| Short and long-term outcome of pregnant women with preexisting dilated cardiomypathy: an NTproBNP and echocardiography-guided study. | |
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MedLine Citation:
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PMID: 21090518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Alex Blatt; Ran Svirski; Gil Morawsky; Nir Uriel; Ortal Neeman; Dan Sherman; Zvi Vered; Ricardo Krakover |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Israel Medical Association journal : IMAJ Volume: 12 ISSN: 1565-1088 ISO Abbreviation: Isr. Med. Assoc. J. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100930740 Medline TA: Isr Med Assoc J Country: Israel |
Other Details:
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Languages: eng Pagination: 613-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel. alexb@asaf.health.gov.il |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain |
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