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Pregnancy in women with dilated cardiomyopathy genetic variants
MA. Restrepo-Córdoba, P. Chmielewski, G. Truszkowska, ML. Peña-Peña, M. Kubánek, A. Krebsová, LR. Lopes, Á. García-Ropero, M. Merlo, A. Paldino, S. Peters, R. Jurcut, R. Barriales-Villa, E. Zorio, M. Hazebroek, J. Mogensen, P. García-Pavía
Language xxx, English Country Spain
Document type Journal Article
- MeSH
- Cardiomyopathy, Dilated * genetics complications MeSH
- Adult MeSH
- Phenotype MeSH
- Genetic Variation MeSH
- Pregnancy Complications, Cardiovascular * genetics MeSH
- Humans MeSH
- Pregnancy MeSH
- Pregnancy Outcome * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION AND OBJECTIVES: Limited information is available on the safety of pregnancy in patients with genetic dilated cardiomyopathy (DCM) and in carriers of DCM-causing genetic variants without the DCM phenotype. We assessed cardiac, obstetric, and fetal or neonatal outcomes in this group of patients. METHODS: We studied 48 women carrying pathogenic or likely pathogenic DCM-associated variants (30 with DCM and 18 without DCM) who had 83 pregnancies. Adverse cardiac events were defined as heart failure (HF), sustained ventricular tachycardia, ventricular assist device implantation, heart transplant, and/or maternal cardiac death during pregnancy, or labor and delivery, and up to the sixth postpartum month. RESULTS: A total of 15 patients, all with DCM (31% of the total cohort and 50% of women with DCM) experienced adverse cardiac events. Obstetric and fetal or neonatal complications were observed in 14% of pregnancies (10 in DCM patients and 2 in genetic carriers). We analyzed the 30 women who had been evaluated before their first pregnancy (12 with overt DCM and 18 without the phenotype). Five of the 12 (42%) women with DCM had adverse cardiac events despite showing NYHA class I or II before pregnancy. Most of these women had a history of cardiac events before pregnancy (80%). Among the 18 women without phenotype, 3 (17%) developed DCM toward the end of pregnancy. CONCLUSIONS: Cardiac complications during pregnancy and postpartum were common in patients with genetic DCM and were primarily related to HF. Despite apparently good tolerance of pregnancy in unaffected genetic carriers, pregnancy may act as a trigger for DCM onset in a subset of these women.
Azienda Sanitaria Universitaria Giuliano Isontina e Università degli Studi di Trieste Trieste Italy
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares Madrid Spain
Centro Nacional de Investigaciones Cardiovasculares Madrid Spain
Department of Cardiology Aalborg University Hospital Hobrovej r bb Denmark
Department of Cardiology Institute for Clinical and Experimental Medicine Praga Czech Republic
Department of Cardiology Maastricht University Medical Center Maastricht Netherlands
Department of Cardiology Royal Melbourne Hospital Victoria Australia
Department of Medical Biology National Institute of Cardiology Varsovia Poland
Guy's and St Thomas' NHS Foundation Trust London United Kingdom
Institute of Cardiovascular Science University College London London United Kingdom
Lewisham and Greenwich NHS Trust London United Kingdom
St Bartholomew's Hospital Barts Heart Centre Barts NHS Trust London United Kingdom
Universidad Francisco de Vitoria Pozuelo de Alarcón Madrid Spain
References provided by Crossref.org
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- $a Pregnancy in women with dilated cardiomyopathy genetic variants / $c MA. Restrepo-Córdoba, P. Chmielewski, G. Truszkowska, ML. Peña-Peña, M. Kubánek, A. Krebsová, LR. Lopes, Á. García-Ropero, M. Merlo, A. Paldino, S. Peters, R. Jurcut, R. Barriales-Villa, E. Zorio, M. Hazebroek, J. Mogensen, P. García-Pavía
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- $a INTRODUCTION AND OBJECTIVES: Limited information is available on the safety of pregnancy in patients with genetic dilated cardiomyopathy (DCM) and in carriers of DCM-causing genetic variants without the DCM phenotype. We assessed cardiac, obstetric, and fetal or neonatal outcomes in this group of patients. METHODS: We studied 48 women carrying pathogenic or likely pathogenic DCM-associated variants (30 with DCM and 18 without DCM) who had 83 pregnancies. Adverse cardiac events were defined as heart failure (HF), sustained ventricular tachycardia, ventricular assist device implantation, heart transplant, and/or maternal cardiac death during pregnancy, or labor and delivery, and up to the sixth postpartum month. RESULTS: A total of 15 patients, all with DCM (31% of the total cohort and 50% of women with DCM) experienced adverse cardiac events. Obstetric and fetal or neonatal complications were observed in 14% of pregnancies (10 in DCM patients and 2 in genetic carriers). We analyzed the 30 women who had been evaluated before their first pregnancy (12 with overt DCM and 18 without the phenotype). Five of the 12 (42%) women with DCM had adverse cardiac events despite showing NYHA class I or II before pregnancy. Most of these women had a history of cardiac events before pregnancy (80%). Among the 18 women without phenotype, 3 (17%) developed DCM toward the end of pregnancy. CONCLUSIONS: Cardiac complications during pregnancy and postpartum were common in patients with genetic DCM and were primarily related to HF. Despite apparently good tolerance of pregnancy in unaffected genetic carriers, pregnancy may act as a trigger for DCM onset in a subset of these women.
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