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Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy

Background: In the last few years, a phenotypic variant of arrhythmogenic cardiomyopathy (ACM) labeled arrhythmogenic left ventricular cardiomyopathy (ALVC) has been defined and researched. This type of cardiomyopathy is characterized by a predominant left ventricular (LV) involvement with no or min...

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Autores principales: Bariani, Riccardo, Bueno Marinas, Maria, Rigato, Ilaria, Veronese, Paola, Celeghin, Rudy, Cipriani, Alberto, Cason, Marco, Pergola, Valeria, Mattesi, Giulia, Deola, Petra, Zorzi, Alessandro, Limongelli, Giuseppe, Iliceto, Sabino, Corrado, Domenico, Basso, Cristina, Pilichou, Kalliopi, Bauce, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698035/
https://www.ncbi.nlm.nih.gov/pubmed/36431211
http://dx.doi.org/10.3390/jcm11226735
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author Bariani, Riccardo
Bueno Marinas, Maria
Rigato, Ilaria
Veronese, Paola
Celeghin, Rudy
Cipriani, Alberto
Cason, Marco
Pergola, Valeria
Mattesi, Giulia
Deola, Petra
Zorzi, Alessandro
Limongelli, Giuseppe
Iliceto, Sabino
Corrado, Domenico
Basso, Cristina
Pilichou, Kalliopi
Bauce, Barbara
author_facet Bariani, Riccardo
Bueno Marinas, Maria
Rigato, Ilaria
Veronese, Paola
Celeghin, Rudy
Cipriani, Alberto
Cason, Marco
Pergola, Valeria
Mattesi, Giulia
Deola, Petra
Zorzi, Alessandro
Limongelli, Giuseppe
Iliceto, Sabino
Corrado, Domenico
Basso, Cristina
Pilichou, Kalliopi
Bauce, Barbara
author_sort Bariani, Riccardo
collection PubMed
description Background: In the last few years, a phenotypic variant of arrhythmogenic cardiomyopathy (ACM) labeled arrhythmogenic left ventricular cardiomyopathy (ALVC) has been defined and researched. This type of cardiomyopathy is characterized by a predominant left ventricular (LV) involvement with no or minor right ventricular (RV) abnormalities. Data on the specific risk and management of pregnancy in women affected by ALVC are, thus far, not available. We have sought to characterize pregnancy course and outcomes in women affected by ALVC through the evaluation of a series of childbearing patients. Methods: A series of consecutive female ALVC patients were analyzed in a cross-sectional, retrospective study. Study protocol included 12-lead ECG assessments, 24-h Holter ECG evaluations, 2D-echocardiogram tests, cardiac magnetic resonance assessments, and genetic analysis. Furthermore, the long-term disease course of childbearing patients was compared with a group of nulliparous ALVC women. Results: A total of 35 patients (mean age 45 ± 9 years, 51% probands) were analyzed. Sixteen women (46%) reported a pregnancy, for a total of 27 singleton viable pregnancies (mean age at first childbirth 30 ± 9 years). Before pregnancy, all patients were in the NYHA class I and none of the patients reported a previous heart failure (HF) episode. No significant differences were found between childbearing and nulliparous women regarding ECG features, LV dimensions, function, and extent of late enhancement. Overall, 7 patients (20%, 4 belonging to the childbearing group) experienced a sustained ventricular tachycardia and 2 (6%)—one for each group—showed heart failure (HF) episodes. The analysis of arrhythmia-free survival patients did not show significant differences between childbearing and nulliparous women. Conclusions: In a cohort of ALVC patients without previous episodes of HF, pregnancy was well tolerated, with no significant influence on disease progression and degree of electrical instability. Further studies on a larger cohort of women with different degrees of disease extent and genetic background are needed in order to achieve a more comprehensive knowledge regarding the outcome of pregnancy in ALVC patients.
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spelling pubmed-96980352022-11-26 Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy Bariani, Riccardo Bueno Marinas, Maria Rigato, Ilaria Veronese, Paola Celeghin, Rudy Cipriani, Alberto Cason, Marco Pergola, Valeria Mattesi, Giulia Deola, Petra Zorzi, Alessandro Limongelli, Giuseppe Iliceto, Sabino Corrado, Domenico Basso, Cristina Pilichou, Kalliopi Bauce, Barbara J Clin Med Article Background: In the last few years, a phenotypic variant of arrhythmogenic cardiomyopathy (ACM) labeled arrhythmogenic left ventricular cardiomyopathy (ALVC) has been defined and researched. This type of cardiomyopathy is characterized by a predominant left ventricular (LV) involvement with no or minor right ventricular (RV) abnormalities. Data on the specific risk and management of pregnancy in women affected by ALVC are, thus far, not available. We have sought to characterize pregnancy course and outcomes in women affected by ALVC through the evaluation of a series of childbearing patients. Methods: A series of consecutive female ALVC patients were analyzed in a cross-sectional, retrospective study. Study protocol included 12-lead ECG assessments, 24-h Holter ECG evaluations, 2D-echocardiogram tests, cardiac magnetic resonance assessments, and genetic analysis. Furthermore, the long-term disease course of childbearing patients was compared with a group of nulliparous ALVC women. Results: A total of 35 patients (mean age 45 ± 9 years, 51% probands) were analyzed. Sixteen women (46%) reported a pregnancy, for a total of 27 singleton viable pregnancies (mean age at first childbirth 30 ± 9 years). Before pregnancy, all patients were in the NYHA class I and none of the patients reported a previous heart failure (HF) episode. No significant differences were found between childbearing and nulliparous women regarding ECG features, LV dimensions, function, and extent of late enhancement. Overall, 7 patients (20%, 4 belonging to the childbearing group) experienced a sustained ventricular tachycardia and 2 (6%)—one for each group—showed heart failure (HF) episodes. The analysis of arrhythmia-free survival patients did not show significant differences between childbearing and nulliparous women. Conclusions: In a cohort of ALVC patients without previous episodes of HF, pregnancy was well tolerated, with no significant influence on disease progression and degree of electrical instability. Further studies on a larger cohort of women with different degrees of disease extent and genetic background are needed in order to achieve a more comprehensive knowledge regarding the outcome of pregnancy in ALVC patients. MDPI 2022-11-14 /pmc/articles/PMC9698035/ /pubmed/36431211 http://dx.doi.org/10.3390/jcm11226735 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bariani, Riccardo
Bueno Marinas, Maria
Rigato, Ilaria
Veronese, Paola
Celeghin, Rudy
Cipriani, Alberto
Cason, Marco
Pergola, Valeria
Mattesi, Giulia
Deola, Petra
Zorzi, Alessandro
Limongelli, Giuseppe
Iliceto, Sabino
Corrado, Domenico
Basso, Cristina
Pilichou, Kalliopi
Bauce, Barbara
Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title_full Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title_fullStr Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title_full_unstemmed Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title_short Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy
title_sort pregnancy in women with arrhythmogenic left ventricular cardiomyopathy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698035/
https://www.ncbi.nlm.nih.gov/pubmed/36431211
http://dx.doi.org/10.3390/jcm11226735
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