Number of pregnancies and subsequent phenotype in a cross-sectional cohort of women with arrhythmogenic cardiomyopathy

Castrini, Anna Isotta; Lie, Øyvind; Leren, Ida Skrinde; Estensen, Mette-Elise; Stokke, Mathis Korseberg; Klæboe, Lars Gunnar; Edvardsen, Thor; Haugaa, Kristina H.

doi:10.1093/ehjci/jey061

Cited by 22 publications

(25 citation statements)

References 28 publications

(42 reference statements)

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“…Almost all of these were spontaneous abortions. One study reported two stillbirths [13]. This rate of miscarriage lies within the normal range reported in the background population.…”

Section: Miscarriage and Abortion (≤ 13 Weeks' Gestation)supporting

confidence: 59%

“…The study cohort differed significantly from other publications by a much longer follow-up and a substantially higher risk profile, including a history of cardiac arrest (40%), sustained VT/VF (74%), HF (33%), heart transplantation (17%), catheter ablation (50%), and ICD implantation (17%) [69]. Similar to the studies by Castrini and Platonov [13,48], the majority of pregnancies (in 76% of women) occurred long before the diagnosis of AC was made.…”

Section: Maternal Mortality and Complications (Va Hf)mentioning

confidence: 61%

“…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). However, all rates of cesarean sections are within normal ranges for a given socioeconomic region.…”

Section: Preterm Delivery and Low Birth Weightmentioning

confidence: 86%

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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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“…Almost all of these were spontaneous abortions. One study reported two stillbirths [13]. This rate of miscarriage lies within the normal range reported in the background population.…”

Section: Miscarriage and Abortion (≤ 13 Weeks' Gestation)supporting

confidence: 59%

Section: Maternal Mortality and Complications (Va Hf)mentioning

confidence: 61%

Section: Preterm Delivery and Low Birth Weightmentioning

confidence: 86%

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Pregnancy in arrhythmogenic cardiomyopathy

Wichter

Milberg²,

Wichter³

et al. 2021

Herzschr Elektrophys

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show abstract

“…Reassuringly, no detrimental (long-term) effects on foetuses/newborns were observed, and no difference was observed in disease course and outcomes when comparing this cohort to a similar cohort of women of childbearing age. Castrini et al 41 similarly found that pregnancy had no effect on LV or RV function or VA in 43 definite ACM patients and 34 mutation carriers. A retrospective study of Gandjbakhch et al 42 revealed that in DCM and HCM patients, the risk of experiencing an adverse cardiac event during pregnancy was higher than in ACM patients.…”

Section: Determinants and Modifiers Of Acm Disease Severity And Scmentioning

confidence: 96%

Arrhythmogenic cardiomyopathy: pathogenesis, pro-arrhythmic remodelling, and novel approaches for risk stratification and therapy

Voorn

Riele

Basso

et al. 2020

Cardiovascular Research

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Abstract Arrhythmogenic cardiomyopathy (ACM) is a life-threatening cardiac disease caused by mutations in genes predominantly encoding for desmosomal proteins that lead to alterations in the molecular composition of the intercalated disc. ACM is characterized by progressive replacement of cardiomyocytes by fibrofatty tissue, ventricular dilatation, cardiac dysfunction, and heart failure but mostly dominated by the occurrence of life-threatening arrhythmias and sudden cardiac death (SCD). As SCD appears mostly in apparently healthy young individuals, there is a demand for better risk stratification of suspected ACM mutation carriers. Moreover, disease severity, progression, and outcome are highly variable in patients with ACM. In this review, we discuss the aetiology of ACM with a focus on pro-arrhythmic disease mechanisms in the early concealed phase of the disease. We summarize potential new biomarkers which might be useful for risk stratification and prediction of disease course. Finally, we explore novel therapeutic strategies to prevent arrhythmias and SCD in the early stages of ACM.

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“…A higher number of pregnancies did not seem to relate to a worse phenotype ARVD in women. The risk of sustained ventricular arrhythmia seems poorly predictable and major cardiac events were frequent in childhood, supporting the need to continue beta-blockers during pregnancy and close cardiac monitoring [29][30] .…”

Section: Classificationmentioning

confidence: 99%

Arrhythmogenic Right Ventricular Dysplasia, Did We Know Everything

Kinsara

2018

Journal of Cardiology and Therapy

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Implantable Cardioverter Defibrillator with its own morbidity. Antiarrhythmic drugs eliminate frequent episodes of ventricular tachycardia and defibrilator shocks but is not a curative therapy. There has been a great progress in studying the underlying role of genetics but the field is still wide open. This review will focus on the recent updates in arrhythmogenic right ventricular dysplasia pathology and treatment.

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Number of pregnancies and subsequent phenotype in a cross-sectional cohort of women with arrhythmogenic cardiomyopathy

Abstract: Higher number of pregnancies did not seem to relate to a worse phenotype in women with AC.

Cited by 22 publications

References 28 publications

Pregnancy in arrhythmogenic cardiomyopathy

Pregnancy in arrhythmogenic cardiomyopathy

Arrhythmogenic cardiomyopathy: pathogenesis, pro-arrhythmic remodelling, and novel approaches for risk stratification and therapy

Arrhythmogenic Right Ventricular Dysplasia, Did We Know Everything

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