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Pregnancy and heart failure

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https://www.readbyqxmd.com/read/29774566/influence-of-sex-and-pregnancy-on-survival-in-patients-admitted-with-heart-failure-data-from-a-prospective-multicenter-registry
#1
Manuel Martínez-Sellés, Pablo Díez-Villanueva, Jesús Álvarez-Gracía, Andreu Ferrero-Gregori, Miquel Vives-Borrás, Fernando Worner, Alfredo Bardají, Juan F Delgado, Rafael Vázquez, José R González-Juanatey, Francisco Fernández-Aviles, Juan Cinca
BACKGROUND: Female sex is an independent predictor of better survival in patients with heart failure but the mechanism of this association is unknown. On the other hand, pregnancies have a strong influence in the cardiovascular system. HYPOTHESIS: Sex and previous gestations might have a prognostic impact on one-year mortality in patients admitted with heart failure. METHODS: Observational prospective consecutive multicenter registry of 1831 patients (756 women [41...
May 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29768659/influence-of-pregnancy-on-cardiac-function-and-hemodynamics-in-women-with-ebstein-s-anomaly
#2
Miki Kanoh, Kei Inai, Tokuko Shinohara, Eriko Shimada, Mikiko Shimizu, Hirofumi Tomimatsu, Masaki Ogawa, Toshio Nakanishi
INTRODUCTION: We examined the perinatal outcomes and right ventricular function before pregnancy, during pregnancy, and after delivery in women with Ebstein's anomaly. MATERIAL AND METHODS: We retrospectively investigated the clinical course and mode of delivery and monitored hemodynamic parameters throughout pregnancy in 17 women with Ebstein's anomaly, who delivered at our institution during the period of 1995-2015. RESULTS: Eight women, including nine pregnancies, underwent elective cesarean section, and nine women, including 14 pregnancies, underwent vaginal delivery...
May 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29767811/peripartum-cardiomyopathy
#3
T Koenig, D Hilfiker-Kleiner, J Bauersachs
Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening disease that occurs toward the end of pregnancy or in the months following delivery in previously heart-healthy women. The incidence varies widely depending on geographical region and ethnic background, with an estimated number of 1 in 1000-1500 pregnancies in Germany. The course of the disease ranges from mild forms with minor symptoms to severe forms with acute heart failure and cardiogenic shock. The understanding of the etiology of PPCM has evolved in recent years...
May 16, 2018: Herz
https://www.readbyqxmd.com/read/29761889/a-novel-human-s10f-hsp20-mutation-induces-lethal-peripartum-cardiomyopathy
#4
Guan-Sheng Liu, George Gardner, George Adly, Min Jiang, Wen-Feng Cai, Chi Keung Lam, Fawzi Alogaili, Nathan Robbins, Jack Rubinstein, Evangelia G Kranias
Heat shock protein 20 (Hsp20) has been shown to be a critical regulator of cardiomyocyte survival upon cardiac stress. In this study, we investigated the functional significance of a novel human Hsp20 mutation (S10F) in peripartum cardiomyopathy. Previous findings showed that cardiac-specific overexpression of this mutant were associated with reduced autophagy, left ventricular dysfunction and early death in male mice. However, this study indicates that females have normal function with no alterations in autophagy but died within a week after 1-4 pregnancies...
May 15, 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29755033/impact-of-a-history-of-hypertension-in-pregnancy-on-later-diagnosis-of-atrial-fibrillation
#5
Dawn C Scantlebury, Andrea G Kattah, Tracey L Weissgerber, Sanket Agarwal, Michelle M Mielke, Amy L Weaver, Lisa E Vaughan, Stanislav Henkin, Katherine Zimmerman, Virginia M Miller, Wendy M White, Sharonne N Hayes, Vesna D Garovic
BACKGROUND: Atrial fibrillation/flutter (AF) produces significant morbidity in women and is typically attributed to cardiac remodeling from multiple causes, particularly hypertension. Hypertensive pregnancy disorders (HPDs) are associated with future hypertension and adverse cardiac remodeling. We evaluated whether women with AF were more likely to have experienced a HPD compared with those without. METHODS AND RESULTS: A nested case-control study was conducted within a cohort of 7566 women who had a live or stillbirth delivery in Olmsted County, Minnesota between 1976 and 1982...
May 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29752389/pregnancy-in-women-with-a-fontan-circulation-a-systematic-review-of-the-literature
#6
Alvaro Garcia Ropero, Shankar Baskar, Jolien W Roos Hesselink, Andrea Girnius, Dominica Zentner, Lorna Swan, Magalie Ladouceur, Nicole Brown, Gruschen R Veldtman
BACKGROUND: The Fontan operation has provided life-saving palliation and adult survival for individuals born with single ventricle physiology. Many now seek advice about safe pregnancy. Little data are, however, available, consisting mainly of anecdotal experience and small series. This article seeks to review the published literature and identify lessons learnt from this collective experience. METHODS AND RESULTS: We conducted a systematic review to evaluate maternal and fetal outcomes of pregnancy in women with a Fontan circulation...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29749620/peripartum-cardiomyopathy-a-systematic-review-of-the-literature
#7
REVIEW
Zain Ul Abideen Asad, Mirwais Maiwand, Fahmi Farah, Tarun W Dasari
Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure. It is defined as cardiomyopathy that develops in the last month of pregnancy or within 5 months of the postpartum period without an identifiable cause. We conducted a systematic review of literature of prospective studies with a focus on echocardiographic and long-term clinical outcomes in PPCM. We searched MEDLINE and Embase up to October 1, 2017. Prospective studies (sample size ≥20) reporting all-cause mortality and follow-up duration of ≥1 year were included...
May 11, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29747728/management-of-obstructive-sleep-apnea-in-pregnancy
#8
REVIEW
Jennifer E Dominguez, Linda Street, Judette Louis
The spectrum of sleep-disordered breathing (SDB) ranges from mild snoring to obstructive sleep apnea, the most severe form of SDB. Current recommendations are to treat these women with continuous positive airway pressure despite limited data. SDB in early and mid-pregnancy is associated with preeclampsia and gestational diabetes. Pregnant women with a diagnosis of obstructive sleep apnea at delivery were at significantly increased risk of having cardiomyopathy, congestive heart failure, pulmonary embolism, and in-hospital death...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29747265/-effect-of-maternal-age-on-pregnancy-outcome-in-patients-with-structural-heart-disease
#9
Q Fu, J H Lin
Objective: To analyze the effect of maternal age on pregnancy outcome in patients with structural heart disease. Methods: Totally 986 patients diagnosed with structural heart disease who had their delivery at Renji Hospital from January 1st, 2003 to December 31st, 2016 were divided into 5 groups according to maternal age. Sixteen (1.6%) were in age group <20 years, 204 (20.7%) were in age group 20-24 years, 461 (46.8%) were in age group 25-29 years, 222 (22.5%) was in age group 30-34 years and 83 (8.4%) was in age group ≥35 years...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29733398/pre-pregnancy-fast-food-and-fruit-intake-is-associated-with-time-to-pregnancy
#10
Jessica A Grieger, Luke E Grzeskowiak, Tina Bianco-Miotto, Tanja Jankovic-Karasoulos, Lisa J Moran, Rebecca L Wilson, Shalem Y Leemaqz, Lucilla Poston, Lesley McCowan, Louise C Kenny, Jenny Myers, James J Walker, Robert J Norman, Gus A Dekker, Claire T Roberts
STUDY QUESTION: Is preconception dietary intake associated with reduced fecundity as measured by a longer time to pregnancy (TTP)? SUMMARY ANSWER: Lower intake of fruit and higher intake of fast food in the preconception period were both associated with a longer TTP. WHAT IS KNOWN ALREADY: Several lifestyle factors, such as smoking and obesity, have consistently been associated with a longer TTP or infertility, but the role of preconception diet in women remains poorly studied...
May 4, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29731013/hypertension-canada-s-2018-guidelines-for-diagnosis-risk-assessment-prevention-and-treatment-of-hypertension-in-adults-and-children
#11
Kara A Nerenberg, Kelly B Zarnke, Alexander A Leung, Kaberi Dasgupta, Sonia Butalia, Kerry McBrien, Kevin C Harris, Meranda Nakhla, Lyne Cloutier, Mark Gelfer, Maxime Lamarre-Cliche, Alain Milot, Peter Bolli, Guy Tremblay, Donna McLean, Raj S Padwal, Karen C Tran, Steven Grover, Simon W Rabkin, Gordon W Moe, Jonathan G Howlett, Patrice Lindsay, Michael D Hill, Mike Sharma, Thalia Field, Theodore H Wein, Ashkan Shoamanesh, George K Dresser, Pavel Hamet, Robert J Herman, Ellen Burgess, Steven E Gryn, Jean C Grégoire, Richard Lewanczuk, Luc Poirier, Tavis S Campbell, Ross D Feldman, Kim L Lavoie, Ross T Tsuyuki, George Honos, Ally P H Prebtani, Gregory Kline, Ernesto L Schiffrin, Andrew Don-Wauchope, Sheldon W Tobe, Richard E Gilbert, Lawrence A Leiter, Charlotte Jones, Vincent Woo, Robert A Hegele, Peter Selby, Andrew Pipe, Philip A McFarlane, Paul Oh, Milan Gupta, Simon L Bacon, Janusz Kaczorowski, Luc Trudeau, Norman R C Campbell, Swapnil Hiremath, Michael Roerecke, Joanne Arcand, Marcel Ruzicka, G V Ramesh Prasad, Michel Vallée, Cedric Edwards, Praveena Sivapalan, S Brian Penner, Anne Fournier, Geneviève Benoit, Janusz Feber, Janis Dionne, Laura A Magee, Alexander G Logan, Anne-Marie Côté, Evelyne Rey, Tabassum Firoz, Laura M Kuyper, Jonathan Y Gabor, Raymond R Townsend, Doreen M Rabi, Stella S Daskalopoulou
Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately. For 2018, 5 new guidelines are introduced, and 1 existing guideline on the blood pressure thresholds and targets in the setting of thrombolysis for acute ischemic stroke is revised. The use of validated wrist devices for the estimation of blood pressure in individuals with large arm circumference is now included...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29716428/the-subset-of-patients-with-acute-heart-failure-able-to-secrete-relaxin-2-at-pregnancy-concentrations-could-have-a-longer-survival-a-pilot-study
#12
Òscar Miró, Pablo Herrero-Puente, Belén Prieto, María García-García, Pablo García-Hernández, Francisco J Martín-Sánchez, Javier Jacob, José Ríos, Rodolfo Romero, Víctor Gil, Étienne Gayat, Pere Llorens, Alexandre Mebazaa
OBJECTIVE: To investigate how many patients with acute heart failure (AHF) hypersecrete relaxin-2 concentrations similar to those of pregnant women and determine their long-term outcome. METHODS: In consecutive AHF patients relaxin-2 was quantified by ELISA sandwich method. Patients were divided into pregnancy-like group (PLG, relaxin-2 ≥ 500 pg/mL) and control group (CG, relaxin-2 < 500 pg/mL). The primary outcome was all-cause death during follow-up...
May 1, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29706899/development-of-the-human-placenta-and-fetal-heart-synergic-or-independent
#13
REVIEW
Graham J Burton, Eric Jauniaux
The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29703438/etiologies-predictors-and-economic-impact-of-30-day-readmissions-among-patients-with-peripartum-cardiomyopathy
#14
Mahek Shah, Pradhum Ram, Kevin Bryan Lo, Soumya Patnaik, Brijesh Patel, Byomesh Tripathi, Shantanu Patil, Marvin Lu, Ulrich P Jorde, Vincent M Figueredo
Peripartum cardiomyopathy (PPCM) is a pregnancy-associated cause of heart failure. Given the significant impact of heart failure on healthcare, we sought to identify etiologies and predictive factors for readmission in PPCM. We queried the 2013 to 2014 National Readmissions Database to identify patients admitted with a diagnosis of PPCM. Patients who were readmitted within 30 days were evaluated to identify etiologies and predictors of readmission. We identified 6,977 index admissions with PPCM. Of the 6,880 (98...
March 29, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29678624/autonomic-cardiovascular-control-and-cardiac-arrhythmia-in-two-pregnant-women-with-hypertrophic-cardiomyopathy-insights-from-icd-monitoring
#15
Pietro Francia, Carmen Adduci, Beatrice Musumeci, Lorenzo Semprini, Francesca Palano, Luigi Zezza, Massimo Volpe, Camillo Autore
In women with hypertrophic cardiomyopathy (HCM), pregnancy prompts major changes in hemodynamic and cardiac autonomic function that may precipitate heart failure (HF) or increase the risk of cardiac arrhythmia. We report the clinical follow-up of two patients with non-obstructive HCM implanted with a cardioverter defibrillator (ICD) allowing for continuous analysis of heart rate (HR), heart rate variability (HRV) and cardiac arrhythmia throughout the entire course of pregnancy. Both patients experienced increased HR and decreased HRV from the early stages of pregnancy, which persisted until delivery...
April 17, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29668027/heart-transplant-in-children-what-a-primary-care-provider-needs-to-know
#16
Swati Sehgal, Emily Shea, Lauren Kelm, Deepak Kamat
Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant...
April 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29667277/arrhythmic-manifestation-of-peripartum-cardiomyopathy-case-report
#17
Patryk Siedlecki, Małgorzata Kurpesa, Barbara Uznańska-Loch, Ewa Trzos, Jarosław Damian Kasprzak
We report a case of 26-year-old woman, with arrhythmic manifestation of peripartum cardiomyopathy with moderate heart failure. Ventricular arrhythmia recorded in ambulatory Holter ECG (premature ventricular contractions) was most severe during pregnancy, reduced when beta-blocker therapy was initiated and almost completely resolved after delivery. Then, 1 year after hospitalization in Cardiology Department, recurrence was observed with recorded short episode of nonsustained ventricular tachycardia.
April 17, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29626099/incidence-risk-factors-and-clinical-characteristics-of-peripartum-cardiomyopathy-in-south-korea
#18
Sunki Lee, Geum Joon Cho, Geun U Park, Log Young Kim, Tae-Seon Lee, Do Young Kim, Suk-Won Choi, Jong-Chan Youn, Seong Woo Han, Kyu-Hyung Ryu, Jin Oh Na, Cheol Ung Choi, Hong Seog Seo, Eung Ju Kim
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare disorder associated with pregnancy that can lead to life-threatening conditions. The incidence and clinical characteristics of this condition remain poorly understood. METHODS AND RESULTS: We aimed to perform the first population-based study of PPCM in South Korea, using the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who fulfilled predefined diagnostic criteria for PPCM from January 1, 2010, to December 31, 2012, were identified from International Classification of Diseases, Tenth Revision, Clinical Modification codes...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29625509/adult-congenital-heart-disease-with-pregnancy
#19
REVIEW
Koichiro Niwa
The number of women with congenital heart disease (CHD) at risk of pregnancy is growing because over 90% of them are grown-up into adulthood. The outcome of pregnancy and delivery is favorable in most of them provided that functional class and systemic ventricular function are good. Women with CHD such as pulmonary hypertension (Eisenmenger syndrome), severe left ventricular outflow stenosis, cyanotic CHD, aortopathy, Fontan procedure and systemic right ventricle (complete transposition of the great arteries [TGA] after atrial switch, congenitally corrected TGA) carry a high-risk...
April 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29616492/contraceptive-strategies-in-women-with-heart-failure-or-with-cardiac-transplantation
#20
REVIEW
Anjli Maroo, Johnny Chahine
PURPOSE OF REVIEW: We describe contraception for two groups of women: (1) women with heart failure and (2) women with cardiac transplantation. RECENT FINDINGS: Medical Eligibility Criteria for contraceptive agents address women with peripartum cardiomyopathy and women with valvular heart disease (Curtis et al. MMWR Recomm Rep 65:1-103, 2016). Recommendations for women with other forms of heart failure are extrapolated from these populations. Recommendations for women with cardiac transplantation have shifted since the 1980s: use of long-acting reversible contraception has increased, and there is a better understanding of the interactions between contraceptive and immunosuppressive regimens...
June 2018: Current Heart Failure Reports
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