Pregnancy in women with dilated cardiomyopathy genetic variants.

Fecha de publicación: 18/04/2024 Fecha Ahead of Print: 17/04/2024

Autores de IIS La Fe

Rosa Merlos Madolell

Autor
Esther Zorio Grima

Autor

Participantes ajenos a IIS La Fe

Restrepo-Córdoba MA
Chmielewski P
Truszkowska G
Peña-Peña ML
Kubánek M
Krebsová A
Lopes LR
García-Ropero Á
Paldino A
Peters S
Jurcut R
Barriales-Villa R
Hazebroek M
Mogensen J
García-Pavía P

Grupos

Cardiopatías familiares, muerte súbita y mecanismos de enfermedad (CAFAMUSME)

Investigador Principal

Aitana Braza Boils

Abstract

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.

Datos de la publicación

ISSN/ISSNe:: 1885-5857, 1885-5857
Tipo:: Article
Páginas:: 2-9
DOI:: 10.1016/j.rec.2024.04.002
Factor de Impacto:: 0,385 SCImago ℠
Cuartil:: Q3 SCImago ℠

Documentos

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Métricas

Filiaciones

Restrepo-Córdoba MA:: Servicio de Cardiología, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, España

Servicio de Cardiología, Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, España
Chmielewski P:: Unit for Screening Studies in Inherited Cardiovascular Diseases National Institute of Cardiology, Varsovia, Polonia
Truszkowska G:: Department of Medical Biology, National Institute of Cardiology, Varsovia, Polonia
Peña-Peña ML:: Unidad de Imagen y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, España
Lopes LR:: Institute of Cardiovascular Science, University College London, Londres, Reino Unido

St. Bartholomew's Hospital, Barts Heart Centre, Barts NHS Trust, Londres, Reino Unido
García-Ropero Á:: Guy's and St. Thomas' NHS Foundation Trust, Londres, Reino Unido

Lewisham and Greenwich NHS Trust, Londres, Reino Unido
Merlo M:: Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) e Università degli Studi di Trieste, Trieste, Italia
Paldino A:: Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI) e Università degli Studi di Trieste, Trieste, Italia
Peters S:: Department of Cardiology, Royal Melbourne Hospital, Victoria, Australia
Barriales-Villa R:: Unidad de Cardiopatías Familiares, Servicio de Cardiología, Complexo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España
Zorio E:: Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España

Instituto de Investigación. Unidad de Cardiopatías Familiares, Muerte Súbita y Mecanismos de Enfermedad (CaFaMuSMe), Instituto de Investigación Sanitaria La Fe, Servicio de Cardiología, Hospital La Fe, Valencia, España

Unidad de Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, España
Hazebroek M:: Department of Cardiology, Maastricht University Medical Center, Maastricht, Países Bajos
Mogensen J:: Department of Cardiology, Aalborg University Hospital, Hobrovej r-bb, Dinamarca
García-Pavía P:: Servicio de Cardiología, Hospital Universitario Puerta de Hierro, IDIPHISA, Madrid, España

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España

Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, España

Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, España

Keywords

Dilated Cardiomyopathy; Embarazo; Heart Failure; Insuficiencia cardiaca; Miocardiopatía dilatada; Mutation; Pregnancy; Variante genética

Proyectos asociados

RED INVESTIGACION (RECAVA)

RD06/0014/0004 . INSTITUTO DE SALUD CARLOS III; FUNDACION PARA LA INV BIOMEDICA- HOSPITAL GREGORIO MARAÑON; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2006