PMID- 32739112
OWN - NLM
STAT- MEDLINE
DCOM- 20211124
LR  - 20211124
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 77
IP  - 3
DP  - 2021 Mar
TI  - Pregnancy outcomes in women with dilated cardiomyopathy: Peripartum 
      cardiovascular events predict post delivery prognosis.
PG  - 217-223
LID - S0914-5087(20)30248-3 [pii]
LID - 10.1016/j.jjcc.2020.07.007 [doi]
AB  - BACKGROUND: The number of pregnant women with dilated cardiomyopathy (DCM) is 
      relatively small, and therefore their prognosis after pregnancy is unknown. This 
      study aims to elucidate pregnancy outcomes among women with DCM, as well as the 
      long-term prognosis after pregnancy. METHODS: Thirty-five pregnancies and 
      deliveries in 30 women, diagnosed with DCM before pregnancy, were retrospectively 
      analyzed. RESULTS: All women had a left ventricular ejection fraction (LVEF) over 
      30% and belonged to the New York Heart Association (NYHA) class I or II before 
      pregnancy. The mean gestational age at delivery was 36 weeks with 15 (43%) 
      preterm deliveries. Eight pregnancies (23%) were complicated by peripartum 
      cardiac events including 1 ventricular arrhythmia, 6 heart failures, and 1 
      significant deterioration in LVEF requiring termination of pregnancy. NYHA class 
      II, pre-pregnancy use of angiotensin-converting enzyme inhibitor/angiotensin II 
      receptor blocker/diuretics, elevated brain natriuretic peptide (BNP), and 
      advanced diastolic dysfunction assessed by Doppler echocardiography were defined 
      as risk factors for cardiac events. Although the more severe cases took 
      beta-blockers during pregnancy, the rates of cardiac events and decreasing LVEF 
      did not differ significantly between those taking beta-blockers and those who 
      were not. Values of LVEF decreased by almost 10% after the average 4-year 
      post-delivery follow-up period. The long-term event-free survival was 
      considerably worse among women with peripartum cardiac events than in those 
      without (p<0.0001). CONCLUSIONS: DCM women with pre-pregnancy LVEF over 30% 
      tolerated pregnancy, but the rate of preterm delivery was high. Peripartum 
      cardiovascular events occurred more often in women with NYHA class II, as well as 
      those who received medications before and during pregnancy and showed more 
      elevated BNP and advanced diastolic dysfunction before pregnancy. Beta-blockers 
      likely allowed similar outcomes for DCM patients with lower initial LVEFs. Close 
      monitoring later in life is required, particularly among the women with 
      peripartum cardiac events.
CI  - Copyright (c) 2020. Published by Elsevier Ltd.
FAU - Yokouchi-Konishi, Tae
AU  - Yokouchi-Konishi T
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan; Advanced Cardiovascular Medicine, Graduate School of 
      Medical Sciences, Kumamoto University, Kumamoto, Japan.
FAU - Kamiya, Chizuko A
AU  - Kamiya CA
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan. Electronic address: chiz@ncvc.go.jp.
FAU - Shionoiri, Tadasu
AU  - Shionoiri T
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
FAU - Nakanishi, Atsushi
AU  - Nakanishi A
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
FAU - Iwanaga, Naoko
AU  - Iwanaga N
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
FAU - Izumi, Chisato
AU  - Izumi C
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
FAU - Yasuda, Satoshi
AU  - Yasuda S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
FAU - Yoshimatsu, Jun
AU  - Yoshimatsu J
AD  - Department of Obstetrics and Gynecology, National Cerebral and Cardiovascular 
      Center, Suita, Osaka, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200730
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - *Cardiomyopathy, Dilated/complications/drug therapy/epidemiology
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Peripartum Period
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular/epidemiology
MH  - Pregnancy Outcome
MH  - Prognosis
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Dilated cardiomyopathy
OT  - Heart failure
OT  - Pregnancy
OT  - Prognosis
EDAT- 2020/08/03 06:00
MHDA- 2021/11/25 06:00
CRDT- 2020/08/03 06:00
PHST- 2020/05/02 00:00 [received]
PHST- 2020/06/26 00:00 [revised]
PHST- 2020/07/02 00:00 [accepted]
PHST- 2020/08/03 06:00 [pubmed]
PHST- 2021/11/25 06:00 [medline]
PHST- 2020/08/03 06:00 [entrez]
AID - S0914-5087(20)30248-3 [pii]
AID - 10.1016/j.jjcc.2020.07.007 [doi]
PST - ppublish
SO  - J Cardiol. 2021 Mar;77(3):217-223. doi: 10.1016/j.jjcc.2020.07.007. Epub 2020 Jul 
      30.