Effect of Pregnancy in Arrhythmogenic Right Ventricular Cardiomyopathy

Wu, Lingmin; Liang, Erpeng; Fan, Siyang; Zheng, Lihui; Hu, Feng; Liu, Shangyu; Liu, Limin; Hu, Zhicheng; Li, Guoliang; Yao, Yan

doi:10.1016/j.amjcard.2019.11.008

Cited by 16 publications

(21 citation statements)

References 14 publications

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“…Similar results were recently published by Wu et al. [ 69 ], who analyzed 224 pregnancies in 120 patients including 30 spontaneous and two medical abortions. In all, 12 cardiac adverse events were recorded during pregnancy, including new-onset frequent PVC in three, increased previous PVC numbers by more than 100% in five, and syncope in two patients.…”

Section: Outcomes Of Pregnancy In Women With Acsupporting

confidence: 89%

“…Hodes et al [31] reported cesarean sections in 11 of 39 women with AC (28%), all but one (HF) for obstetric indications. Another large study recently published by Wu et al [69] reported similar results with cesarean section in 44 of 224 Chinese women (20%). Castrini et al [13] and Gandjbakhch et al [27] both reported lower rates of cesarean sections in their cohorts (7 and 13%, respectively).…”

Section: Preterm Delivery and Low Birth Weightsupporting

confidence: 60%

“…Another large study recently published by Wu et al. [ 69 ] reported similar results with cesarean section in 44 of 224 Chinese women (20%). Castrini et al.…”

Section: Outcomes Of Pregnancy In Women With Acsupporting

confidence: 60%

“…Only case reports [ 1 , 3 , 15 , 22 , 23 , 30 , 33 , 34 , 54 , 61 ] and small series [ 5 , 7 , 9 , 36 ] with a total of 30 pregnancies in 30 women with AC had been reported prior to the first larger case studies and registry reports on pregnancy in AC that were recently published ([ 13 , 27 , 31 , 48 , 69 ]; Tables 1 and 2 ). All reported pregnancies in AC were singleton.…”

Section: Outcomes Of Pregnancy In Women With Acmentioning

confidence: 99%

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Pregnancy in arrhythmogenic cardiomyopathy

Wichter

Milberg²,

Wichter³

et al. 2021

Herzschr Elektrophys

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Arrhythmogenic cardiomyopathy (AC) is a rare heart muscle disease with a genetic background and autosomal dominant mode of transmission. The clinical manifestation is characterized by ventricular arrhythmias (VA), heart failure (HF) and the risk of sudden cardiac death (SCD). Pregnancy in young female patients with AC represents a challenging condition for the life and family planning of young affected women. In addition to genetic mechanisms that influence the complex pathophysiology of AC, experimental and clinical data have confirmed the pathogenetic role of strenuous exercise and competitive sports in the early onset and rapid progression of AC symptoms and complications. Pregnancy and exercise share a number of physiological aspects of adaptation. In AC, both result in ventricular volume overload and myocardial stretch. Therefore, pregnancy has been postulated as a potential risk factor for HF, VA, SCD, and pregnancy-related obstetric complications in patients with AC. However, the available evidence on pregnancy in AC does not confirm this hypothesis. In most women with AC, pregnancies are well tolerated, uneventful, and follow a benign course. Pregnancy-related symptoms (VA, syncope, HF) and mortality, as well as obstetric complications, are uncommon in AC patients and range in the order of background populations and cohorts with AC and no pregnancy. The number of completed pregnancies is not associated with an acceleration of AC pathology or an increased risk of VA or HF during pregnancy and follow-up. Accordingly, there is no medical indication to advise against pregnancy in patients with AC. Preconditions include stability of rhythm and hemodynamics at baseline, as well as clinical follow-ups and the availability of multidisciplinary expert consultation during pregnancy and postpartum. Genetic counseling is recommended prior to pregnancy for all couples and their families affected by AC.

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Section: Outcomes Of Pregnancy In Women With Acsupporting

confidence: 89%

Section: Preterm Delivery and Low Birth Weightsupporting

confidence: 60%

“…Another large study recently published by Wu et al. [ 69 ] reported similar results with cesarean section in 44 of 224 Chinese women (20%). Castrini et al.…”

Section: Outcomes Of Pregnancy In Women With Acsupporting

confidence: 60%

Section: Outcomes Of Pregnancy In Women With Acmentioning

confidence: 99%

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Pregnancy in arrhythmogenic cardiomyopathy

Wichter

Milberg²,

Wichter³

et al. 2021

Herzschr Elektrophys

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“…It is widely recognized that idiopathic PVCs are relatively benign in structurally normal hearts 16 ; however, relatively few studies have evaluated the relationship between PVCs and the adverse outcomes of fetuses or neonates among pregnant women 10,17 . In this study, we found that PVCs were associated with a higher frequency fetal/neonatal adverse events among pregnant women with a structurally normal heart.…”

Section: Discussionmentioning

confidence: 99%

The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease

Lin

Qian

et al. 2020

Preprint

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Objective: To investigate the outcomes of fetuses or neonates of pregnant women with premature ventricular contractions (PVCs). Study design: 6, 148 pregnant women were prospectively enrolled in the study. Of these women, 103 with a PVC burden >0.5% were divided into two groups based on the presence or absence of adverse fetal or neonatal events. The adverse outcomes were compared between the groups to assess the impact of PVCs on pregnancy. Results: A total of 17 adverse events (12 cases) occurred among 103 pregnant women with PVCs, which was significantly higher than that among women without PVCs (11.65% vs. 2.93%, p<0.01). The median PVC burden among pregnant women with PVCs was 2.84% (1.02% to 6.1%). Furthermore, compared with that of the women without adverse events, the median PVC burden of women with adverse fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%, p<0.01). Multivariate logistic regression analysis demonstrated that PVC burden was associated with adverse fetal or neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI (1.11-1.61), p<0.01). Conclusions: Frequent PVCs have adverse effects on pregnancy, and the PVC burden might be an important factor associated with adverse fetal and neonatal outcomes among pregnant women with PVCs. Our cohort study indicated that the higher the PVC burden is, the higher the likelihood of adverse events would be.

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The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease: A prospective cohort study

Lin

Qian

Chen

et al. 2021

Clinical Cardiology

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Background Premature ventricular contractions (PVCs) may increase during pregnancy, however, few studies have evaluated the relationship between PVCs and the pregnant outcomes. Hypothesis PVCs may increase the adverse fetal/neonatal outcomes in pregnant women. Methods Six thousand one hundred and forty‐eight pregnant women were prospectively enrolled in our center between 2017 and 2019 in the study. The average PVC burden was determined by calculating the number of PVCs in total beats. Those who had a PVC burden >0.5% were divided into two groups based on the presence or absence of adverse fetal or neonatal events. The adverse outcomes were compared between the groups to assess the impact of PVCs on pregnancy. Results A total of 103 (1.68%) women with a PVC burden >0.5% were recorded. Among them, 17 adverse events (12 cases) were documented, which was significantly higher than that among women without PVCs (11.65% vs. 2.93%, p < .01). The median PVC burden among pregnant women with PVCs was 2.84% (1.02%–6.1%). Furthermore, compared with that of the women without adverse events, the median PVC burden of women with adverse fetal or neonatal outcomes was significantly higher (9.02% vs. 2.30%, p < .01). Multivariate logistic regression analysis demonstrated that not the LVEF, heart rate and bigeminy, but only the PVC burden was associated with adverse fetal or neonatal outcomes among pregnant women with PVCs (OR: 1.34, 95% CI [1.11–1.61], p < .01). Conclusions Frequent PVCs have adverse effects on pregnancy, and the PVC burden might be an important factor associated with adverse fetal and neonatal outcomes among pregnant women with PVCs.

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Effect of Pregnancy in Arrhythmogenic Right Ventricular Cardiomyopathy

Cited by 16 publications

References 14 publications

Pregnancy in arrhythmogenic cardiomyopathy

Pregnancy in arrhythmogenic cardiomyopathy

The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease

The burden of premature ventricular contractions predicts adverse fetal and neonatal outcomes among pregnant women without structural heart disease: A prospective cohort study

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