Effect of Pregnancy on Ventricular and Aortic Dimensions in Repaired Tetralogy of Fallot

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Roshni R. Patel¹  Mark R. Johnson¹  Matthew Cauldwell¹  Philip J. Steer¹  Gillian S. Smith²  Sarah Ghonim²  Michael A. Quail²  Dudley J. Pennell²  Anselm Uebing²  Michael A. Gatzoulis²  Ee Ling Heng²  Lorna Swan²  Wei Li²  Sonya V. Babu‐Narayan² 

[1] Academic Department of Obstetrics and Gynaecology, Imperial College London, United Kingdom;NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital Imperial College London, United Kingdom;

关键词: cardiovascular magnetic resonance imaging;    pregnancy;    tetralogy of Fallot;   

DOI  :  10.1161/JAHA.116.005420

来源: DOAJ

【 摘 要 】

BackgroundThe aim was to assess whether cardiovascular adaptation to pregnancy in women with repaired tetralogy of Fallot (TOF) adversely affects hemodynamic stability, in particular with respect to right ventricular (RV) dilatation, pulmonary regurgitation, or aortic root dilatation. Methods and ResultsThis was a retrospective cohort study of women with repaired TOF with paired cardiovascular magnetic resonance scans before and after their first pregnancy (baseline RV end systolic volume index 49 mL/m2 and RV end diastolic volume index 118 mL/m2) matched with a comparison group of nulliparous women with TOF. Cases were matched for age at baseline cardiovascular magnetic resonance scan, time between follow‐up of cardiovascular magnetic resonance scans, QRS duration, RV ejection fraction, and indexed RV end systolic and diastolic volume at baseline. Effect of pregnancy and time on parameters was assessed using mixed‐effects modelling. Nineteen women with repaired TOF who had completed their first pregnancy were identified and matched with 38 nulliparous women. We observed no deleterious effects of pregnancy on RV volumes, aortic dimensions, or exercise data. There was an effect of pregnancy observed in both left ventricular end diastolic volume and left ventricular stroke volume, consistent with a sustained small increase in left ventricular stroke volume attributed to pregnancy (53–55 mL/m2). ConclusionsWomen with repaired TOF and with mild‐to‐moderate RV dilatation considering pregnancy can be reassured that pregnancy is unlikely to cause deterioration in their cardiovascular status. We recommend that women are routinely assessed and followed up before and after pregnancy and that prepregnancy counseling is tailored to their individual clinical status.

【 授权许可】

Unknown