samanta, Yi Nuo Lin, Jun Chen, Xiaochun Dai, Xia Hong, Qiangli Xie, Weijian Huang
Pheochromocytoma associated with pregnancy is not common. Caesarean section may induce pheochromocytoma crisis, resulting in a lethal condition. The clinical picture of pheochromocytoma crisis is extremely variable. In this report, we describe a case of severe pheochromocytoma crisis induced by caesarean section presenting with hyperpyrexia, haemodynamic collapse, muscle weakness, heart failure, and acute kidney injury. Furthermore, we report that the muscle weakness was a manifestation of rhabdomyolysis, resulting from the pheochromocytoma crisis...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27852228/pregnancy-outcome-in-women-with-eisenmenger-s-syndrome-a-case-series-from-west-china
#4
Ruiqi Duan, Xiumei Xu, Xiaodong Wang, Haiyan Yu, Yong You, Xinghui Liu, Aiyun Xing, Rong Zhou, Mingrong Xi
BACKGROUND: Eisenmenger's syndrome (ES) consists of pulmonary hypertension with a reversed or bidirectional shunt at the atrioventricular, or aortopulmonary level. The cardiovascular changes that occur during the pregnancy contribute to the high maternal morbidity and mortality in patients with ES. This study is to assess maternal and fetal outcomes in patients with ES. METHODS: This study is a retrospective analysis of 11 pregnancies in women with ES who delivered at a tertiary care center in west China between 2010 and 2014...
November 16, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27830098/a-pregnancy-with-severe-hypertrophic-obstructive-cardiomyopathy-after-surgery-for-an-implantable-cardioverter-defibrillator-a-case-report-and-literature-review
#5
Takashi Mitsui, Hisashi Masuyama, Kentaro Ejiri, Kei Hayata, Hiroshi Ito, Yuji Hiramatsu
Hypertrophic obstructive cardiomyopathy (HOCM) is cardiac hypertrophy of ventricular myocardium with left ventricular outflow tract obstruction. We report a pregnancy with HOCM after defibrillator implantation surgery. The patient was a 33-year-old nulligravida and was categorized as New York Heart Association class II. Her brain natriuretic peptide (BNP) level was 724.6 pg/dL at preconception. She received careful pregnancy management. However, because frequent uterine contractions were observed at 25 weeks and 6 days of pregnancy, she was hospitalized, and magnesium sulfate was started as a tocolytic agent...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27829880/immunosuppression-therapy-in-the-management-of-peripartum-cardiomyopathy-a-case-series-and-literature-review
#6
Joyee Basu, Christopher Redman, Oliver Ormerod
Peripartum cardiomyopathy is a heart failure syndrome occurring late in pregnancy or during the early post-natal period. The pathophysiology of peripartum cardiomyopathy is not fully understood and various mechanisms have been postulated including an underlying inflammatory process. We here report four cases presenting with acute left ventricular systolic dysfunction. Three out of four of the patients presented with a left ventricular ejection fraction <30% and one with a left ventricular ejection fraction of 35%...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27804179/preeclampsia-an-important-female-specific-risk-factor-for-asymptomatic-heart-failure
#7
Chahinda Ghossein-Doha, Jolijn van Neer, Brechtje Wissink, Nicolette Breetveld, Leon J de Windt, Arie Pj van Dijk, Maureen J van der Vlugt, Mirian Ch Janssen, Wieteke M Heidema, Ralph R Scholten, Marc Ea Spaanderman
OBJECTIVES: Preeclampsia (PE) is on the one hand associated with postpartum structural asymptomatic heart disease, consistent with heart failure (HF) stage-B, and on the other hand with conventional cardiovascular (CV) risk factors. With this study we aim to evaluate to which extent PE together with conventional CV risk factors are associated with asymptomatic cardiac abnormalities postpartum. METHODS: In this cross-sectional cohort study, formerly PE women (n = 107) and women with uneventful pregnancies (controls) (n = 41) were invited for CV risk-assessment 4-10 years postpartum...
November 1, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27756175/pregnancies-complicated-by-both-preeclampsia-and-growth-restriction-between-34-and-37-weeks-gestation-are-associated-with-adverse-perinatal-outcomes
#8
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27754163/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#9
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754119/os-23-06-can-left-ventricular-torsional-mechanics-using-speckle-tracking-echocardiography-in-pregnancy-to-predict-the-new-onset-heart-failure
#10
Krasimira Hristova, Rumen Marinov, Georgi Stamenov, Kristina Chacheva, Marina Michova, Sabina Persenska, Ani Racheva
OBJECTIVE: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics, consistent with an increase in preload and decrease in afterload and systemic vascular resistance. The aim is to evaluate left ventricular (LV) twist and untwist mechanics in a population of pregnant women during differing stages of a healthy pregnancy. DESIGN AND METHOD: We included 22 pregnant patients, 10 with multiple pregnancy (mean age 36.5 ± 3 years) and 20 healthy non pregnant women (mean age 33 ± 4years)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753830/sy-03-3-overview-of-somatic-mutations-and-epigenetic-regulation-of-aldosterone-producing-adenoma-apa
#11
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27747531/rituximab-for-rheumatoid-arthritis
#12
Marc D Cohen, Edward Keystone
Rituximab is a chimeric monoclonal antibody directed at the CD20 molecule on the surfaces of some but not all B cells. It depletes almost all peripheral B cells, but other niches of B cells are variably depleted, including synovium. Its mechanism of action in rheumatoid arthritis (RA) is only partially understood. Rituximab was efficacious in clinical trials of patients with RA, including those who are methotrexate naïve, those with an incomplete response to methotrexate, and those with an incomplete response to tumor necrosis factor inhibitors...
December 2015: Rheumatol Ther
https://www.readbyqxmd.com/read/27737738/risk-of-pregnancy-in-moderate-and-severe%C3%A2-aortic-stenosis-from-the-multinational-ropac-registry
#13
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27727514/serelaxin-in-acute-heart-failure-most-recent-update-on-clinical-and-preclinical-evidence
#14
Raktim Kumar Ghosh, Kinjal Banerjee, Ramyashree Tummala, Somedeb Ball, Keyvan Ravakhah, Anjan Gupta
Heart failure continues to be a widely prevalent disease across the world, affecting millions of Americans annually. Acute heart failure (AHF) has a substantial effect on rising health care costs and one of the major causes of morbidity and mortality. The search for new drugs for symptom relief and to improve long term outcomes in heart failure has led to development of serelaxin, a recombinant human relaxin-2 hormone. Relaxin was discovered in pregnancy but eventually found to have a number of other physiological actions, not only in pregnancy, but also in non-pregnant women and men...
October 11, 2016: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27702930/triple-threat-in-pregnancy
#15
Swati Vishwanathan, Michael Lucke, Indu G Poornima
A woman aged 22 years with a history of lupus presented in the 18th week of pregnancy with hypertensive emergency and flash pulmonary oedema. Bedside echocardiogram revealed severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 25% and pericardial effusion. Laboratories revealed hypocomplementemia, proteinuria, elevated C reactive protein and anti-DS-DNA, raising concern for a lupus flare. Cardiac MRI showed an acute intramyocardial oedematous process, consistent with lupus carditis, and further worsening of LVEF to 13%...
October 4, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27682655/epidemiology-of-hypertensive-disorders-in-pregnancy-prevalence-risk-factors-predictors-and-prognosis
#16
Mitsumasa Umesawa, Gen Kobashi
Hypertensive disorders in pregnancy (HDP) represent some of the most important problems faced by public health because HDP is a major cause of maternal and prenatal morbidity and mortality. Several epidemiological studies have been performed to determine the prevalence and risk factors of HDP as well as its subtypes. The prevalences of HDP, gestational hypertension and preeclampsia are 5.2-8.2%, 1.8-4.4% and 0.2-9.2%, respectively. Body mass index, anemia and lower education appear to be modifiable risk factors for HDP...
September 29, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27680799/d3-early-prediction-of-preeclampsia-risk-assessment-analytical-determination-for-marinobufagenin-in-pregnant-women
#17
Charline Lenaerts, Liz Bond, Robin Tuytten, Cedric Delporte, Pierre Van Antwerpen, Bertrand Blankert
INTRODUCTION: Marinobufagenin (MBG), an endogenous bufadienolide cardiac inotrope, is responsible for vasoconstriction and natriuresis [1,2]. Growing interest by its implication in volume expansion mediated hypertensive states such as essential hypertension, congestive heart failure, chronic renal failure, primary aldosterism and preeclampsia (PE). Elevated endogenous MBG levels have been described early in preeclamptic patients [2-5]. AIMS: To develop a specific and sensitive analytical MBG assay with special attention for the limit of quantification (LOQ)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27680793/c2-maternal-cardiac-deceleration-capacity-a-novel-insight-into-maternal-autonomic-function
#18
D Casati, T Stampalija, E Ferrazzi, A Alberti, I Scebba, A Paganelli, D Di Martino, M L Muggiasca, A Bauer
OBJECTIVE: To explore maternal cardiac deceleration capacity (DC), a marker of autonomic function derived from heart rate variability analysis, in pregnancies complicated by intrauterine growth restriction (IUGR) and hypertensive disorders of pregnancy (HDP) associated to IUGR (HDP-IUGR) or to appropriate for gestational age fetuses (HDP-AGAf). METHODS: Single-center case-control study conducted at Buzzi Children's Hospital, Milan. Maternal electrocardiograms were analyzed by Phase-Rectified Signal Averaging (PRSA) to obtain cardiac beat-to-beat DC in women with: HDP-IUGR; HDP-AGAf; severe-IUGR; mild- IUGR; uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27643118/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#19
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643046/os-23-06-can-left-ventricular-torsional-mechanics-using-speckle-tracking-echocardiography-in-pregnancy-to-predict-the-new-onset-heart-failure
#20
Krasimira Hristova, Rumen Marinov, Georgi Stamenov, Kristina Chacheva, Marina Michova, Sabina Persenska, Ani Racheva
OBJECTIVE: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics, consistent with an increase in preload and decrease in afterload and systemic vascular resistance. The aim is to evaluate left ventricular (LV) twist and untwist mechanics in a population of pregnant women during differing stages of a healthy pregnancy. DESIGN AND METHOD: We included 22 pregnant patients, 10 with multiple pregnancy (mean age 36.5 ± 3 years) and 20 healthy non pregnant women (mean age 33 ± 4years)...
September 2016: Journal of Hypertension
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