THE EFFECTS OF PREGNANCY IN SUBJECTS WITH REPAIRED TETRALOGY OF FALLOT.

adult congenital heart disease cardiac magnetic resonance cardio-obstetrics pregnancy tetralogy of Fallot

Journal

American heart journal
ISSN: 1097-6744
Titre abrégé: Am Heart J
Pays: United States
ID NLM: 0370465

Informations de publication

Date de publication:
25 Apr 2024
Historique:
received: 28 12 2023
revised: 10 04 2024
accepted: 23 04 2024
medline: 28 4 2024
pubmed: 28 4 2024
entrez: 27 4 2024
Statut: aheadofprint

Résumé

Previous reports reveal inconsistent findings of right ventricular (RV) changes following pregnancy in subjects with repaired tetralogy of Fallot (rTOF). A two-center, retrospective cohort study which included women with rTOF who completed pregnancy that were matched to nulliparous women with rTOF by age at the time of baseline cardiac magnetic resonance (CMR), RV ejection fraction (RVEF), and indexed RV end-diastolic volume (RVEDVi). Pre-pregnancy and postpartum cardiac magnetic resonance (CMR) were analyzed and compared to sequential CMR of nulliparous subjects with rTOF. Thirty-six women with rTOF who completed pregnancy were matched to 72 nulliparous women with rTOF. Over a mean period of 3.1 years for the pregnancy group and 2.7 years for the comparison group, there was no significant change in the RVEDVi, RVEF, RV mass, pulmonary regurgitation severity, left ventricular (LV) volumes, LV ejection fraction (LVEF), or LV mass when comparing the baseline CMR and the follow-up CMR in either of the groups. There was a slight increase in RV indexed end-systolic volume (RVESVi) when comparing the baseline CMR and the follow-up CMR in the pregnancy group (68.93, SD 23.34 ml/m Most ventricular remodeling parameters measured by CMR did not significantly change in subjects with rTOF who completed pregnancy or in nulliparous subjects with rTOF. In the pregnancy group, RVESVi is larger in those individuals who have undergone pregnancy without a significant change in ventricular function. These patients should be followed longitudinally to determine the long-term ventricular and clinical effects of pregnancy.

Sections du résumé

BACKGROUND BACKGROUND
Previous reports reveal inconsistent findings of right ventricular (RV) changes following pregnancy in subjects with repaired tetralogy of Fallot (rTOF).
METHODS METHODS
A two-center, retrospective cohort study which included women with rTOF who completed pregnancy that were matched to nulliparous women with rTOF by age at the time of baseline cardiac magnetic resonance (CMR), RV ejection fraction (RVEF), and indexed RV end-diastolic volume (RVEDVi). Pre-pregnancy and postpartum cardiac magnetic resonance (CMR) were analyzed and compared to sequential CMR of nulliparous subjects with rTOF.
RESULTS RESULTS
Thirty-six women with rTOF who completed pregnancy were matched to 72 nulliparous women with rTOF. Over a mean period of 3.1 years for the pregnancy group and 2.7 years for the comparison group, there was no significant change in the RVEDVi, RVEF, RV mass, pulmonary regurgitation severity, left ventricular (LV) volumes, LV ejection fraction (LVEF), or LV mass when comparing the baseline CMR and the follow-up CMR in either of the groups. There was a slight increase in RV indexed end-systolic volume (RVESVi) when comparing the baseline CMR and the follow-up CMR in the pregnancy group (68.93, SD 23.34 ml/m
CONCLUSIONS CONCLUSIONS
Most ventricular remodeling parameters measured by CMR did not significantly change in subjects with rTOF who completed pregnancy or in nulliparous subjects with rTOF. In the pregnancy group, RVESVi is larger in those individuals who have undergone pregnancy without a significant change in ventricular function. These patients should be followed longitudinally to determine the long-term ventricular and clinical effects of pregnancy.

Identifiants

DOI: 10.1016/j.ahj.2024.04.015 PMID: 38677503
pubmed: 38677503
pii: S0002-8703(24)00102-9
doi: 10.1016/j.ahj.2024.04.015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Valeria E Duarte (VE)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: vduarte@houstonmethodist.org.

Kenichiro Yamamura (K)

University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Katherine E Economy (KE)

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Julia A Graf (JA)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Minmin Lu (M)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Gabriele Egidy Assenza (GE)

Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Gauri R Karur (GR)

Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.

Anais Marenco (A)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Ayako Ishikita (A)

University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Madeline E Duncan (ME)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Tal Geva (T)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

Rachel M Wald (RM)

University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

Anne Marie Valente (AM)

Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Boston, MA, USA.

Classifications MeSH