Cardiac adaption during pregnancy in women with congenital heart disease and healthy women.
Heart
; 102(16): 1302-8, 2016 08 15.
Article
em En
| MEDLINE
| ID: mdl-27048772
ABSTRACT
OBJECTIVE:
Pregnancy in women with congenital heart disease (CHD) is associated with deterioration in cardiac function. However, longitudinal data are scarce. This study describes serial changes in cardiac dimensions and function during pregnancy in women with CHD and compares these with healthy pregnant women (controls).METHODS:
Eight tertiary centres prospectively enrolled 125 pregnant women with CHD (pregnancy duration <20â weeks). Controls (N=49) were recruited from low-risk midwife practices. Standardised echocardiography at 20 and 32â weeks gestation and 1â year postpartum was performed.RESULTS:
Age and parity were comparable between both groups (p>0.1). Left ventricular ejection fraction (LVEF) <45% was present in 3.2% of women with CHD and 14.4% had tricuspid annular plane systolic excursion (TAPSE) <16â mm. Absolute values of ventricular function parameters and diameters were less favourable in women with CHD. No permanent changes occurred in right and left ventricular function parameters and dimensions in women with CHD. The patterns of change in cardiac function and dimensions were comparable between women with CHD and controls, except for LVEF (p=0.026). In women with right-sided CHD the pattern of TAPSE over time differed from controls (p=0.043) (no decrease in TAPSE postpregnancy in CHD). In women with left-sided CHD left ventricular end-diastolic diameter (LVEDD) tended to increase compared with controls (p=0.045).CONCLUSIONS:
Absolute levels of ventricular function parameters and diameters differ between CHD and controls, but changes during and after pregnancy are generally comparable. However, different patterns over time seen for TAPSE and LVEDD in women with right-sided and left-sided CHD, respectively, compared with controls indicate the importance of echocardiographic follow-up during pregnancy in women with CHD.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Cardiovasculares na Gravidez
/
Coração
/
Cardiopatias Congênitas
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article