Document Detail


Short and long-term outcome of pregnant women with preexisting dilated cardiomypathy: an NTproBNP and echocardiography-guided study.
MedLine Citation:
PMID:  21090518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known of the outcome of pregnant patients with previously diagnosed dilated cardiomyopathy. These patients are usually firmly advised against continuation of the pregnancy.
OBJECTIVES: To examine the usefulness of serial echocardiographic follow-up and plasma N-terminal pro-B type natriuretic peptide levels in the management of pregnant women with preexisting DCM.
METHODS: We prospectively enrolled pregnant women with DCM either known or diagnosed in the first trimester. Clinical examination and serial echocardiography studies were performed at baseline, at 30 weeks gestation, peripartum, and 3 and 18 months postpartum. Blinded NTproBNP levels were obtained at 30 weeks, at delivery and 3 months postpartum.
RESULTS: Between June 2005 and October 2006 we enrolled seven women who fulfilled the study criteria. Delivery and postpartum were complicated in 3 patients (42%): 2 with acute heart failure, which resolved conservatively, and 1 with major pulmonary embolism. The left ventricular ejection fraction was stable throughout the pregnancy (35% +/- 2.8 at baseline, 33% +/- 2.9 at 30 weeks) and postpartum (35% +/- 2.8 at 1 day, 34% +/- 3.1 at 90 days). Similar stable behavior was observed regarding left ventricular dimensions: LV end-systolic diameters 43.3 +/- 2.7 mm and LV end-diastolic diameters 57.3 +/- 3.3 mm at baseline compared with 44.1 +/- 3.1 mm and 58.7 +/- 3.1 mm postpartum, respectively. The NTproBNP levels rose significantly peripartum in all three patients with complications.
CONCLUSIONS: Serial NTproBNP levels, as compared to echocardiography, may be a better clinical tool in monitoring and management of pregnant women with preexisting DCM. An early rise in NTproBNP level appears to predict the occurrence of adverse events.
Authors:
Alex Blatt; Ran Svirski; Gil Morawsky; Nir Uriel; Ortal Neeman; Dan Sherman; Zvi Vered; Ricardo Krakover
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  12     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  613-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel. alexb@asaf.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Dilated / blood*,  therapy,  ultrasonography*
Female
Follow-Up Studies
Humans
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Peripartum Period
Pregnancy
Pregnancy Complications, Cardiovascular / blood*,  therapy,  ultrasonography*
Pregnancy Outcome
Prospective Studies
Stroke Volume
Treatment Outcome
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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