Pregnancy outcome in thoracic aortic disease data from the Registry Of Pregnancy And Cardiac disease.
Marfan and associated disorders
aortic and arterial disease
aortic aneurysm
bicuspid aortic valve
pregnancy
Journal
Heart (British Cardiac Society)
ISSN: 1468-201X
Titre abrégé: Heart
Pays: England
ID NLM: 9602087
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
04
09
2020
revised:
15
12
2020
accepted:
15
12
2020
pubmed:
21
1
2021
medline:
15
12
2021
entrez:
20
1
2021
Statut:
ppublish
Résumé
Cardiovascular disease is the leading cause of death during pregnancy with thoracic aortic dissection being one of the main causes. Thoracic aortic disease is commonly related to hereditary disorders and congenital heart malformations such as bicuspid aortic valve (BAV). Pregnancy is considered a high risk period in women with underlying aortopathy. The ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC) is a prospective global registry that enrolled 5739 women with pre-existing cardiac disease. With this analysis, we aim to study the maternal and fetal outcome of pregnancy in women with thoracic aortic disease. Thoracic aortic disease was reported in 189 women (3.3%). Half of them were patients with Marfan syndrome (MFS), 26% had a BAV, 8% Turner syndrome, 2% vascular Ehlers-Danlos syndrome and 11% had no underlying genetic defect or associated congenital heart defect. Aortic dilatation was reported in 58% of patients and 6% had a history of aortic dissection. Four patients, of whom three were patients with MFS, had an acute aortic dissection (three type A and one type B aortic dissection) without maternal or fetal mortality. No complications occurred in women with a history of aortic dissection. There was no significant difference in median fetal birth weight if treated with a beta-blocker or not (2960 g (2358-3390 g) vs 3270 g (2750-3570 g), p value 0.25). This ancillary analysis provides the largest prospective data review on pregnancy risk for patients with thoracic aortic disease. Overall pregnancy outcomes in women with thoracic aortic disease followed according to current guidelines are good.
Sections du résumé
BACKGROUND
Cardiovascular disease is the leading cause of death during pregnancy with thoracic aortic dissection being one of the main causes. Thoracic aortic disease is commonly related to hereditary disorders and congenital heart malformations such as bicuspid aortic valve (BAV). Pregnancy is considered a high risk period in women with underlying aortopathy.
METHODS
The ESC EORP Registry Of Pregnancy And Cardiac disease (ROPAC) is a prospective global registry that enrolled 5739 women with pre-existing cardiac disease. With this analysis, we aim to study the maternal and fetal outcome of pregnancy in women with thoracic aortic disease.
RESULTS
Thoracic aortic disease was reported in 189 women (3.3%). Half of them were patients with Marfan syndrome (MFS), 26% had a BAV, 8% Turner syndrome, 2% vascular Ehlers-Danlos syndrome and 11% had no underlying genetic defect or associated congenital heart defect. Aortic dilatation was reported in 58% of patients and 6% had a history of aortic dissection. Four patients, of whom three were patients with MFS, had an acute aortic dissection (three type A and one type B aortic dissection) without maternal or fetal mortality. No complications occurred in women with a history of aortic dissection. There was no significant difference in median fetal birth weight if treated with a beta-blocker or not (2960 g (2358-3390 g) vs 3270 g (2750-3570 g), p value 0.25).
CONCLUSION
This ancillary analysis provides the largest prospective data review on pregnancy risk for patients with thoracic aortic disease. Overall pregnancy outcomes in women with thoracic aortic disease followed according to current guidelines are good.
Identifiants
pubmed: 33468574
pii: heartjnl-2020-318183
doi: 10.1136/heartjnl-2020-318183
pmc: PMC8522458
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1704-1709Investigateurs
A Aquieri
(A)
A Saad
(A)
H Ruda Vega
(H)
J Hojman
(J)
J M Caparros
(JM)
M Vazquez Blanco
(M)
M Arstall
(M)
C M Chung
(CM)
G Mahadavan
(G)
E Aldridge
(E)
M Wittwer
(M)
Y Y Chow
(YY)
W A Parsonage
(WA)
K Lust
(K)
N Collins
(N)
G Warner
(G)
R Hatton
(R)
A Gordon
(A)
E Nyman
(E)
J Stein
(J)
E Donhauser
(E)
H Gabriel
(H)
A Bahshaliyev
(A)
F Guliyev
(F)
I Hasanova
(I)
T Jahangirov
(T)
Z Gasimov
(Z)
A Salim
(A)
C M Ahmed
(CM)
F Begum
(F)
M Mahmood
(M)
M N Islam
(MN)
P P Haque
(PP)
S K Banerjee
(SK)
T Parveen
(T)
M Morissens
(M)
J De Backer
(J)
L Demulier
(L)
M de Hosson
(M)
W Budts
(W)
M Beckx
(M)
M Kozic
(M)
M Lovric
(M)
T Kovacevic-Preradovic
(T)
N Chilingirova
(N)
P Kratunkov
(P)
N Wahab
(N)
E Gordon
(E)
L Walter
(L)
A Marelli
(A)
A R Montesclaros
(AR)
G Monsalve
(G)
C Rodriguez
(C)
F Balthazar
(F)
V Quintero
(V)
W Palacio
(W)
L A Mejía Cadavid
(LA)
E Munoz Ortiz
(E)
F Fortich Hoyos
(F)
E Arevalo Guerrero
(E)
J Gandara Ricardo
(J)
J Velasquez Penagos
(J)
Z Vavera
(Z)
J Popelova
(J)
N Vejlstrup
(N)
L Grønbeck
(L)
M Johansen
(M)
A Ersboll
(A)
Y Elrakshy
(Y)
K Eltamawy
(K)
M Gamal Abd-El Aziz
(M)
A El Nagar
(A)
H Ebaid
(H)
H Abo Elenin
(H)
M Saed
(M)
S Farag
(S)
W Makled
(W)
K Sorour
(K)
Z Ashour
(Z)
G El-Sayed
(G)
M Abdel Meguid Mahdy
(M)
N Taha
(N)
A Dardeer
(A)
M Shabaan
(M)
A Saad
(A)
M Ali
(M)
P Moceri
(P)
G Duthoit
(G)
M Gouton
(M)
J Nizard
(J)
L Baris
(L)
S Cohen
(S)
M Ladouceur
(M)
D Khimoud
(D)
B Iung
(B)
F Berger
(F)
A Olsson
(A)
U Gembruch
(U)
W M Merz
(WM)
E Reinert
(E)
S Clade
(S)
Y Kliesch
(Y)
C Sinning
(C)
R Kozlik-Feldmann
(R)
S Blankenberg
(S)
E Zengin-Sahm
(E)
G Mueller
(G)
M Hillebrand
(M)
P Hauck
(P)
Y von Kodolitsch
(Y)
N Zarniko
(N)
H Baumgartner
(H)
A Hellige
(A)
O Tutarel
(O)
H Kaemmerer
(H)
B Kuschel
(B)
R Motz
(R)
D Maisuradze
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A Frogoudaki
(A)
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(M)
D Marousi
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G Triantafyllis
(G)
H Bekiaris
(H)
G Karvounis
(G)
D Giannakoulas
(D)
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A Mouratoglou
(A)
H Balint Temesvari
(HB)
D Kohalmi
(D)
B Merkely
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C Liptai
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A Kalapos
(A)
K Berek
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K Havasi
(K)
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(N)
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(A)
S Patil
(S)
E Martanto
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T M Aprami
(TM)
A Purnomowati
(A)
C J Cool
(CJ)
M Hasan
(M)
R Akbar
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S Hidayat
(S)
T I Dewi
(TI)
W Permadi
(W)
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M M Ansari-Ramandi
(MM)
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(N)
A Tabib
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F Kashfi
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S Rezaei
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(H)
A Al-Hussein
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G Al-Saedi
(G)
G Mahmood
(G)
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L Al-Yousuf
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M AlBayati
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(S)
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(T)
Z Dakhil
(Z)
P Thornton
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J Donnelly
(J)
M Bowen
(M)
A Blatt
(A)
G Elbaz-Greener
(G)
A Shotan
(A)
S Yalonetsky
(S)
S Goland
(S)
M Biener
(M)
G Egidy Assenza
(G)
M Bonvicini
(M)
A Donti
(A)
A Bulgarelli
(A)
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R Crepaz
(R)
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M Metra
(M)
R Orabona
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L Ait Ali
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P Festa
(P)
V Fesslova
(V)
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(C)
M Calcagnino
(M)
F Lombardi
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A M Colli
(AM)
M W Ossola
(MW)
C Gobbi
(C)
E Gherbesi
(E)
L Tondi
(L)
M Schiavone
(M)
M Squillace
(M)
M G Carmina
(MG)
A Maina
(A)
C Macchi
(C)
E Gollo
(E)
F M Comoglio
(FM)
N Montali
(N)
P Re
(P)
R Bordese
(R)
T Todros
(T)
V Donvito
(V)
W Grosso Marra
(W)
G Sinagra
(G)
B D'Agata Mottolese
(B)
M Bobbo
(M)
V Gesuete
(V)
S Rakar
(S)
F Ramani
(F)
K Niwa
(K)
D Mekebekova
(D)
A Mussagaliyeva
(A)
T Lee
(T)
E Mirrakhimov
(E)
S Abilova
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E Bektasheva
(E)
K Neronova
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O Lunegova
(O)
R Žaliūnas
(R)
R Jonkaitienė
(R)
J Petrauskaitė
(J)
A Lauce
(A)
D Vicius
(D)
L Jancauskaite
(L)
L Lauciuviene
(L)
L Gumbiene
(L)
S Lankutiene
(S)
M Laukyte Glaveckaite
(ML)
S Solovjova
(S)
V Rudiene
(V)
K H Chee
(KH)
Yim C C-W
(Y)
H L Ang
(HL)
R Kuppusamy
(R)
T Watson
(T)
M Caruana
(M)
M-E Estensen
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M G A Mahmood Kayani
(MGA)
R Munir
(R)
B Sobkowicz
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J Przepiesc
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A Lesniak-Sobelga
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L Tomkiewicz-Pajak
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(M)
M Olszowska
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M Lelonek
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U Faflik
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A Cichocka-Radwan
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K Plaskota
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O Trojnarska
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L de Sousa
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V Petrescu
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R Jurcut
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C Ginghina
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I Mircea Coman
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M Musteata
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O Osipova
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T Golivets
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I Khamnagadaev
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O Golovchenko
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A Nagibina
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I Ropatko
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I R Gaisin
(IR)
L Valeryevna Shilina
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N Sharashkina
(N)
E Shlyakhto
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O Irtyuga
(O)
O Moiseeva
(O)
E Karelkina
(E)
I Zazerskaya
(I)
A Kozlenok
(A)
I Sukhova
(I)
L Jovovic
(L)
K Prokšelj
(K)
M Koželj
(M)
A O Askar
(AO)
A A Abdilaahi
(AA)
M H Mohamed
(MH)
K Sliwa
(K)
P Manga
(P)
L Galian-Gay
(L)
P Tornos
(P)
M T Subirana
(MT)
M T Subirana
(MT)
N Murga
(N)
J M Oliver
(JM)
B Garcia-Aranda Dominguez
(B)
I Hernandez Gonzalez
(I)
P Escribano Subias
(P)
A Elbushi
(A)
A Suliman
(A)
K Jazzar
(K)
M Murtada
(M)
N Ahamed
(N)
M Dellborg
(M)
E Furenas
(E)
M Jinesjo
(M)
K Skoglund
(K)
P Eriksson
(P)
T Gilljam
(T)
U Thilen
(U)
D Tobler
(D)
K Wustmann
(K)
F Schwitz
(F)
M Schwerzmann
(M)
T Rutz
(T)
J Bouchardy
(J)
M Greutmann
(M)
B M Santos Lopes
(BM)
L Meier
(L)
M Arrigo
(M)
K de Boer
(K)
T Konings
(T)
E Wajon
(E)
L J Wagenaar
(LJ)
P Polak
(P)
E Pg Pieper
(EP)
J Roos-Hesselink
(J)
L Baris
(L)
I van Hagen
(I)
H Duvekot
(H)
J M J Cornette
(JMJ)
C De Groot
(C)
C van Oppen
(C)
L Sarac
(L)
O Batukan Esen
(O)
S Catirli Enar
(S)
C Mondo
(C)
P Ingabire
(P)
B Nalwanga
(B)
T Semu
(T)
B T Salih
(BT)
W A R Almahmeed
(WAR)
S Wani
(S)
F S Mohamed Farook
(FS)
F Gerges Al Ain
(FG)
F Gerges
(F)
A M Komaranchath
(AM)
F Al Bakshi
(F)
A Al Mulla
(A)
A H Yusufali
(AH)
E I Al Hatou
(EI)
N Bazargani
(N)
F Hussain
(F)
L Hudsmith
(L)
P Thompson
(P)
S Thorne
(S)
S Bowater
(S)
A Money-Kyrle
(A)
P Clifford
(P)
P Ramrakha
(P)
S Firoozan
(S)
J Chaplin
(J)
N Bowers
(N)
D Adamson
(D)
F Schroeder
(F)
R Wendler
(R)
P Nihoyannopoulos
(P)
R Hall
(R)
L Freeman
(L)
G Veldtman
(G)
J Kerr
(J)
L Tellett
(L)
N Scott
(N)
A B Bhatt
(AB)
D DeFaria Yeh
(D)
M A Youniss
(MA)
M Wood
(M)
A A Sarma
(AA)
S Tsiaras
(S)
A Stefanescu
(A)
J M Duran
(JM)
L Stone
(L)
D S Majdalany
(DS)
J Chapa
(J)
K Chintala
(K)
P Gupta
(P)
J Botti
(J)
J Ting
(J)
W R Davidson
(WR)
G Wells
(G)
D Sparks
(D)
V Paruchuri
(V)
K Marzo
(K)
D Patel
(D)
W Wagner
(W)
S N Ahanya
(SN)
L Colicchia
(L)
T Jentink
(T)
K Han
(K)
M Loichinger
(M)
M Parker
(M)
W Wagner
(W)
C Longtin
(C)
A Yetman
(A)
K Erickson
(K)
S Tsai
(S)
B Fletcher
(B)
S Warta
(S)
C Cohen
(C)
C Lindblade
(C)
R Puntel
(R)
K Nagaran
(K)
N Croft
(N)
M Gurvitz
(M)
C Otto
(C)
C Talluto
(C)
D Murphy
(D)
M G Perlroth
(MG)
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Am Coll Cardiol. 2010 Jun 22;55(25):2789-800
pubmed: 20579534
Circ Cardiovasc Genet. 2017 Jun;10(3):
pubmed: 28600386
Eur Heart J. 2011 Feb;32(4):443-9
pubmed: 21147864
J Vasc Surg. 1995 Mar;21(3):515-20
pubmed: 7877236
Can J Cardiol. 2016 Jan;32(1):78-85
pubmed: 26604124
Int J Cardiol. 2009 Aug 14;136(2):156-61
pubmed: 18632169
Genet Med. 2019 Sep;21(9):2015-2024
pubmed: 30739908
Best Pract Res Clin Obstet Gynaecol. 2014 May;28(4):537-50
pubmed: 24726851
J Am Heart Assoc. 2016 Aug 11;5(8):
pubmed: 27515814
Genet Med. 2014 Dec;16(12):874-80
pubmed: 24922461
Eur Heart J. 2018 Sep 7;39(34):3165-3241
pubmed: 30165544
PLoS One. 2017 Jul 14;12(7):e0181166
pubmed: 28708846
Cardiol Clin. 2012 Aug;30(3):317-29
pubmed: 22813360
Ultrasound Obstet Gynecol. 2018 Jul;52(1):44-51
pubmed: 29696704
Eur J Obstet Gynecol Reprod Biol. 2018 Nov;230:68-72
pubmed: 30243228
Congenit Heart Dis. 2018 Mar;13(2):203-209
pubmed: 29063738
BJOG. 2018 Mar;125(4):487-493
pubmed: 28294527
Eur Heart J. 2011 Dec;32(24):3147-97
pubmed: 21873418
Heart. 2019 Nov;105(22):1725-1731
pubmed: 31129614
Annu Rev Physiol. 2019 Feb 10;81:89-111
pubmed: 30742784
Eur Heart J. 2013 Mar;34(9):657-65
pubmed: 22968232
Eur Heart J. 2019 Dec 14;40(47):3848-3855
pubmed: 30907409
J Am Coll Cardiol. 2015 Jan 27;65(3):246-54
pubmed: 25614422