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Heart disease in pregnancy

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https://www.readbyqxmd.com/read/28532196/fetal-and-neonatal-involvement-in-maternal-rheumatologic-disease
#1
Shigeo Iijima
A pregnancy complicated with rheumatologic diseases can have various influences on the fetus and/or neonate. Maternal systemic lupus erythematosus (SLE) may cause preterm and/or small for gestational age (SGA) delivery and neonatal lupus (NL). Some neonates with NL have congenital heart block (CHB) with increased morbidity and mortality, even requiring pacemakers. Antiphospholipid syndrome may occur with SLE and affect fetal and/or neonatal outcomes. Pregnancy involving primary Sjögren syndrome (pSS) tends to result in preterm delivery and low birthweight infants...
May 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28525397/an-unusual-case-of-sudden-death-is-there-a-relationship-between-thyroid-disorders-and-fatal-pulmonary-thromboembolism-a-case-report-and-review-of-literature
#2
Isabella Aquila, Silvia Boca, Fiorella Caputo, Matteo A Sacco, Santo Gratteri, Vittorio Fineschi, Pietrantonio Ricci
In adults, the most common cause of sudden death is coronary heart disease or defects in the cardiac conduction system; however, there are many cases of sudden death occurring from other causes such as fatal pulmonary thromboembolism. Several risk factors are recognized, including hospitalization, surgery, obesity, pregnancy, the use of oral contraceptives, traumatic fractures, and genetic conditions, which cause hypercoagulable states such as factor V Leiden mutations. Although many risk factors have been identified, the mortality rate is still high...
May 19, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28511860/first-trimester-fetal-echocardiography-identification-of-cardiac-structures-for-screening-from-6-to-13%C3%A2-weeks-gestational-age
#3
Darren Hutchinson, Angela McBrien, Lisa Howley, Yuka Yamamoto, Priya Sekar, Tarek Motan, Venu Jain, Winnie Savard, Lisa K Hornberger
BACKGROUND: Early fetal echocardiography (FE), performed at 12 to 16 weeks' gestational age (GA), can be used to screen for fetal heart disease akin to that routinely performed in the second trimester. The efficacy of FE at earlier GAs has not been as well explored, particularly with recent advances in ultrasound technology. The aim of this study was to evaluate the efficacy of early FE in assessing fetal heart structure, and the added benefit of color Doppler (CD), from as early as 6 weeks through to 13(+6) weeks' GA...
May 13, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28511453/pregnancy-outcome-of-abnormal-nuchal-translucency-a-systematic-review
#4
Nasibeh Roozbeh, Maryam Azizi, Leili Darvish
INTRODUCTION: Nuchal Translucency (NT) is the sonographic form of subcutaneous gathering of liquid behind the foetal neck in the first trimester of pregnancy. There is association of increased NT with chromosomal and non-chromosomal abnormalities. AIM: The purpose of this systemic review was to review the pregnancy outcome of abnormal nuchal translucency. MATERIALS AND METHODS: The present systematic review was conducted by searching English language articles from sources such as International Medical Sciences, Medline, Web of science, Scopus, Google Scholar, PubMed, Index Copernicus, DOAJ, EBSCO-CINAHL...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28498066/atrial-fibrillation-in-pregnancy-a-growing-challenge
#5
Vasiliki Katsi, Georgios Georgiopoulos, Maria Marketou, Dimitrios Oikonomou, Fragiskos Parthenakis, Thomas Makris, Petros Nihoyannopoulos, P Vardas, Dimitris Tousoulis
Atrial fibrillation (AF) constitutes a relatively infrequent pregnancy complication, which may be a therapeutic Gordian knot. Indeed, sparse data exist regarding the prevalence, prognosis and management of AF during pregnancy. In general, AF occurs as a benign, self-limited arrhythmia but occasionally may have severe hemodynamic consequences in pregnant patients suffering from heart failure, congenital heart disease, or other comorbidities. Extra-cardiac causes of AF should always be meticulously excluded. Treatment decisions are difficult, since medications may cross placental barrier and potentially affect fetal growth and organogenesis or even result in fetal bradyarrhythmias...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28491088/novel-biomarkers-for-cardiovascular-risk-prediction
#6
REVIEW
Juan Wang, Guo-Juan Tan, Li-Na Han, Yong-Yi Bai, Miao He, Hong-Bin Liu
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. The primary prevention of CVD is dependent upon the ability to identify high-risk individuals long before the development of overt events. This highlights the need for accurate risk stratification. An increasing number of novel biomarkers have been identified to predict cardiovascular events. Biomarkers play a critical role in the definition, prognostication, and decision-making regarding the management of cardiovascular events...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28489799/comparison-of-clinical-outcomes-in-peripartum-cardiomyopathy-and-age-matched-dilated-cardiomyopathy-a-15-year-nationwide-population-based-study-in-asia
#7
Cheng-Hui Lu, Wen-Chen Lee, Michael Wu, Shao-Wei Chen, Jih-Kai Yeh, Chun-Wen Cheng, Katie Pei-Hsuan Wu, Ming-Shien Wen, Tien-Hsing Chen, Victor Chien-Chia Wu
Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months.The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM.Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28480255/risk-factors-for-influenza-associated-severe-acute-respiratory-illness-hospitalization-in-south-africa-2012-2015
#8
Stefano Tempia, Sibongile Walaza, Jocelyn Moyes, Adam L Cohen, Claire von Mollendorf, Florette K Treurnicht, Marietjie Venter, Marthi Pretorius, Orienka Hellferscee, Senzo Mtshali, Mpho Seleka, Akhona Tshangela, Athermon Nguweneza, Johanna M McAnerney, Nicole Wolter, Anne von Gottberg, Halima Dawood, Ebrahim Variava, Shabir A Madhi, Cheryl Cohen
BACKGROUND: Data on risk factors for influenza-associated hospitalizations in low- and middle-income countries are limited. METHODS: We conducted active syndromic surveillance for hospitalized severe acute respiratory illness (SARI) and outpatient influenza-like illness (ILI) in 2 provinces of South Africa during 2012-2015. We compared the characteristics of influenza-positive patients with SARI to those with ILI to identify factors associated with severe disease requiring hospitalization, using unconditional logistic regression...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28466998/cardiac-remodelling-and-preeclampsia-an-overview-of-overlapping-circulating-mirnas
#9
Zenab Mohseni, Marc E A Spaanderman, Jolien Oben, Martina Calore, Elianne Derksen, Salwan Al-Nasiry, Leon de Windt, Chahinda Ghossein-Doha
OBJECTIVES: Preeclampsia (PE) is strongly associated with heart failure (HF) later in life. During preeclamptic pregnancy the left ventricle (LV) remodels in a concentric way. This aberrant remodelling often persists after delivery. The concentric remodelling during PE can induce molecular signatures that may explain the associated increased risk of HF. This signature may be evaluated in terms of microRNAs (miRNAs). This review evaluates existing literature on miRNA expression data in concentric remodelling on the one hand and PE on the other to generate a list of overlapping miRNA expression patterns in both...
May 3, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28461601/angiogenic-markers-and-cardiovascular-indices-in-the-prediction-of-hypertensive-disorders-of-pregnancy
#10
Stefan Verlohren, Frank H Perschel, Baskaran Thilaganathan, Lisa Antonia Dröge, Wolfgang Henrich, Andreas Busjahn, Asma Khalil
Angiogenic and antiangiogenic factors have proven to be an accurate predictive means of preeclampsia. Echocardiographic studies have shown that women with preeclampsia exhibit significant cardiovascular strain, especially early-onset preeclampsia. The aim of this study is to determine preeclampsia risk with soluble fms-like tyrosin kinase 1/placental growth factor ratio, serum NT-proBNP (N-terminal pro B-type natriuretic peptide), and biophysical markers of cardiovascular function in a prospective case-control study...
June 2017: Hypertension
https://www.readbyqxmd.com/read/28454805/managing-subfertility-in-patients-with-heart-disease-what-are-the-choices
#11
REVIEW
Matthew Cauldwell, Roshni R Patel, Philip J Steer, Lorna Swan, Julian Norman-Taylor, Michael Gatzoulis, Mark R Johnson
More women with heart disease are reaching reproductive age and will want to embark upon pregnancy. Furthermore, many of these women are delaying pregnancy until later in life when they may be exposed to a greater number of complications from their heart disease. A relatively high proportion of these women will pursue fertility treatment to achieve a pregnancy; consequently, the management of subfertile couples where the woman (or man) has heart disease is of growing importance. In this review, we discuss how fertility investigations and treatment can impact a women with heart disease and how some of the potential complications can be minimized or avoided...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28453725/serelaxin-treatment-promotes-adaptive-hypertrophy-but-does-not-prevent-heart-failure-in-experimental-peripartum-cardiomyopathy
#12
Justus Nonhoff, Melanie Ricke-Hoch, Mirco Mueller, Britta Stapel, Tobias Pfeffer, Martina Kasten, Michaela Scherr, Constantin von Kaisenberg, Johann Bauersachs, Arash Haghikia, Denise Hilfiker-Kleiner
Aims: Peripartum cardiomyopathy (PPCM) is a systolic left ventricular dysfunction developing in the peripartum phase in previously healthy women. Relaxin-2 is a pregnancy hormone with potential beneficial effects in heart failure patients. We evaluated Relaxin-2 as a potential diagnostic marker and/or a therapeutic agent in PPCM. Methods and results: In healthy peripartum women, serum Relaxin-2 levels (measured by ELISA in the second half of pregnancy) were elevated showing a decreasing trend in the first postpartum week and returned to non-pregnant levels thereafter...
May 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28444063/effect-of-lactation-on-myocardial-vulnerability-to-ischemic-insult-in-rats
#13
Sahar Askari, Alireza Imani, Hamidreza Sadeghipour, Mahdieh Faghihi, Zohreh Edalatyzadeh, Samira Choopani, Nasser Karimi, Sulail Fatima
Background: Cardiovascular diseases are the leading cause of mortality and long-term disability worldwide. Various studies have suggested a protective effect of lactation in reducing the risk of cardiovascular diseases. Objective: This study was designed to assess the effects of pregnancy and lactation on the vulnerability of the myocardium to an ischemic insult. Methods: Eighteen female rats were randomly divided into three groups: ischemia-reperfusion (IR), in which the hearts of virgin rats underwent IR (n = 6); lactating, in which the rats nursed their pups for 3 weeks and the maternal hearts were then submitted to IR (n = 6); and non-lactating, in which the pups were separated after birth and the maternal hearts were submitted to IR (n = 6)...
April 20, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28442640/left-recumbent-position-decreases-heart-rate-without-alterations-in-cardiac-autonomic-nervous-system-activity-in-healthy-young-adults
#14
Konosuke Sasaki, Mayu Haga, Yoichi Endo, Junko Fujiwara, Ryoko Maruyama
Some studies have reported that recumbent position may have advantages in patients with heart disease and in pregnancy. However, it remains controversial whether recumbent position affects autonomic nervous system activity and hemodynamics in healthy adults. The aim of this study was to evaluate alterations in heart rate variability (HRV) and hemodynamics in the supine, left recumbent and right recumbent positions in healthy young adults. A total of 80 participants aged 22.8 ± 3.1 years were enrolled in this observational study...
April 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28440905/clinical-follow-up-of-women-after-hypertensive-disease-in-pregnancy
#15
H A Boyd
That hypertensive disorders of pregnancy (HDP) affect maternal health even after delivery of the baby and the placenta, is no longer in doubt. Women with a history of HDP, preeclampsia in particular, have well-documented increased risks of later hypertension, ischemic heart disease, myocardial infarction, ischemic stroke, venous thromboembolism, and cardiomyopathy. However, our understanding of how "later" is defined - i.e. when exactly HDP-associated disease risks increase - is shifting. This article is protected by copyright...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28436940/disruption-of-spatiotemporal-hypoxic-signaling-causes-congenital-heart-disease-in-mice
#16
Xuejun Yuan, Hui Qi, Xiang Li, Fan Wu, Jian Fang, Eva Bober, Gergana Dobreva, Yonggang Zhou, Thomas Braun
Congenital heart disease (CHD) represents the most prevalent inborn anomaly. Only a minority of CHD cases are attributed to genetic causes, suggesting a major role of environmental factors. Nonphysiological hypoxia during early pregnancy induces CHD, but the underlying reasons are unknown. Here, we have demonstrated that cells in the mouse heart tube are hypoxic, while cardiac progenitor cells (CPCs) expressing islet 1 (ISL1) in the secondary heart field (SHF) are normoxic. In ISL1+ CPCs, induction of hypoxic responses caused CHD by repressing Isl1 and activating NK2 homeobox 5 (Nkx2...
April 24, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28426617/clinical-updates-in-women-s-health-care-summary-arrhythmias-primary-and-preventive-care-review
#17
Brittany S Fuller, Michele D Voeltz
Obstetrician-gynecologists often are the sole providers of health care to female patients. Because cardiovascular disease is the leading cause of death in women in the United States, obstetrician- gynecologists must be aware of the risk factors, symptoms, and signs of cardiovascular disease and arrhythmia. Furthermore, they must be prepared to identify and treat common types of arrhythmia in this population and refer patients to cardiology for specialized care. Understanding the role of pregnancy among women with arrhythmia is critically important to optimize both maternal and fetal outcomes...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28425011/pregnancy-related-myocardial-infarction
#18
H Lameijer, M C Lont, H Buter, A J van Boven, P W Boonstra, P G Pieper
INTRODUCTION: The risk of acute myocardial infarction in young women is low, but increases during pregnancy due to the physiological changes in pregnancy, including hypercoagulability. Ischaemic heart disease during pregnancy is not only associated with increased maternal morbidity and mortality, but also with high neonatal complications. Advancing maternal age and other risk factors for cardiovascular diseases may further increase the risk of ischaemic heart disease in young women. METHODS: We searched the coronary angiography database of a Dutch teaching hospital to identify women with acute myocardial infarction who presented during pregnancy or postpartum between 2011 and 2013...
April 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28424040/challenges-of-takayasu-arteritis-in-pregnancy-a-case-report
#19
Sarah Soo-Hoo, Jenny Seong, Brandon R Porten, Nedaa Skeik
Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. Furthermore, optimal management has not yet been established for pregnant patients with Takayasu arteritis, posing a clinical challenge...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28416028/attitudes-and-perceptions-of-pregnant-women-with-chd-results-of-a-single-site-survey
#20
Aarthi Sabanayagam, David Briston, Ali N Zaidi
Introduction CHD occurs in about 1% of the United States population, and is now the most common cardiac condition affecting women during pregnancy. METHODS: An anonymous, single-site, cross-sectional, 50-question survey was performed at a national Adult Congenital Heart Disease conference to assess the level of knowledge, attitudes, and perceptions regarding cardiac care during pregnancy in women with CHD. RESULTS: A total of 77 women completed the survey. Among them, 50% (n=39) had moderate and 38% (n=29) had severely complex disease; 30% (n=23) of women were told that pregnancy was contraindicated given their underlying cardiac condition...
April 18, 2017: Cardiology in the Young
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