PMID- 22967110
OWN - NLM
STAT- MEDLINE
DCOM- 20140226
LR  - 20240109
IS  - 1747-0803 (Electronic)
IS  - 1747-079X (Linking)
VI  - 8
IP  - 4
DP  - 2013 Jul-Aug
TI  - Long-term outcome following pregnancy in women with a systemic right ventricle: 
      is the deterioration due to pregnancy or a consequence of time?
PG  - 302-7
LID - 10.1111/chd.12001 [doi]
AB  - INTRODUCTION: The right ventricle (RV) supports the systemic circulation in 
      patients who have had an intraatrial repair of transposition of the great 
      arteries or have congenitally corrected transposition. There is concern about the 
      ability of a systemic RV to support the additional volume load of pregnancy, and 
      previous studies have reported deterioration in RV function following pregnancy. 
      However, conditions with a systemic RV are also associated with progressive RV 
      dysfunction over time. To date, no study has examined whether the deterioration 
      associated with pregnancy is due to the physiological changes of pregnancy 
      itself, or is part of the known deterioration that occurs with time in these 
      patients. METHODS: Women who had undergone pregnancy under the care of the Adult 
      Congenital Heart Disease Unit at the Queen Elizabeth Hospital were 
      retrospectively identified and matched to separate male and nulliparous female 
      controls. Functional status (New York Health Association [NYHA]), RV function, 
      and systemic atrioventricular valve regurgitation were recorded for each group at 
      baseline, postpregnancy (or at 1 year for control groups) and at latest 
      follow-up. RESULTS: Eighteen women had 31 pregnancies (range 1-4) resulting in 32 
      live births. There were no maternal but one neonatal death. At baseline, there 
      was no significant difference in NYHA class or RV function between pregnancy and 
      control groups. In postpregnancy, there was a significant deterioration in the 
      pregnant group alone for both NYHA class (P = 0.004) and RV function (P = 0.02). 
      At latest follow-up, there was a significant deterioration in RV function in all 
      three groups. There was still a reduction from baseline in NYHA of women who had 
      undergone pregnancy (P = 0.014), which again was not seen in the controls groups. 
      CONCLUSION: This study suggests that pregnancy is associated with a premature 
      deterioration in RV function in women with a systemic RV. These women are also 
      more symptomatic, with a greater reduction in functional class compared with 
      patients with a systemic RV who do not undergo pregnancy. This study will allow 
      this cohort of women to be more accurately counseled as to the potential 
      long-term risks of pregnancy.
CI  - (c) 2012 Wiley Periodicals, Inc.
FAU - Bowater, Sarah E
AU  - Bowater SE
AD  - Department of Cardiology, Queen Elizabeth Hospital NHS Foundation Trust, 
      Birmingham, UK.
FAU - Selman, Tara J
AU  - Selman TJ
FAU - Hudsmith, Lucy E
AU  - Hudsmith LE
FAU - Clift, Paul F
AU  - Clift PF
FAU - Thompson, Peter J
AU  - Thompson PJ
FAU - Thorne, Sara A
AU  - Thorne SA
LA  - eng
PT  - Journal Article
DEP - 20120912
PL  - United States
TA  - Congenit Heart Dis
JT  - Congenital heart disease
JID - 101256510
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Chi-Square Distribution
MH  - Congenitally Corrected Transposition of the Great Arteries
MH  - Disease Progression
MH  - England
MH  - Female
MH  - Heart Ventricles/abnormalities/*physiopathology/surgery
MH  - Humans
MH  - *Parity
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*etiology/physiopathology
MH  - Pregnancy Outcome
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - Transposition of Great Vessels/*complications/physiopathology/surgery
MH  - Ventricular Dysfunction, Right/*etiology/physiopathology
MH  - *Ventricular Function, Right
MH  - Young Adult
OTO - NOTNLM
OT  - Key Words. Systemic Right Ventricle
OT  - NYHA Class
OT  - Pregnancy
OT  - Ventricular Function
EDAT- 2012/09/13 06:00
MHDA- 2014/02/27 06:00
CRDT- 2012/09/13 06:00
PHST- 2012/07/27 00:00 [accepted]
PHST- 2012/09/13 06:00 [entrez]
PHST- 2012/09/13 06:00 [pubmed]
PHST- 2014/02/27 06:00 [medline]
AID - 10.1111/chd.12001 [doi]
PST - ppublish
SO  - Congenit Heart Dis. 2013 Jul-Aug;8(4):302-7. doi: 10.1111/chd.12001. Epub 2012 
      Sep 12.