Role of echocardiography in the assessment and management of adult congenital heart disease in pregnancy

Vitarelli, Antonio; Capotosto, Lidia

doi:10.1007/s10554-010-9750-9

Cited by 16 publications

(13 citation statements)

References 101 publications

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“…In this study, morphological cardiac changes reached the maximum during the early postpartum period, within 1 week after childbirth, not during the late stage of pregnancy irrespective of modes of delivery, suggesting that cardiac volume load is most likely to occur during the early postpartum period. Although expected, this phenomenon was documented here for the first time, as many investigators have focused on cardiac changes during pregnancy and not during the early postpartum period 2–4 20–27. To our knowledge, there have been no reports of echocardiography performed immediately postpartum within 1 week after childbirth.…”

Section: Discussionsupporting

confidence: 59%

Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Umazume

Yamada

et al. 2018

Open Heart

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ObjectiveThis longitudinal study was performed to determine changes in echocardiography parameters in association with various biomarker levels in pregnancy/postpartum.MethodsFifty-one healthy pregnant women underwent echocardiography with simultaneous determination of blood levels of five biomarkers at each of the first, second and third trimesters of pregnancy, immediately postpartum within 1 week after childbirth and approximately 1 month postpartum. Data on 255 echocardiography scans (five times per woman) and biomarkers were analysed.ResultsLeft ventricular end-diastolic dimension, left atrial (LA) volume index and left ventricular (LV) mass index increased with advancing gestation and reached the maximum immediately postpartum concomitant with the highest brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI) and creatine kinase MB levels. The inferior vena cava diameter was significantly reduced in the third trimester compared with that in the first trimester and the peak occurred immediately after childbirth. In 255 paired measurements, hs-TnI level was significantly positively correlated with LA volume index and LV mass index; BNP and NT-proBNP were significantly positively correlated with LA volume index and estimated glomerular filtration rate (eGFR) was significantly positively correlated with the average of early diastolic septal and lateral mitral annular velocity (e′).ConclusionsMaximal cardiac changes in morphology occurred postpartum within 1 week after childbirth, not during pregnancy. BNP/NT-proBNP, hs-TnI and eGFR reflected cardiac changes in pregnancy.

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Section: Discussionsupporting

confidence: 59%

Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Umazume

Yamada

et al. 2018

Open Heart

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“…Cardiovascular disease in pregnancy is the leading cause of maternal morbidity and mortality in North America [1,2]. In the developed world, hypertension, arrhythmias, valvular heart disease, heart failure, and other acquired diseases of the maternal circulation can severely impact pregnancies [1].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular magnetic resonance in pregnancy: Insights from the cardiac hemodynamic imaging and remodeling in pregnancy (CHIRP) study

Ducas

Elliott

Melnyk

et al. 2014

Journal of Cardiovascular Magnetic Resonance

171

130

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BackgroundCardiovascular disease in pregnancy is the leading cause of maternal mortality in North America. Although transthoracic echocardiography (TTE) is the most widely used imaging modality for the assessment of cardiovascular function during pregnancy, little is known on the role of cardiovascular magnetic resonance (CMR). The objective of the Cardiac Hemodynamic Imaging and Remodeling in Pregnancy (CHIRP) study was to compare TTE and CMR in the non-invasive assessment of maternal cardiac remodeling during the peripartum period.MethodsBetween 2010–2012, healthy pregnant women aged 18 to 35 years were prospectively enrolled. All women underwent TTE and CMR during the third trimester and at least 3 months postpartum (surrogate for non-pregnant state).ResultsThe study population included a total of 34 women (mean age 29 ± 3 years). During the third trimester, TTE and CMR demonstrated an increase in left ventricular end-diastolic volume from 95 ± 11 mL to 115 ± 14 mL and 98 ± 6 mL to 125 ± 5 mL, respectively (p < 0.05). By TTE and CMR, there was also an increase in left ventricular (LV) mass during pregnancy from 111 ± 10 g to 163 ± 11 g and 121 ± 5 g to 179 ± 5 g, respectively (p < 0.05). Although there was good correlation between both imaging modalities for LV mass, stroke volume, and cardiac output, the values were consistently underestimated by TTE.ConclusionThis CMR study provides reference values for cardiac indices during normal pregnancy and the postpartum state.

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“…Other residual lesions include persistent RV outflow tract obstruction, residual VSD, aortic dilation, and aortic regurgitation. Due to RV enlargement and paradoxical septal motion or prior cardiopulmonary bypass, LV dysfunction may also occur [11,33]. Elective pulmonary valve replacement is recommended for severe pulmonic regurgitation with RV enlargement [(RV end systolic volume index >80 ml/m 2 , end diastolic volume index >150 ml/m 2 , and RVejection fraction less than 47 % on magnetic resonance imaging (MRI)] and exercise intolerance before pregnancy [2••, 34].…”

Section: Tetralogy Of Fallotmentioning

confidence: 99%

Echocardiography in Pregnancy: Part 1

2016

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The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves.

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Role of echocardiography in the assessment and management of adult congenital heart disease in pregnancy

Cited by 16 publications

References 101 publications

Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Morphofunctional cardiac changes in pregnant women: associations with biomarkers

Cardiovascular magnetic resonance in pregnancy: Insights from the cardiac hemodynamic imaging and remodeling in pregnancy (CHIRP) study

Echocardiography in Pregnancy: Part 1

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