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Pregnancy and heart failure

Leili Pourafkari, Samad Ghaffari, Mojan Ahmadi, Rezvaniye Salehi, Sarvin Mazani, Raziyeh Parizad, Nader D Nader
OBJECTIVE: Aortic dissection is an uncommon and potentially fatal complication of pregnancy; however, the association of the number of pregnancies with the indexed and absolute size of ascending aorta in patients without aortic aneurysm or connective tissue disorders is not well elucidated. RESEARCH DESIGN AND METHODS: In this prospective observational study, women aged 18-80 years old undergoing transesophageal echocardiography in a university-affiliated echocardiography laboratory between January 1st 2015 and September 1st 2015 were enrolled...
March 16, 2018: Current Medical Research and Opinion
E Gandjbakhch, E Varlet, G Duthoit, V Fressart, P Charron, C Himbert, C Maupain, C Bordet, F Hidden-Lucet, J Nizard
INTRODUCTION: The prognosis of pregnancy in patients with Arrhythmogenic Right Ventricular Cardiomyopathy/dysplasia (ARVC/D) is poorly documented. The aim of this study is to assess the cardiac risks during pregnancy and the impact of ARVC/D on fetuses/neonates/children. METHODS: We included all ARVC/D women with a history of pregnancy from the ARVC/D Pitié-Salpêtrière registry. Cardiac and obstetrical events having occurred during pregnancy/delivery/post-partum periods and neonatal data/follow-up were collected...
May 1, 2018: International Journal of Cardiology
Bozidarka L Zaric, Milan Obradovic, Vladan Bajic, Mohamed A Haidara, Milos Jovanovic, Esma R Isenovic
Homocysteine (Hcy) is thiol group containing the amino acid, which naturally occurs in all humans. Hcy is degraded in the body through two metabolic pathways, while a minor part is excreted through kidneys. The chemical reactions that are necessary for degradation of Hcy require the presence of the folic acid, vitamins B6 and B12. Consequently, the level of the total Hcy in the serum is influenced by the presence or absence of these vitamins. An elevated level of the Hcy, hyperhomocysteinemia (HHcy) and homocystinuria are connected with occlusive artery disease, especially in the brain, the heart, and the kidney, in addition to venous thrombosis, chronic renal failure, megaloblastic anemia, osteoporosis, depression, Alzheimer's disease, pregnancy problems, and others...
March 12, 2018: Current Medicinal Chemistry
Lesley J Scott
Intravenous ferric carboxymaltose (Ferinject® ; Injectafer® ) is a colloidal solution of nanoparticles which consist of a polynuclear iron (III)-(oxyhydr)oxide core stabilized by carboxymaltose and may be given as a single high-dose, 15-min infusion. This article reviews the clinical use of ferric carboxymaltose in various patient populations with iron deficiency (ID) [± anaemia] and briefly summarizes its pharmacological properties. Based on extensive experience in the clinical trial and real-world settings, ferric carboxymaltose is an effective and generally well tolerated treatment for rapidly replenishing iron stores and correcting anaemia in patients with ID (± anaemia) of various aetiologies, including patients with chronic heart failure (CHF), chronic kidney disease, inflammatory bowel disease or perioperative anaemia, and women with ID during pregnancy, postpartum or associated with heavy uterine bleeding...
March 2018: Drugs
Wolfgang Miehsler, Clemens Dejaco, Hans-Peter Gröchenig, Harry Fuchssteiner, Christoph Högenauer, Lili Kazemi-Shirazi, Harald Maier, Andreas Mayer, Alexander Moschen, Walter Reinisch, Wolfgang Petritsch, Reingard Platzer, Pius Steiner, Herbert Tilg, Harald Vogelsang, Heimo Wenzl, Gottfried Novacek
Anti-TNFα-antibodies have revolutionized the therapy of inflammatory bowel diseases and other immune-mediated inflammatory diseases. Due to the increasing application of these substances, the Working Group of Inflammatory Bowel Diseases of the Austrian Association of Gastroenterology and Hepatology intended to update their consensus report on the safe use of Infliximab (published in 2010) and to enlarge its scope to cover all anti-TNFα-antibodies. The present consensus report summarizes the current evidence on the safe use of anti-TNFα-antibodies and covers the following topics: general risk of infection, bacterial infections (i...
March 2018: Zeitschrift Für Gastroenterologie
Ajith Ananthakrishna Pillai, Chandramohan Ramasamy, Saranya Gousy V, Harichandrakumar Kottyath
BACKGROUND: Mitral stenosis may present with decompensated heart failure during pregnancy. Many patients do have advanced sub valve disease and present late with decompensated state. The outcomes of balloon mitral valvuloplasty (BMV) in such advanced sub valve disease with severe heart failure in pregnancy has not been specifically studied till now. METHODS: A descriptive study looking at the immediate and long-term outcomes of pregnant patients with MS who presented with severe heart failure and sub valve disease who had undergone BMV...
March 11, 2018: Journal of Interventional Cardiology
Teja Devarakonda, Fadi N Salloum
The hormone relaxin has long been recognized for its involvement in maternal adaptation during pregnancy. However, discoveries during the past two decades on the mechanism of action of relaxin, its family of receptors, and newly described roles in attenuating ischemia/reperfusion (I/R) injury, inflammation, and arrhythmias have prompted vast interest in exploring its therapeutic potential in cardiovascular disease. These observations inspired recently concluded clinical trials in patients with acute heart failure...
March 8, 2018: Trends in Endocrinology and Metabolism: TEM
Risto J Kaaja, M Gary Nicholls
Studies in the early 1990s suggested that a hormone identical to ouabain or an isomer of ouabain is secreted by the adrenal glands into the circulation and plays a role in the regulation of arterial pressure and cardiac and renal function. This hormone, known as endogenous ouabain (EO), was claimed to contribute to the pathophysiology of a number of disorders including heart failure, renal failure, pregnancy-induced, and essential hypertension. However, some research groups have been unable to confirm the presence of EO in the human circulation and the issue remains in dispute...
March 10, 2018: BioFactors
A Drobníková, Z Vocásek, M Kacerovský
OBJECTIVE: A case report of the pregnancy complicated by the presence of vein of Galen aneurysmal malformation in fetus. DESIGN: The case report. SETTING: Department of Obstetrics and Gynaecology, Masaryks Hospital, Jilemnice; Obstetrics and Gynecology Clinic, University Hospital in Hradec Králové. CASE REPORT: The description of the pregnancy complicated by the presence of vein of Galen aneurysmal malformation in a fetus 32 weeks gestation which led to a progressive heart failure and the development of the hydrocephalus...
2018: Ceská Gynekologie
James H O'Keefe, James J DiNicolantonio, Carl J Lavie
Coffee, a complex brew containing hundreds of biologically active compounds, exerts potent effects on long-term human health. Recently, a plethora of studies have been published focusing on health outcomes associated with coffee intake. An inverse association between coffee consumption and all-cause mortality has been seen consistently in large prospective studies. Habitual coffee consumption is also associated with lower risks for cardiovascular (CV) death and a variety of adverse CV outcomes, including coronary heart disease (CHD), congestive heart failure (HF), and stroke; coffee's effects on arrhythmias and hypertension are neutral...
February 20, 2018: Progress in Cardiovascular Diseases
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
Nadia Bouabdallaoui, Pierre Demondion, Sylvestre Maréchaux, Shaida Varnous, Guillaume Lebreton, Frédéric Mouquet, Pascal Leprince
BACKGROUND: Peripartum cardiomyopathy is an idiopathic disorder defined by the occurrence of acute heart failure during late pregnancy or post-partum period in the absence of any other definable cause. Its clinical course is variable and severe cases might require heart transplantation. OBJECTIVE: To investigate long-term outcomes after heart transplantation (HT) for peripartum cardiomyopathy (PPCM). METHODS: Out of a single-center series of 1938 HT, 14 HT were performed for PPCM...
February 19, 2018: Arquivos Brasileiros de Cardiologia
Adnan Yamanoglu, Nalan Gokce Celebi Yamanoglu, Sumeyye Cakmak, Ozgur Sogut
Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure (HF) secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of HF is found. The symptoms and signs of this rare disorder mimic those of the physiological changes of pregnancy or other cardiovascular diseases. Consequently, its diagnosis is frequently delayed, which worsens an already poor prognosis. Here, we report a young adult who was diagnosed with PPCM, early, with the help of focused cardiac ultrasonography, performed after presenting to the emergency department with nonspecific respiratory complaints, including dyspnea and hemoptysis, which suggested at first pulmonary embolism...
December 2017: Turkish Journal of Emergency Medicine
Calvin Tong, Marla Kiess, Marc William Deyell, Michael Qiu, Merav Orgad, Valerie Rychel, Ariel Claman, Emma Hardwick, Beverly McCarthy, Candice K Silversides, Jasmine Grewal
OBJECTIVES: To determine cardiac and fetal/neonatal event rates among pregnant women with premature ventricular contractions (PVCs) and compare with control groups. METHODS: Prospective case-control cohort study: 53 consecutive pregnancies in 49 women referred to the St. Paul's Hospital between 2010 and 2016 with PVC burden >1% in women without underlying cardiac disease. Maternal cardiac and fetal/neonatal outcomes were compared with two pregnant control groups: (1) supraventricular tachycardia (SVT) group of 53 women referred for a history of SVT/SVT in the current pregnancy and (2) low-risk group of 53 women with no cardiac disease...
February 20, 2018: Heart: Official Journal of the British Cardiac Society
Iris M van Hagen, Sara A Thorne, Nasser Taha, Ghada Youssef, Amro Elnagar, Harald Gabriel, Yahia ElRakshy, Bernard Iung, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink
BACKGROUND: Cardiac disease is 1 of the major causes of maternal mortality. We studied pregnancy outcomes in women with rheumatic mitral valve disease. METHODS: The Registry of Pregnancy and Cardiac Disease is an international prospective registry, and consecutive pregnant women with cardiac disease were included. Pregnancy outcomes in all women with rheumatic mitral valve disease and no prepregnancy valve replacement is described in the present study (n=390). A maternal cardiac event was defined as cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, and hospitalization for other cardiac reasons or cardiac intervention...
February 20, 2018: Circulation
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
February 17, 2018: Heart and Vessels
Atsushi Daimon, Chizuko A Kamiya, Masami Sawada, Yusuke Ueda, Chinami Horiuchi, Takekazu Miyoshi, Mitsuhiro Tsuritani, Naoko Iwanaga, Reiko Neki, Hideo Okamura, Shingo Kusano, Jun Yoshimatsu
Recently, implantable cardioverter-defibrillators (ICD) have become capable of monitoring intrathoracic impedance to detect an increased fluid volume and heart failure. Pregnancy is a well-known cause of an increased body fluid volume; however, it is not clear whether the measurement of intrathoracic impedance by ICD is clinically useful for precisely detecting heart failure in pregnant women. We herein report the case of a 39-year-old woman with an ICD that had been implanted after an event of ventricular fibrillation due to severe aortic regurgitation with a bicuspid aortic valve...
February 14, 2018: International Heart Journal
Lucy Fox, Solomon J Cohney, Joshua Y Kausman, Jake Shortt, Peter D Hughes, Erica M Wood, Nicole M Isbel, Theo de Malmanche, Anne Durkan, Pravin Hissaria, Piers Blombery, Thomas D Barbour
Thrombotic microangiopathy (TMA) arises in a variety of clinical circumstances with the potential to cause significant dysfunction of the kidneys, brain, gastrointestinal tract and heart. TMA should be considered in all patients with thrombocytopenia and anaemia, with an immediate request to the haematology laboratory to look for red cell fragments on a blood film. Whilst TMA of any aetiology generally demands prompt treatment, this is especially so in thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS), where organ failure may be precipitous, irreversible and fatal...
February 8, 2018: Nephrology
Edin Begic, Zijo Begic, Nabil Naser
Objective: Demonstration of idiopathic dilated cardiomyopathy with unusual flow, unpredictable clinical picture and complex therapy. Case report: Patient A.P., female, 38 years old, had symptoms of dilated cardiomyopathy (with possible infectious myocarditis in the background) at age 17. After hospitalization for ten months and ten days, while waiting for heart transplantation (with threatening death outcome), without a clearly pronounced threatening arrhythmia, but with a low ejection fraction and a poor general condition, remission occurred...
February 2018: Medical Archives
Maria Jelinic, Sarah A Marshall, Dennis Stewart, Elaine Unemori, Laura J Parry, Chen Huei Leo
The peptide hormone relaxin has numerous roles both within and independent of pregnancy and is often thought of as a 'pleiotropic hormone'. Relaxin targets several tissues throughout the body, and has many functions associated with extracellular matrix remodeling and the vasculature. This review considers the potential therapeutic applications of relaxin in cervical ripening, in vitro fertilization, preeclampsia, acute heart failure, ischemia-reperfusion and cirrhosis. We first outline the animal models used in preclinical studies to progress relaxin into clinical trials and then discuss the findings from these studies...
February 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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