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The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot.
Int J Cardiol. 2013 Oct 03; 168(3):1847-52.IJ

Abstract

OBJECTIVES

The aim of this study was to better understand the quantitative volumetric changes associated with pregnancy in women with repaired tetralogy of Fallot (TOF), utilizing sequential cardiovascular magnetic resonance (CMR) imaging.

BACKGROUND

An increasing number of women with repaired TOF are reaching childbearing age. Limited echocardiographic studies suggest accelerated remodeling of the right ventricle (RV) in women with repaired TOF after pregnancy.

METHODS

Sequential CMRs from a group of women with repaired TOF who completed pregnancy and from a matched comparison group of nulliparous women with repaired TOF were evaluated. The two groups were matched according to baseline QRS duration, RV end-diastolic volume (EDV), age at CMR and time between CMRs. Longitudinal change of CMR parameters was compared between the groups.

RESULTS

Thirteen women (mean age 26.6 ± 7.4 years) with repaired TOF who completed pregnancy and 26 nulliparous women with repaired TOF (mean age 22.6 ± 8.0 years) were included in this analysis. The rate of increase of RV EDV in the pregnancy group was higher than the comparison group (4.1 ± 1.1 ml/m(2)/year vs. 1.6 ± 0.6 ml/m(2)/year, p=0.07). RV EF did not change significantly in either group. No definitive interaction between degree of pulmonary regurgitation and increase of RV EDV was identified.

CONCLUSIONS

Women with repaired TOF who have completed pregnancy appear to experience an accelerated rate of right ventricular remodeling, defined as an increase in end-diastolic volume; however RV systolic function does not deteriorate. Further investigations with a prospective study design, larger cohorts, and longer follow-up are needed to confirm these initial observations.

Authors+Show Affiliations

Department of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, "Sapienza Universita' di Roma" University, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23369674

Citation

Egidy Assenza, Gabriele, et al. "The Effects of Pregnancy On Right Ventricular Remodeling in Women With Repaired Tetralogy of Fallot." International Journal of Cardiology, vol. 168, no. 3, 2013, pp. 1847-52.
Egidy Assenza G, Cassater D, Landzberg M, et al. The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot. Int J Cardiol. 2013;168(3):1847-52.
Egidy Assenza, G., Cassater, D., Landzberg, M., Geva, T., Schreier, J., Graham, D., Volpe, M., Barker, N., Economy, K., & Valente, A. M. (2013). The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot. International Journal of Cardiology, 168(3), 1847-52. https://doi.org/10.1016/j.ijcard.2012.12.071
Egidy Assenza G, et al. The Effects of Pregnancy On Right Ventricular Remodeling in Women With Repaired Tetralogy of Fallot. Int J Cardiol. 2013 Oct 3;168(3):1847-52. PubMed PMID: 23369674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot. AU - Egidy Assenza,Gabriele, AU - Cassater,Daiana, AU - Landzberg,Michael, AU - Geva,Tal, AU - Schreier,Jenna, AU - Graham,Dionne, AU - Volpe,Massimo, AU - Barker,Nancy, AU - Economy,Katherine, AU - Valente,Anne Marie, Y1 - 2013/01/28/ PY - 2012/10/17/received PY - 2012/12/03/revised PY - 2012/12/25/accepted PY - 2013/2/2/entrez PY - 2013/2/2/pubmed PY - 2014/8/13/medline KW - BSA KW - CMR KW - Cardiovascular magnetic resonance KW - Congenital heart disease KW - EDV KW - EF KW - ESV KW - LV KW - PR KW - Pregnancy KW - RV KW - Right ventricle KW - TOF KW - Tetralogy of Fallot KW - body surface area KW - cardiac magnetic resonance KW - ejection fraction KW - end-diastolic volume KW - end-systolic volume KW - left ventricle KW - pulmonary regurgitation KW - right ventricle KW - tetralogy of Fallot SP - 1847 EP - 52 JF - International journal of cardiology JO - Int J Cardiol VL - 168 IS - 3 N2 - OBJECTIVES: The aim of this study was to better understand the quantitative volumetric changes associated with pregnancy in women with repaired tetralogy of Fallot (TOF), utilizing sequential cardiovascular magnetic resonance (CMR) imaging. BACKGROUND: An increasing number of women with repaired TOF are reaching childbearing age. Limited echocardiographic studies suggest accelerated remodeling of the right ventricle (RV) in women with repaired TOF after pregnancy. METHODS: Sequential CMRs from a group of women with repaired TOF who completed pregnancy and from a matched comparison group of nulliparous women with repaired TOF were evaluated. The two groups were matched according to baseline QRS duration, RV end-diastolic volume (EDV), age at CMR and time between CMRs. Longitudinal change of CMR parameters was compared between the groups. RESULTS: Thirteen women (mean age 26.6 ± 7.4 years) with repaired TOF who completed pregnancy and 26 nulliparous women with repaired TOF (mean age 22.6 ± 8.0 years) were included in this analysis. The rate of increase of RV EDV in the pregnancy group was higher than the comparison group (4.1 ± 1.1 ml/m(2)/year vs. 1.6 ± 0.6 ml/m(2)/year, p=0.07). RV EF did not change significantly in either group. No definitive interaction between degree of pulmonary regurgitation and increase of RV EDV was identified. CONCLUSIONS: Women with repaired TOF who have completed pregnancy appear to experience an accelerated rate of right ventricular remodeling, defined as an increase in end-diastolic volume; however RV systolic function does not deteriorate. Further investigations with a prospective study design, larger cohorts, and longer follow-up are needed to confirm these initial observations. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/23369674/The_effects_of_pregnancy_on_right_ventricular_remodeling_in_women_with_repaired_tetralogy_of_Fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(12)01700-7 DB - PRIME DP - Unbound Medicine ER -