Risk factors for maternal outcome in pregnancy complicated with dilated cardiomyopathy

• Published in: Journal of perinatology Vol. 32; no. 3; pp. 170 - 175
• Main Authors: Katsuragi, S, Omoto, A, Kamiya, C, Ueda, K, Sasaki, Y, Yamanaka, K, Neki, R, Yoshimatsu, J, Niwa, K, Ikeda, T
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.03.2012; Nature Publishing Group
• Subjects: 692/499; 692/699/75/74; 692/700/1750/1747; Abortion; Adult; Cardiac function; Cardiomyopathy; Cardiomyopathy, Dilated; Cardiomyopathy, Dilated - complications; Cardiomyopathy, Dilated - diagnostic imaging; Cardiovascular disease; Congestive heart failure; Demographic aspects; Diabetes; Dilated cardiomyopathy; Echocardiography; Female; Follow-Up Studies; Glucose; Gynecology; Heart failure; Heart Failure - etiology; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Hypertension; Medical prognosis; Medicine; Medicine & Public Health; Mortality; original-article; Patients; Pediatric Surgery; Pediatrics; Pregnancy; Pregnancy Complications, Cardiovascular - diagnostic imaging; Pregnancy, Complications of; Prognosis; Risk analysis; Risk Factors; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Young Adult; Japan; New York; United States > US; USA, New York; cardiac function; prognosis; pregnancy; dilated cardiomyopathy
• ISSN: 0743-8346; 1476-5543; 1476-5543
• DOI: 10.1038/jp.2011.81

Objective: The goal of the study was to determine risk factors for maternal cardiac failure in pregnancy complicated with dilated cardiomyopathy (DCM). Study Design: The subjects were 29 patients diagnosed with DCM before conception or during the first 7 months of pregnancy. DCM was defined as left ventricle end-diastolic dimension (LVDd)⩾48 mm and/or fractional shortening (%FS)⩽30% on echocardiography. Patients were followed until at least 1 year after delivery and were categorized into a poor prognosis group ( n =6; death or end stage heart failure of New York Heart Association (NYHA) class III and IV) and a good prognosis group ( n =23; all other cases). Result: DCM was initially diagnosed during pregnancy in 6/6 and 8/23 patients in the poor and good prognosis groups, respectively ( P <0.005). The %FS of the first test during pregnancy was 17.5±6.2 and 27.4±9.3% in the respective groups ( P <0.005). In eight abortion cases with %FS 15.2±3.1%, %FS, cardiac function and NYHA class were maintained until 20 months after abortion. There was no relationship between LVDd and maternal outcome. Conclusion: Onset during pregnancy and decreased %FS are risk factors for a poor maternal outcome in patients with DCM. Abortion prevents further deterioration of cardiac function in patients with a very low %FS.