14 results on '"Cornette P"'
Search Results
2. Pregnancy outcomes in women with a mitral valve prosthesis: A systematic review and meta-analysisCentral MessagePerspective
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Pepijn Grashuis, BSc, Shanti D.M. Khargi, BSc, Kevin Veen, BSc, PhD, Azzeddine el Osrouti, BSc, Shirin Bemelmans-Lalezari, MD, PhD, Jérôme M.J. Cornette, MD, PhD, Jolien W. Roos-Hesselink, MD, PhD, Johanna J.M. Takkenberg, MD, PhD, and Mostafa M. Mokhles, MD, PhD
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mitral valve replacement ,pregnancy ,bioprosthesis ,mechanical valve ,oral anticoagulant ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Surgery ,RD1-811 - Abstract
Objectives: To evaluate the ongoing debate concerning the choice of valve prosthesis for women requiring mitral valve replacement (MVR) and who wish to conceive. Bioprostheses are associated with risk of early structural valve deterioration. Mechanical prostheses require lifelong anticoagulation and carry maternal and fetal risks. Also, the optimal anticoagulation regimen during pregnancy after MVR remains unclear. Methods: A systematic review and meta-analysis was conducted of studies reporting on pregnancy after MVR. Valve- and anticoagulation-related maternal and fetal risks during pregnancy and 30 days’ postpartum were analyzed. Results: Fifteen studies reporting 722 pregnancies were included. In total, 87.2% of pregnant women had a mechanical prosthesis and 12.5% a bioprosthesis. Maternal mortality risk was 1.33% (95% confidence interval [CI], 0.69-2.56), any hemorrhage risk 6.90% (95% CI, 3.70-12.88). Valve thrombosis risk was 4.71% (95% CI, 3.06-7.26) in patients with mechanical prostheses. 3.23% (95% CI, 1.34-7.75) of the patients with bioprostheses experienced early structural valve deterioration. Of these, the mortality was 40%. Pregnancy loss risk was 29.29% (95% CI, 19.74-43.47) with mechanical prostheses versus 13.50% (95% CI, 4.31-42.30) for bioprostheses. Switching to heparin during the first trimester demonstrated a bleeding risk of 7.78% (95% CI, 3.71-16.31) versus 4.08% (95% CI, 1.17-14.28) for women on oral anticoagulants throughout pregnancy and a valve thrombosis risk of 6.99% (95% CI, 2.08-23.51) versus 2.89% (95% CI, 1.40-5.94). Administration of anticoagulant dosages greater than 5 mg resulted in a risk of fetal adverse events of 74.24% (95% CI, 56.11-98.23) versus 8.85% (95% CI, 2.70-28.99) in ≤5 mg. Conclusions: A bioprosthesis seems the best option for women of childbearing age who are interested in future pregnancy after MVR. If mechanical valve replacement is preferred, the favorable anticoagulation regimen is continuous low-dose oral anticoagulants. Shared decision-making remains priority when choosing a prosthetic valve for young women.
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- 2023
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3. Maternal, fetal, neonatal and breastmilk flecainide concentration during maternal therapy and lactation: a case report
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Johanna A. van der Zande, Jérôme M.J. Cornette, Jolien W. Roos-Hesselink, and Robert B. Flint
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Breastfeeding ,Flecainide ,Pregnancy ,Maternal medication use ,Neonatal blood sampling ,Pediatrics ,RJ1-570 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Mothers requiring the antiarrhythmic agent flecainide are often advised not to breastfeed, because of the lack of data concercing neonatal effects and flecainide plasma concentrations following maternal exposure as well as via lactation. This is the first report on combined maternal, fetal, neonatal and breastmilk flecainide concentrations in a breastfed infant of a mother requiring flecainide treatment. Case presentation A 35-year old Gravida 2 Para 1, known with ventricular arrhythmia, was referred to our tertiary center at 35 + 4 weeks of gestation. Because of an increase of ventricular ectopy, oral metoprolol 11.9 milligrams once daily was switched to oral flecainide 87.3 milligrams twice daily. Weekly collected maternal flecainide plasma trough concentrations fell within the therapeutic range of 0.2 to 1.0 mg/L and no further clinically significant arrhythmias occurred during the study period. A healthy son was born at 39 weeks of gestation and had a normal electrocardiogram. The fetal to maternal flecainide ratio was 0.72 and at three different timepoints, the flecainide concentration was higher in breastmilk than in maternal plasma. The relative infant dose received via breastmilk compared to maternal dose was 5.6%. Neonatal plasma concentrations were not detectable, despite the flecainide passage into breastmilk. All electrocardiograms to assess the neonatal antiarrhytmic effect were normal. Conclusions Our results assume that flecainide can be prescribed safely to lactating mothers. Quantification of drug concentrations in neonatal blood in addition to measurements in maternal and fetal blood, and breastmilk, are helpful to evaluate the effects and safety of maternal medication use during pregnancy and lactation.
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- 2023
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4. Corrigendum: Nailfold video capillaroscopy in pregnant women with and without cardiovascular risk factors
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Kristof Thevissen, Merve Demir, Jerome Cornette, and Wilfried Gyselaers
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nailfold video capillaroscopy ,microcirculation ,pregnancy ,pre-eclampsia ,hypertension ,Medicine (General) ,R5-920 - Published
- 2023
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5. Women of reproductive age in a tertiary intensive care unit: indications, outcome and the impact of pregnancy—a retrospective cohort study
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Karishma P. Ramlakhan, Diederik Gommers, Carmen E. R. M. Jacobs, Khaoula Makouri, Johannes J. Duvekot, Irwin K. M. Reiss, Arie Franx, Jolien W. Roos-Hesselink, and Jérôme M. J. Cornette
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Critical care ,Pregnancy ,Mortality ,Women’s health ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background To evaluate the indications for admission and mortality rates of women of reproductive age admitted to a tertiary Intensive Care Unit (ICU) and to compare the outcomes of obstetric and non-obstetric admissions. Methods A retrospective cohort study was performed, including all women aged 17–41 years admitted to a level 3 ICU in the Netherlands, between January 1, 2000 and January 1, 2016. Primary outcome was indication for admission and mortality. Mortality, length of stay (LOS), need for mechanical ventilation and APACHE II score were compared between obstetric and non-obstetric admissions. The obstetric group was further analyzed for maternal and perinatal outcomes. Results 3461 women (median age 32 years) were included, with an overall mortality rate of 13.3%. The obstetric group consisted of 265 women (7.7%). The non-obstetric group (n = 3196) was admitted most often for cardiovascular disease (19.6%), followed by oncologic disease (15%). Mortality was the highest in women with oncologic disease (23.9%). The obstetric group had lower mortality compared to the non-obstetric group (4.9% vs. 14%, p
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- 2021
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6. Nailfold Video Capillaroscopy in Pregnant Women With and Without Cardiovascular Risk Factors
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Kristof Thevissen, Merve Demir, Jerome Cornette, and Wilfried Gyselaers
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Nailfold video capillaroscopy ,microcirculation ,pregnancy ,pre-eclampsia ,hypertension ,Medicine (General) ,R5-920 - Abstract
ObjectiveTo evaluate microvasculature in pregnant women with and without cardiovascular risk factors.DesignCross-sectional, observational study.PopulationWomen were recruited at the outpatient clinic for high risk prenatal care. Out of a total of 345 women assessed at first and/or second and/or third trimester, 169 women without and 176 with cardiovascular risk factors were included.MethodsNailfold video capillaroscopy (NVC) measurements were performed at magnification of 200x at all fingers except thumbs. Images were stored for offline measurement of capillary density (CDe) and capillary diameters (CDi). Maternal anthropometrics, obstetric, and medical history were used for categorization in low and high cardiovascular risk. Comparison between groups and trimesters, with respect to pregnancy outcome, was performed using linear mixed model analysis.ResultsWomen with a high risk cardiovascular profile show higher CDe, regardless of pregnancy outcome. CDi drops during pregnancy, with lowest CDi in third trimester in patients with preeclampsia. Capillary bed (CB), as a composite of CDe and CDi, is stable during pregnancy in women with low risk cardiovascular profile. In women with high risk cardiovascular profile, CB drops from the first to the second trimester, regardless of pregnancy outcome. Only in women with pre-eclampsia, the CB is lower in the third trimester as compared to the first trimester.There is an inverse association between CDe and mean arterial pressure (MAP) in women with high cardiovascular risk and pre-eclampsia.ConclusionMicrocirculation is altered during the course of pregnancy and microcirculatory behavior is different in patients with low and high cardiovascular risk profile, as well as in patients with preeclampsia.
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- 2022
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7. Women of reproductive age in a tertiary intensive care unit: indications, outcome and the impact of pregnancy—a retrospective cohort study
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Ramlakhan, Karishma P., Gommers, Diederik, Jacobs, Carmen E. R. M., Makouri, Khaoula, Duvekot, Johannes J., Reiss, Irwin K. M., Franx, Arie, Roos-Hesselink, Jolien W., and Cornette, Jérôme M. J.
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- 2021
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8. Ventricular tachycardia and pregnancy
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Nicole Schenkelaars, Robert M. Kauling, Karishma P. Ramlakhan, Sing-Chien Yap, Jérôme M.J. Cornette, and Jolien W. Roos-Hesselink
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Ventricular tachycardia ,Pregnancy ,Arrhythmia ,Maternal-fetal health ,Clinical management ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The risk of developing new-onset arrhythmia or exacerbation of a pre-existing arrhythmia is increased during pregnancy because of profound physiological and hormonal changes. The incidence of arrhythmias in pregnancy is not well-reported and especially data on ventricular arrhythmia are scarce. Arrhythmia during pregnancy is associated with adverse maternal and fetal outcomes and the optimization of clinical management is hindered by a paucity of evidence, as guidelines are either based on studies in the general population or on case series in pregnancy. In any case, optimal care for these patients includes a multidisciplinary approach, integrating the different considerations in maternal cardiac, obstetric and fetal health. In this manuscript we present three cases of ventricular arrhythmia during pregnancy and describe our considerations in clinical decision-making with regard to diagnostic challenges and treatment choices.
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- 2021
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9. Congenital heart disease in the ESC EORP Registry of Pregnancy and Cardiac disease (ROPAC)
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Karishma P. Ramlakhan, Mark R. Johnson, Malgorzata Lelonek, Aly Saad, Zaur Gasimov, Natalia V. Sharashkina, Patrick Thornton, Margaret Arstall, Roger Hall, Jolien W. Roos-Hesselink, Jolien Roos-Hesselink, Joerg Stein, William Anthony Parsonage, Werner Budts, Julie De Backer, Jasmin Grewal, Ariane Marelli, Harald Kaemmerer, Guillaume Jondeau, Mark Johnson, Aldo P. Maggioni, Luigi Tavazzi, Ulf Thilen, Uri Elkayam, Catherine Otto, Karen Sliwa, A. Aquieri, A. Saad, H. Ruda Vega, J. Hojman, J.M. Caparros, M. Vazquez Blanco, M. Arstall, C.M. Chung, G. Mahadavan, E. Aldridge, M. Wittwer, Y.Y. Chow, W.A. Parsonage, K. Lust, N. Collins, G. Warner, R. Hatton, A. Gordon, E. Nyman, J. Stein, E. Donhauser, H. Gabriel, A. Bahshaliyev, F. Guliyev, I. Hasanova, T. Jahangirov, Z. Gasimov, A. Salim, C.M. Ahmed, F. Begum, M.H. Hoque, M. Mahmood, M.N. Islam, P.P. Haque, S.K. Banerjee, T. Parveen, M. Morissens, J. De Backer, L. Demulier, M. de Hosson, W. Budts, M. Beckx, M. Kozic, M. Lovric, T. Kovacevic-Preradovic, N. Chilingirova, P. Kratunkov, N. Wahab, S. McLean, E. Gordon, L. Walter, A. Marelli, A.R. Montesclaros, G. Monsalve, C. Rodriguez, F. Balthazar, V. Quintero, W. Palacio, L.A. Mejía Cadavid, E. Munoz Ortiz, F. Fortich Hoyos, E. Arevalo Guerrero, J. Gandara Ricardo, J. Velasquez Penagos, Z. Vavera, Prague, J. Popelova, N. Vejlstrup, L. Grønbeck, M. Johansen, A. Ersboll, Y. Elrakshy, K. Eltamawy, M. Gamal Abd-El Aziz, A. El Nagar, H. Ebaid, H. Abo Elenin, M. Saed, S. Farag, W. Makled, K. Sorour, Z. Ashour, G. El-Sayed, M. Abdel Meguid Mahdy, N. Taha, A. Dardeer, M. Shabaan, M. Ali, P. Moceri, G. Duthoit, M. Gouton, J. Nizard, L. Baris, S. Cohen, M. Ladouceur, D. Khimoud, B. Iung, F. Berger, A. Olsson, U. Gembruch, W.M. Merz, E. Reinert, S. Clade, Y. Kliesch, C. Wald, C. Sinning, R. Kozlik-Feldmann, S. Blankenberg, E. Zengin-Sahm, G. Mueller, M. Hillebrand, P. Hauck, Y. von Kodolitsch, N. Zarniko, Muenster H. Baumgartner, R. Schmidt, A. Hellige, O. Tutarel, H. Kaemmerer, B. Kuschel, N. Nagdyman, R. Motz, D. Maisuradze, A. Frogoudaki, E. Iliodromitis, M. Anastasiou-Nana, Marousi, D. Triantafyllis, G. Bekiaris, H. Karvounis, G. Giannakoulas, D. Ntiloudi, S.A. Mouratoglou, A. Temesvari, H. Balint, D. Kohalmi, B. Merkely, C. Liptai, A. Nemes, T. Forster, A. Kalapos, K. Berek, K. Havasi, N. Ambrus, A. Shelke, R. Kawade, S. Patil, E. Martanto, T.M. Aprami, A. Purnomowati, C.J. Cool, M. Hasan, R. Akbar, S. Hidayat, T.I. Dewi, W. Permadi, D.A. Soedarsono, M.M. Ansari-Ramandi, N. Samiei, A. Tabib, F. Kashfi, S. Ansari-Ramandi, S. Rezaei, H. Ali Farhan, A. Al-Hussein, G. Al-Saedi, G. Mahmood, I.F. Yaseen, L. Al-Yousuf, M. AlBayati, S. Mahmood, S. Raheem, T. AlHaidari, Z. Dakhil, P. Thornton, J. Donnelly, M. Bowen, A. Blatt, G. Elbaz-Greener, A. Shotan, S. Yalonetsky, S. Goland, M. Biener, G. Egidy Assenza, M. Bonvicini, A. Donti, A. Bulgarelli, D. Prandstraller, C. Romeo, R. Crepaz, E. Sciatti, M. Metra, R. Orabona, L. Ait Ali, P. Festa, V. Fesslova, C. Bonanomi, M. Calcagnino, F. Lombardi, A.M. Colli, M.W. Ossola, C. Gobbi, E. Gherbesi, L. Tondi, M. Schiavone, M. Squillace, M.G. Carmina, A. Maina, C. Macchi, E. Gollo, F.M. Comoglio, N. Montali, P. Re, R. Bordese, T. Todros, V. Donvito, W. Grosso Marra, G. Sinagra, B. D'Agata Mottolese, M. Bobbo, V. Gesuete, S. Rakar, F. Ramani, K. Niwa, D. Mekebekova, A. Mussagaliyeva, T. Lee, E. Mirrakhimov, S. Abilova, E. Bektasheva, K. Neronova, O. Lunegova, R. Žaliūnas, R. Jonkaitienė, J. Petrauskaitė, A. Laucevicius, D. Jancauskaite, L. Lauciuviene, L. Gumbiene, L. Lankutiene, S. Glaveckaite, M. Laukyte, S. Solovjova, V. Rudiene, K.H. Chee, C.C.-W. Yim, H.L. Ang, R. Kuppusamy, T. Watson, M. Caruana, M.-E. Estensen, M.G.A. Mahmood Kayani, R. Munir, A. Tomaszuk-Kazberuk, B. Sobkowicz, J. Przepiesc, A. Lesniak-Sobelga, L. Tomkiewicz-Pajak, M. Komar, M. Olszowska, P. Podolec, S. Wisniowska-Smialek, M. Lelonek, U. Faflik, A. Cichocka-Radwan, K. Plaskota, O. Trojnarska, N. Guerra, L. de Sousa, C. Cruz, V. Ribeiro, S. Jovanova, V. Petrescu, R. Jurcut, C. Ginghina, I. Mircea Coman, M. Musteata, O. Osipova, T. Golivets, I. Khamnagadaev, O. Golovchenko, A. Nagibina, I. Ropatko, I.R. Gaisin, L. Valeryevna Shilina, N. Sharashkina, E. Shlyakhto, O. Irtyuga, O. Moiseeva, E. Karelkina, I. Zazerskaya, A. Kozlenok, I. Sukhova, L. Jovovic, K. Prokšelj, M. Koželj, A.O. Askar, A.A. Abdilaahi, M.H. Mohamed, A.M. Dirir, K. Sliwa, P. Manga, A. Pijuan-Domenech, L. Galian-Gay, P. Tornos, M.T. Subirana, M. T, Subirana, J.M. Oliver, B. Garcia-Aranda Dominguez, I. Hernandez Gonzalez, J.F. Delgado Jimenez, P. Escribano Subias, N. Murga, A. Elbushi, A. Suliman, K. Jazzar, M. Murtada, N. Ahamed, M. Dellborg, E. Furenas, M. Jinesjo, K. Skoglund, P. Eriksson, T. Gilljam, U. Thilen, D. Tobler, K. Wustmann, F. Schwitz, M. Schwerzmann, T. Rutz, J. Bouchardy, M. Greutmann, B.M. Santos Lopes, L. Meier, M. Arrigo, K. de Boer, T. Konings, E. Wajon, L.J. Wagenaar, P. Polak, E.P.G. Pieper, J. Roos-Hesselink, I. van Hagen, H. Duvekot, J.M.J. Cornette, C. De Groot, C. van Oppen, L. Sarac, O. Batukan Esen, S. Catirli Enar, C. Mondo, P. Ingabire, B. Nalwanga, T. Semu, B.T. Salih, W.A.R. Almahmeed, S. Wani, F.S. Mohamed Farook, Al Ain, F. Gerges, A.M. Komaranchath, F. Al bakshi, A. Al Mulla, A.H. Yusufali, E.I. Al Hatou, N. Bazargani, F. Hussain, L. Hudsmith, P. Thompson, S. Thorne, S. Bowater, A. Money-Kyrle, P. Clifford, P. Ramrakha, S. Firoozan, J. Chaplin, N. Bowers, D. Adamson, F. Schroeder, R. Wendler, S. Hammond, P. Nihoyannopoulos, Norwich Norfolk, R. Hall, L. Freeman, G. Veldtman, J. Kerr, L. Tellett, N. Scott, A.B. Bhatt, D. DeFaria Yeh, M.A. Youniss, M. Wood, A.A. Sarma, S. Tsiaras, A. Stefanescu, J.M. Duran, L. Stone, D.S. Majdalany, J. Chapa, K. Chintala, P. Gupta, J. Botti, J. Ting, W.R. Davidson, G. Wells, D. Sparks, V. Paruchuri, K. Marzo, D. Patel, W. Wagner, S.N. Ahanya, L. Colicchia, T. Jentink, K. Han, M. Loichinger, M. Parker, C. Longtin, A. Yetman, K. Erickson, J. Cramer, S. Tsai, B. Fletcher, S. Warta, C. Cohen, C. Lindblade, R. Puntel, K. Nagaran, N. Croft, M. Gurvitz, C. Otto, C. Talluto, D. Murphy, and M.G. Perlroth
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Congenital heart disease ,Pregnancy ,Maternal health ,Observational registry ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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10. The physiological effect of early pregnancy on a woman’s response to a submaximal cardiopulmonary exercise test
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Rianne C. Bijl, Jérôme M. J. Cornette, Kim van derHam, Merle L. deZwart, Dinis Dos Reis Miranda, Régine P. M. Steegers‐Theunissen, Arie Franx, Jeroen Molinger, and M. P. H. (Wendy) Koster
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breath‐by‐breath analysis ,cardiopulmonary exercise test ,impedance cardiography ,pregnancy ,ventilatory threshold ,Physiology ,QP1-981 - Abstract
Abstract Given all its systemic adaptive requirements, pregnancy shares several features with physical exercise. In this pilot study, we aimed to assess the physiological response to submaximal cardiopulmonary exercise testing (CPET) in early pregnancy. In 20 healthy, pregnant women (
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- 2020
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11. Acute Coronary Syndrome and Ischemic Heart Disease in Pregnancy: Data From the EURObservational Research Programme‐European Society of Cardiology Registry of Pregnancy and Cardiac Disease
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Lucia Baris, Abdul Hakeem, Tabitha Moe, Jérôme Cornette, Nasser Taha, Fathima Farook, Ilshat Gaisin, Carla Bonanomi, William Parsonage, Mark Johnson, Roger Hall, and Jolien W. Roos‐Hesselink
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acute coronary syndrome ,infarction ,ischemic heart disease ,maternal health ,pregnancy ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The prevalence of ischemic heart disease (IHD) in women of child‐bearing age is rising. Data on pregnancies however are scarce. The objective is to describe the pregnancy outcomes in these women. Methods and Results The European Society of Cardiology‐EURObservational Research Programme ROPAC (Registry of Pregnancy and Cardiac Disease) is a prospective registry in which data on pregnancies in women with heart disease were collected from 138 centers in 53 countries. Pregnant women with preexistent and pregnancy‐onset IHD were included. Primary end point were maternal cardiac events. Secondary end points were obstetric and fetal complications. There were 117 women with IHD, of which 104 had preexisting IHD. Median age was 35.5 years and 17.1% of women were smoking. There was no maternal mortality, heart failure occurred in 5 pregnancies (4.8%). Of the 104 women with preexisting IHD, 11 women suffered from acute coronary syndrome during pregnancy. ST‐segment‒elevation myocardial infarction were more common than non‒ST‐segment‒elevation myocardial infarction, and atherosclerosis was the most common etiology. Women who had undergone revascularization before pregnancy did not have less events than women who had not. There were 13 women with pregnancy‐onset IHD, in whom non‒ST‐segment‒elevation myocardial infarction was the most common. Smoking during pregnancy was associated with acute coronary syndrome. Caesarean section was the primary mode of delivery (55.8% in preexisting IHD, 84.6% in pregnancy‐onset IHD) and there were high rates of preterm births (20.2% and 38.5%, respectively). Conclusions Women with IHD tolerate pregnancy relatively well, however there is a high rate of ischemic events and these women should therefore be considered moderate‐ to high‐risk. Ongoing cigarette smoking is associated with acute coronary syndrome during pregnancy.
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- 2020
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12. Validation of Non-invasive Measurement of Cardiac Output: Using Whole-Body Bio-impedance Versus Inert Gas Rebreathing in Healthy Women Undergoing In Vitro Fertilisation.
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Jaspal, Raj-Kamael, Allen, Mae, Cornette, Jerome, Rizopoulos, Dimitris, and Lees, Christoph
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PREGNANCY ,PREGNANCY complications ,CARDIAC output ,HUMAN in vitro fertilization ,HEMODYNAMICS - Abstract
Background: Haemodynamic assessment in and before pregnancy is becoming increasingly important in relation to pregnancy complications and outcomes. Different methodologies exist but there is no gold-standard technique for non-invasive measurement of cardiac output (CO). We sought to assess two methods of CO measurement in healthy women undergoing in vitro fertilisation cycles (IVF). This was a prospective longitudinal study of 71 women aged 18--44 years planning IVF undergoing CO measurements obtained via inert gas rebreathing (IGR) using Innocor™ and whole-body bio-impedance (WBI) using Nicas™ to assess the reproducibility between the methods. Four visits occurred at which both techniques were used: initial assessment, embryo transfer, day of pregnancy test and 4 weeks post-transfer (regardless of whether conception occurred). Cross-sectional agreement of the methods was assessed using the calculation of bias, percentage error and limits of agreement (LOA) via the Bland--Altman analysis. Longitudinal agreement of the methods was assessed using a 4-quadrant plot with concordance rate, angular bias and radial limits of agreement (%). Results: One hundred and thirteen measurements from 44 participants were suitable for cross-sectional (Bland--Altman) analysis. IGR (Innocor™) Mean CO was 4.61 L/min and 5.05 L/min with WBI (Nicas™). The bias was 0.44 L/min. The percentage error was 76% and intra-correlation coefficient was 0.135 (95% CI -0.43--0.306). Fifty-nine measurements from 28 participants were suitable for longitudinal (4Q-plot) analysis. The concordance rate was 64.4%, angular bias -- 0.14, and radial limits of agreement + - 13.25°. Conclusion: There was poor cross-sectional and longitudinal agreement between inert gas rebreathing and whole-body bio-impedance techniques. These techniques cannot be used interchangeably when measuring CO in women undergoing IVF, and these results may be more generalizable, to women in the peri-conception period. [ABSTRACT FROM AUTHOR]
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- 2022
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13. Pregnancy and delivery in cardiac disease.
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Ruys, Titia P.E., Cornette, Jérôme, and Roos-Hesselink, Jolien W.
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PREGNANCY complications ,HEART diseases ,DISEASE prevalence ,MATERNAL mortality ,HEREDITY ,DELIVERY (Obstetrics) ,DEVELOPED countries - Abstract
Although its prevalence is relatively low in pregnant women, heart disease is the most important cause of maternal mortality. Problems may arise due to hemodynamic burden and the hypercoagulable state of pregnancy. Heart disease may be congenital or acquired. In developed countries, the former composes the biggest part of women with heart disease. Patients with unrepaired lesions, cyanotic lesions, diminished systemic ventricular function, complex congenital heart disease, left ventricular outflow tract obstruction, pulmonary hypertension, or mechanical valves are at highest risk of developing complications during pregnancy. All patients with known cardiac disease should preferably be counseled before conception. Pre-pregnancy evaluation should include risk assessment for the mother and fetus, including medication use and information on heredity of the cardiac lesion. Management of pregnancy and delivery should be planned accordingly on individual bases. The types of complications are related to the cardiac diagnosis, with arrhythmias and heart failure being most common. Treatment options should be discussed with the future parents, as they may affect both mother and child. In general, the preferred route of delivery is vaginal. The optimal care for pregnant women with heart disease requires multidisciplinary involvement and is best concentrated in tertiary centers. [ABSTRACT FROM AUTHOR]
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- 2013
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14. Influence of pregnancy on long-term durability of allografts in right ventricular outflow tract.
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Romeo, Jamie L.R., Papageorgiou, Grigorios, Takkenberg, Johanna J.M., Roos-Hesselink, Jolien W., van Leeuwen, Wouter J., Cornette, Jerome M.J., Rizopoulos, Dimitris, Bogers, Ad J.J.C., and Mokhles, M. Mostafa
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There is very limited published evidence about the influence of pregnancy on allograft durability in right ventricular outflow tract position. We present the first study using mixed and joint modeling. This retrospective study compared clinical and valve related outcomes of all consecutive female hospital survivors in their fertile life phase (18-50 years) based on pregnancy. Serial echocardiographic measurements of pulmonary gradient and regurgitation were analyzed for their association with valve replacement using joint models for longitudinal and time-to-event data. Occurrence of first pregnancy was included as a time-dependent intermediate event in both the longitudinal and survival analyses of the joint model to assess its impact on the hemodynamic and clinical outcome. In total, 196 consecutive women in their fertile life-phase with an allograft were included. Complete information of 176 (90%) allografts in 165 women was available, including 1395 echocardiograms. Of these women, 51 (30.9%) women had 84 completed pregnancies at an average age of 29.1 ± 3.9 (SD) years; 8.1 ± 6.1 years since allograft implantation. Tetralogy of Fallot was the most common diagnosis in both groups. After a mean follow-up of 15.2 years (range 0.1-30), 7 (13.7%) parous women underwent valve replacement versus 20 (17.5%) nulliparous women. During this follow-up, the mean allograft gradient in parous (24.2 mm Hg) and nulliparous (21.0 mm Hg) women was comparable (P =.225). A 1-mm Hg increase in pulmonary gradient increased the instantaneous risk of pulmonary valve replacement (PVR) by a ratio of 1.051 (P <.001), regardless of pregnancy. Similarly, development of moderate or severe regurgitation increased the risk of PVR (P =.038), regardless of pregnancy. Pregnancy was not associated with a change in the allograft gradient (P =.258), regurgitation grade (P =.774), or hazard of PVR (P =.796) during follow-up. Pregnancy is not associated with impaired allograft durability in women with good cardiac health. [ABSTRACT FROM AUTHOR]
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- 2020
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