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cardiac disease in pregnancy

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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
#1
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/28523440/assessing-and-modifying-coronary-artery-disease-risk-in-women
#2
REVIEW
Amy Sarma, Nandita S Scott
Despite continued advances in the field, cardiovascular disease remains the leading cause of death in women in the USA with an annual mortality rate that has remained higher for women as compared to men. The factors leading to this sex difference remain incompletely understood. Likely contributors include atypical symptoms at presentation and lack of recognition of cardiovascular risk by women and their providers alike. In addition, women have a higher burden of comorbidities at the time of disease diagnosis and can have differential pathophysiological mechanisms of their acute events...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28516275/the-role-of-cardiac-biomarkers-in-pregnancy
#3
REVIEW
Emily S Lau, Amy Sarma
Cardiovascular disease (CVD) is the leading cause of pregnancy-associated mortality, with an increasingly complex pregnant population. While our understanding of CVD in pregnancy continues to evolve, there remains a need to develop widely accessible tools to follow pregnant women both with and without preexisting disease with respect to cardiovascular risk, particularly for those presenting with symptoms suggestive of cardiovascular pathology. Thus, research is emerging with respect to the potential role of novel and established cardiac biomarkers in diagnosing and following CVD in pregnancy...
July 2017: Current Treatment Options in Cardiovascular Medicine
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
#4
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
#5
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
#6
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/28491125/indirect-maternal-deaths-uk-and-global-perspectives
#7
Manisha Nair, Catherine Nelson-Piercy, Marian Knight
Indirect maternal deaths outnumber direct deaths due to obstetric causes in many high-income countries, and there has been a significant increase in the proportion of maternal deaths due to indirect medical causes in low- to middle-income countries. This review presents a detailed analysis of indirect maternal deaths in the UK and a perspective on the causes and trends in indirect maternal deaths and issues related to care in low- to middle-income countries. There has been no significant decrease in the rate of indirect maternal deaths in the UK since 2003...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28491088/novel-biomarkers-for-cardiovascular-risk-prediction
#8
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
#9
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/28466998/cardiac-remodelling-and-preeclampsia-an-overview-of-overlapping-circulating-mirnas
#10
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
#11
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/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/28442640/left-recumbent-position-decreases-heart-rate-without-alterations-in-cardiac-autonomic-nervous-system-activity-in-healthy-young-adults
#13
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/28439937/maternal-nutrient-restriction-during-pregnancy-and-lactation-leads-to-impaired-right-ventricular-function-in-young-adult-baboons
#14
Anderson H Kuo, Cun Li, Hillary F Huber, Matthias Schwab, Peter W Nathanielsz, Geoffrey D Clarke
KEY POINTS: Maternal nutrient restriction induces intrauterine growth restriction (IUGR) and leads to heightened cardiovascular risks later in life. We report right ventricular (RV) filling and ejection abnormalities in IUGR young adult baboons using cardiac magnetic resonance imaging. Both functional and morphological indicators of poor RV function were seen, many of which were similar to effects of ageing, but also with a few key differences. We observed more pronounced RV changes compared to our previous report of the left ventricle, suggesting there is likely to be a component of isolated RV abnormality in addition to expected haemodynamic sequelae from left ventricular dysfunction...
April 25, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28436940/disruption-of-spatiotemporal-hypoxic-signaling-causes-congenital-heart-disease-in-mice
#15
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
#16
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/28420371/effect-of-pulmonary-arteriovenous-malformations-on-the-mechanical-properties-of-the-lungs
#17
Cécile Rotenberg, Marcel Bonay, Mostafa El Hajjam, Sandra Blivet, Alain Beauchet, Pascal Lacombe, Thierry Chinet
BACKGROUND: Pulmonary arteriovenous malformations (PAVMs) are present in approximately 15-50% individuals with hereditary hemorrhagic telangiectasia (HHT). They may be isolated but more often are multiple. The goal of this study was to evaluate the influence of PAVMs on lung mechanical properties. METHODS: We reviewed the files of all adult patients (age ≥ 18 years) referred to our Center for evaluation of HHT between 2005 and 2013. The diagnosis of HHT was based on the Curacao criteria and/or the presence of a pathogenic mutation...
April 19, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28416028/attitudes-and-perceptions-of-pregnant-women-with-chd-results-of-a-single-site-survey
#18
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
https://www.readbyqxmd.com/read/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#19
Manish Kela, Madhvi Buddhi
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412993/paediatric-onset-coronary-artery-anomalies-in-pregnancy-a-single-centre-experience-and-systematic-literature-review
#20
Michelle Keir, Catriona Bhagra, Debra Vatenmakher, Francisca Arancibia-Galilea, Katrijn Jansen, Norihisa Toh, Candice K Silversides, Jack Colman, Samuel C Siu, Mathew Sermer, Andrew M Crean, Rachel M Wald
OBJECTIVES: Individuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population. METHODS: We performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases...
April 17, 2017: Cardiology in the Young
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