1. Pregnancy Outcomes in Women With Rheumatic Mitral Valve Disease Results From the Registry of Pregnancy and Cardiac Disease
- Author
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Van Hagen I. M., Thorne S. A., Taha N., Youssef G., Elnagar A., Gabriel H., ElRakshy Y., Iung B., Johnson M. R., Hall R., Roos-Hesselink J. W., Ferrari R., Maggioni A. P., Marelli A., Webb G., Kaemmerer H., Popelova J., Sliwa K., Tavazzi L., Anthony Parsonage W., Stein J., Elkayam U., Thilen U., Budts W., Ruys T., Ferreira T., Missiamenou V., Folkesson Lefrancq E., Aquieri A., Ruda Vega H., Vazquez Blanco M., Lust K., Fagermo N., Donhauser E., Gasimov Z., Jahangirov T., Hasanova I., De Backer J., Demulier L., de Hosson M., Beckx M., Moissens M., Kovacevic-Preradovic T., Kozic M., Lovric M., Vilas Freire C., Chilingirova N., Kratunkov P., Montesclaros A. R., Beaubien E., Gordon E., Walter L., Lindsay C., Wahab N., Vavera Z., El Nagar A., Ebaid H. H., A. El Sayed Makled W., Dardier A., Shabaan M., Eltamawey K., Gamal Abd-El Aziz M., Saad A., Aboleineen W., Ashour Z., Sorour K., A. Meguid Mahdy M., Iserin L., Ladouceur M., Cohen S., Maisuradze D., Mebus S., Gembruch U., Hammerstingl C., Merz W. M., Wald C., Hellige A., Baumgartner H., Schmidt R., Motz R., Olsson A., Berger F., Nagdyman N., Frogoudaki A., Anastasiou-Nana M., Temesvari A., Kohalmi D., Balint H., Merkely B., Liptai C., Bowen M., Cullen M., Thornton P., Husarova V., Blatt A., Elbaz-Greener G., Moravsky G., Vered Z., Vazan Fuhrmann A., Shotan A., Goland S., Festa P., Ait Ali L., Sinagra G., Puggia I., D'Agata Mottolese B., Carmina M. G., Romeo C., Crepaz R., Fesslova V., Azzarelli A., Baldi D., Bovenzi F., Donvito V., Vasario E., Todros T., Niwa K., Mussagaliyeva A., Mekebekova D., Sharipova S., Zaliunas R., Jonkaitiene R., Petrauskaite J., Gumbiene L., Jovanova S., Cassar A., Caruana M., Karamermer Y., Cornette J. M. J., van Dijk A., Bellersen L., Duijnhouwer T., De Groot C., PG Pieper E., van Oppen C., Polak P., Wajon E., Wagenaar L., Estensen M., Lesniak-Sobelga A., Podolec P., Wisniowska-Smialek S., Trybuch A., Hoffman P., Cichocka-Radwan A., Lelonek M., Sobczak S., Faflik U., Tomaszuk-Kazberuk A., Przepiesc J., Gil M., Plaskota K., Trojnarska O., Guerra N., de Sousa L., Petrescu V., Ginghina C., Jurcut R., Mircea Coman I., Ravilevich Gaisin I., Valeryevna Shilina L., Sharashkina N., Tkacheva O., Ivanov D., Irtyuga O., Jovovic L., Prokselj K., Kozelj M., Elliott C., Galian-Gay L., Pijuan-Domenech A., Subirana-Domenech M. T., Tornos P., Murga N., M. Oliver J., Escribano-Subias P., J. Ruiz-Cano M., Delgado-Jimenez J., Furenas E., Dellborg M., Schwerzmann M., Bouchardy J., Rutz T., Tobler D., Sarac L., Batukan Esen O., Catirli Enar S., Al Mulla A., Bazargani N., Al Hatou E., Farook F., Almahmeed W., Cardiology, Van Hagen, I. M., Thorne, S. A., Taha, N., Youssef, G., Elnagar, A., Gabriel, H., Elrakshy, Y., Iung, B., Johnson, M. R., Hall, R., Roos-Hesselink, J. W., Ferrari, R., Maggioni, A. P., Marelli, A., Webb, G., Kaemmerer, H., Popelova, J., Sliwa, K., Tavazzi, L., Anthony Parsonage, W., Stein, J., Elkayam, U., Thilen, U., Budts, W., Ruys, T., Ferreira, T., Missiamenou, V., Folkesson Lefrancq, E., Aquieri, A., Ruda Vega, H., Vazquez Blanco, M., Lust, K., Fagermo, N., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Vilas Freire, C., Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., A. El Sayed Makled, W., Dardier, A., Shabaan, M., Eltamawey, K., Gamal Abd-El Aziz, M., Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., A. Meguid Mahdy, M., Iserin, L., Ladouceur, M., Cohen, S., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Hellige, A., Baumgartner, H., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Vazan Fuhrmann, A., Shotan, A., Goland, S., Festa, P., Ait Ali, L., Sinagra, G., Puggia, I., D'Agata Mottolese, B., Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M. J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., PG Pieper, E., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Mircea Coman, I., Ravilevich Gaisin, I., Valeryevna Shilina, L., Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., M. Oliver, J., Escribano-Subias, P., J. Ruiz-Cano, M., Delgado-Jimenez, J., Furenas, E., Dellborg, M., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Batukan Esen, O., Catirli Enar, S., Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., and Almahmeed, W.
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Registrie ,Cardiac & Cardiovascular Systems ,VALVULAR HEART-DISEASE ,heart disease ,Disease ,030204 cardiovascular system & hematology ,Cardiovascular ,0302 clinical medicine ,Pregnancy ,Models ,Mitral valve ,Rheumatic heart disease ,Valvular heart disease ,Women ,Women and minorities ,Adult ,Female ,Humans ,Prospective Studies ,Mitral Valve Insufficiency ,Models, Cardiovascular ,Pregnancy Complications, Cardiovascular ,Pregnancy Outcome ,Registries ,Rheumatic Heart Disease ,Prospective cohort study ,1102 Cardiorespiratory Medicine and Haematology ,030219 obstetrics & reproductive medicine ,valvular heart disease ,ROPAC Investigators and EORP Team ,SOUTH-AFRICA ,EUROPEAN-SOCIETY ,OUTPUT ,medicine.anatomical_structure ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Women and minoritie ,Human ,medicine.medical_specialty ,DEATHS ,STENOSIS ,1117 Public Health and Health Services ,03 medical and health sciences ,Physiology (medical) ,Internal medicine ,MANAGEMENT ,medicine ,Pregnancy outcomes ,Science & Technology ,business.industry ,1103 Clinical Sciences ,medicine.disease ,Pregnancy Complications ,Prospective Studie ,Stenosis ,Peripheral Vascular Disease ,Cardiovascular System & Hematology ,Cardiovascular System & Cardiology ,rheumatic ,business - Abstract
Background: Cardiac disease is 1 of the major causes of maternal mortality. We studied pregnancy outcomes in women with rheumatic mitral valve disease. Methods: The Registry of Pregnancy and Cardiac Disease is an international prospective registry, and consecutive pregnant women with cardiac disease were included. Pregnancy outcomes in all women with rheumatic mitral valve disease and no prepregnancy valve replacement is described in the present study (n=390). A maternal cardiac event was defined as cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, and hospitalization for other cardiac reasons or cardiac intervention. Associations between patient characteristics and cardiac outcomes were checked in a 3-level model (patient–center–country). Results: Most patients came from emerging countries (75%). Mitral stenosis (MS) with or without mitral regurgitation (MR) was present in 273 women, isolated MR in 117. The degree of MS was mild in 20.9%, moderate in 39.2%, severe in 19.8%, and severity not classified in the remainder. Maternal death during pregnancy occurred in 1 patient with severe MS. Hospital admission occurred in 23.1% of the women with MS, and the main reason was heart failure (mild MS 15.8%, moderate 23.4%, severe 48.1%; P 1 was an independent predictor of maternal cardiac events. Follow-up at 6 months postpartum was available for 53%, and 3 more patients died (1 with severe MS, 1 with moderate MS, 1 with moderate to severe MR). Conclusions: Although mortality was only 1.9% during pregnancy, ≈50% of the patients with severe rheumatic MS and 23% of those with significant MR developed heart failure during pregnancy. Prepregnancy counseling and considering mitral valve interventions in selected patients are important to prevent these complications.
- Published
- 2018