Risk associated with pregnancy in hypertrophic cardiomyopathy
Risk associated with pregnancy in hypertrophic cardiomyopathy
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DOI：
10.1016/s0735-1097(02)02495-6
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发表时间：
2002-11-20
影响因子：
24
通讯作者：
Spirito, P
中科院分区：
文献类型：
--
作者：
Autore, C;Conte, MR;Spirito, P
我们试图评估孕妇与肥厚型心肌病（HCM）的死亡率和发病率。背景与妊娠相关的风险，在妇女与HCM是一个重要的和日益频繁的临床问题，系统的数据是不可用的，很大程度上的不确定性，stressed.METHODS产妇死亡率在91个连续评估的家庭与HCM相比，在一般人群中报道。研究队列包括100名患有HCM的妇女，其中有一次或多次活产，共199例活产。在妊娠期间与HCM相关的发病率在40名妇女中进行了调查，这些妇女在妊娠后的5个月内进行了评估。产妇死亡率为10/1，000活产（95%置信区间[CI] 1.1至36.2/1，000），超过了意大利一般人群的预期死亡率（相对风险17.1，95% CI 2.0至61.8）。在40例妊娠期评估的患者中，28例既往无症状患者中有1例（4%）和12例有症状患者中有5例（42%）在妊娠期间进展为功能III或IV级（p < 0.01）。一名患者有房颤和晕厥，他们都已经经历了类似的和经常性的事件之前，他们pregnancy.CONCLUSIONS产妇死亡率增加与HCM患者相比，一般人群。然而，产妇绝对死亡率很低，而且似乎主要局限于风险特别高的妇女。在良好的临床表现的情况下，症状进展、房颤和晕厥在妊娠期间也不常见。(C)2002年，美国心脏病学会基金会。
OBJECTIVES We sought to assess mortality and morbidity in pregnant women with hypertrophic cardiomyopathy (HCM).BACKGROUND The risk associated with pregnancy, in women with HCM is an important and increasingly frequent clinical issue for which systematic data are not available and a large measure of uncertainty, persists.METHODS Maternal mortality in 91 consecutively evaluated families with HCM was compared with that reported in the general population. The study cohort included 100 women with HCM with one or more live births, for a total of 199 live births. Morbidity related to HCM during pregnancy was investigated in 40 women evaluated within five pears of their pregnancy.RESULTS Two pregnancy-related deaths occurred, both in patients at a particularly high risk. The maternal mortality rate was 10 per 1,000 live births (95% confidence interval [CI] 1.1 to 36.2/1,000) and was in excess of the expected mortality in the general Italian population (relative risk 17.1, 95% CI 2.0 to 61.8). In the 40 patients evaluated within close proximity of their pregnancy, 1 (4%) of the 28 who were previously asymptomatic and 5 (42%) of the 12 with symptoms progressed to functional class III or IV during pregnancy (p < 0.01). One patient had atrial fibrillation and one had syncope, both of whom had already experienced similar and recurrent events before their pregnancy.CONCLUSIONS Maternal mortality is increased in patients with HCM compared with the general population. However, absolute maternal mortality is low and appears to be principally confined in women at a particularly high risk. In the presence of a favorable clinical profile, the progression of symptoms, atrial fibrillation, and syncope are also uncommon during pregnancy. (C) 2002 by the American College of Cardiology Foundation.