Risk factors for maternal outcome in pregnancy complicated with dilated cardiomyopathy

Abstract

Objective: The goal of the study was to determine risk factors for maternal cardiac failure in pregnancy complicated with dilated cardiomyopathy (DCM).Study Design: The subjects were 29 patients diagnosed with DCM before conception or during the first 7 months of pregnancy. DCM was defined as left ventricle end-diastolic dimension (LVDd)X48 mm and/or fractional shortening (%FS)p30% on echocardiography. Patients were followed until at least 1 year after delivery and were categorized into a poor prognosis group (n ¼ 6; death or end stage heart failure of New York Heart Association (NYHA) class III and IV) and a good prognosis group (n ¼ 23; all other cases).Result: DCM was initially diagnosed during pregnancy in 6/6 and 8/23 patients in the poor and good prognosis groups, respectively (P<0.005). The %FS of the first test during pregnancy was 17.5 ± 6.2 and 27.4±9.3% in the respective groups (P<0.005). In eight abortion cases with %FS 15.2 ± 3.1%, %FS, cardiac function and NYHA class were maintained until 20 months after abortion. There was no relationship between LVDd and maternal outcome. Conclusion:Onset during pregnancy and decreased %FS are risk factors for a poor maternal outcome in patients with DCM. Abortion prevents further deterioration of cardiac function in patients with a very low %FS.

Pregnancy outcomes in women with dilated cardiomyopathy: Peripartum cardiovascular events predict post delivery prognosis

“…Moreover, Elkayam et al defined 'pregnancyassociated cardiomyopathy' as a condition that was diagnosed during pregnancy (excluding in the last month) and reported similar clinical characteristics to those of PPCM [13]. The former study also showed that pregnancy outcomes were better among women with preexisting DCM than in those with 'pregnancyassociated cardiomyopathy' [6]. Thus, this study focused only on preexisting DCM.…”

“…A few studies have assessed the outcomes of pregnancies complicated by DCM and the risk factors for cardiovascular events during pregnancy [5][6][7]. However, the influence of medical therapy on pregnancy outcomes and long-term prognosis after pregnancy remains unknown.…”

Obesity, not a high fat, high sucrose diet alone, induced glucose intolerance and cardiac dysfunction during pregnancy and postpartum

“…Significantly decreased systolic dysfunction indicated by %FS in HFHS/OP group at late pregnancy and weaning may be attributed to increased left ventricle end-diastolic dimension (LVIDd) or increased posterior wall thickness (LVPWd) 34 . However, decreased %FS was no longer persistent at 6 weeks postpartum which agreed with previous pregnancy studies in mice fed with the standard laboratory chow diet.…”

Heart failure in pregnancy: what is the long-term impact of pregnancy on cardiac function? A tertiary care centre experience and systematic review

“…Other CM Among the 23 non-ICM/non-PPCM studies reviewed, there were 14 that met the inclusion criteria (353 women; (LVEF reported in 155 (44%)) [41][42][43][44][45][46][47][48][49][50] (online supplemental S51-54). LVEF was <50% in 43 (28%) women and there were 222 (63%) patients assessed for VT/VF and 304 (86%) for maternal death, with VT/VF occurring in 34 (15%) and maternal death in 7 (2%).…”