Pregnancy in women with hypertrophic cardiomyopathy: Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)

ROPAC investigators

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

Original languageEnglish (US)
Pages (from-to)2683-2690
Number of pages8
JournalEuropean heart journal
Volume38
Issue number35
DOIs
StatePublished - Jan 1 2017

Fingerprint

Hypertrophic Cardiomyopathy
Registries
Heart Diseases
Pregnancy
Pregnant Women
Heart Failure
Cardiovascular Pregnancy Complications
Cardiac Arrhythmias
Prenatal Care
Maternal Mortality
Pregnancy Outcome
Atrial Fibrillation
Postpartum Period
Obstetrics
Counseling
Emergencies
Mothers
Parturition

Keywords

  • Cardiomyopathy
  • Hypertrophic
  • Outcome
  • Pregnancy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Pregnancy in women with hypertrophic cardiomyopathy : Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC). / ROPAC investigators.

In: European heart journal, Vol. 38, No. 35, 01.01.2017, p. 2683-2690.

Research output: Contribution to journalArticle

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title = "Pregnancy in women with hypertrophic cardiomyopathy: Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)",
abstract = "We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7{\%} obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23{\%}) patients at least one MACE occurred: 9 (15.0{\%}) HF and 7 (12{\%}) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0{\%}) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4{\%} vs. 0{\%}, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.",
keywords = "Cardiomyopathy, Hypertrophic, Outcome, Pregnancy",
author = "{ROPAC investigators} and S. Goland and {Van Hagen}, {I. M.} and G. Elbaz-Greener and U. Elkayam and A. Shotan and Merz, {W. M.} and Enar, {S. C.} and Gaisin, {I. R.} and Pieper, {P. G.} and Johnson, {M. R.} and R. Hall and A. Blatt and Roos-Hesselink, {J. W.} and Roberto Ferrari and Ariane Marelli and Harald Kaemmerer and Jana Popelova and Luigi Tavazzi and Joerg Stein and Ulf Thilen and Titia Ruys and Panos Vardas and Michel Komajda and Fausto Pinto and Angeles Alonso and David Wood and Nikolaos Maniadakis and Thierry Ferreira and G{\'e}rard Gracia and C{\'e}cile Laroche and Viviane Missiamenou and Charles Taylor and Mar{\`e}me Konte and Maryna Andarala and Emanuela Fiorucci and Lefrancq, {Elin Folkesson} and Myriam Gl{\'e}mot and McNeill, {Patti Ann} and Caroline Pommier and Myriam Lafay and A. Aquieri and Vega, {H. Ruda} and K. Lust and N. Fagermo and H. Gabriel and E. Donhauser and Z. Gasimov and T. Jahangirov and I. Hasanova and Emmanuelle Pare",
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T1 - Pregnancy in women with hypertrophic cardiomyopathy

T2 - Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)

AU - ROPAC investigators

AU - Goland, S.

AU - Van Hagen, I. M.

AU - Elbaz-Greener, G.

AU - Elkayam, U.

AU - Shotan, A.

AU - Merz, W. M.

AU - Enar, S. C.

AU - Gaisin, I. R.

AU - Pieper, P. G.

AU - Johnson, M. R.

AU - Hall, R.

AU - Blatt, A.

AU - Roos-Hesselink, J. W.

AU - Ferrari, Roberto

AU - Marelli, Ariane

AU - Kaemmerer, Harald

AU - Popelova, Jana

AU - Tavazzi, Luigi

AU - Stein, Joerg

AU - Thilen, Ulf

AU - Ruys, Titia

AU - Vardas, Panos

AU - Komajda, Michel

AU - Pinto, Fausto

AU - Alonso, Angeles

AU - Wood, David

AU - Maniadakis, Nikolaos

AU - Ferreira, Thierry

AU - Gracia, Gérard

AU - Laroche, Cécile

AU - Missiamenou, Viviane

AU - Taylor, Charles

AU - Konte, Marème

AU - Andarala, Maryna

AU - Fiorucci, Emanuela

AU - Lefrancq, Elin Folkesson

AU - Glémot, Myriam

AU - McNeill, Patti Ann

AU - Pommier, Caroline

AU - Lafay, Myriam

AU - Aquieri, A.

AU - Vega, H. Ruda

AU - Lust, K.

AU - Fagermo, N.

AU - Gabriel, H.

AU - Donhauser, E.

AU - Gasimov, Z.

AU - Jahangirov, T.

AU - Hasanova, I.

AU - Pare, Emmanuelle

PY - 2017/1/1

Y1 - 2017/1/1

N2 - We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

AB - We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

KW - Cardiomyopathy

KW - Hypertrophic

KW - Outcome

KW - Pregnancy

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U2 - 10.1093/eurheartj/ehx189

DO - 10.1093/eurheartj/ehx189

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C2 - 28934836

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VL - 38

SP - 2683

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JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

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