The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot

Gabriele Egidy Assenza, Daiana Cassater, Michael Landzberg, Tal Geva, Jenna Schreier, Dionne Graham, Massimo Volpe, Nancy Barker, Katherine Economy, Anne Marie Valente

Research output: Contribution to journalArticle

32 Citations (Scopus)

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/m2/year vs. 1.6 ± 0.6 ml/m2/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.

Original languageEnglish
Pages (from-to)1847-1852
Number of pages6
JournalInternational Journal of Cardiology
Volume168
Issue number3
DOIs
Publication statusPublished - Oct 3 2013

Fingerprint

Ventricular Remodeling
Tetralogy of Fallot
Heart Ventricles
Pregnancy
Research Design
Magnetic Resonance Spectroscopy
Pulmonary Valve Insufficiency
Magnetic Resonance Imaging
Prospective Studies

Keywords

  • Cardiovascular magnetic resonance
  • Congenital heart disease
  • Pregnancy
  • Right ventricle
  • Tetralogy of Fallot

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Egidy Assenza, G., Cassater, D., Landzberg, M., Geva, T., Schreier, J., Graham, D., ... 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), 1847-1852. https://doi.org/10.1016/j.ijcard.2012.12.071

The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot. / Egidy Assenza, Gabriele; Cassater, Daiana; Landzberg, Michael; Geva, Tal; Schreier, Jenna; Graham, Dionne; Volpe, Massimo; Barker, Nancy; Economy, Katherine; Valente, Anne Marie.

In: International Journal of Cardiology, Vol. 168, No. 3, 03.10.2013, p. 1847-1852.

Research output: Contribution to journalArticle

Egidy Assenza, G, Cassater, D, Landzberg, M, Geva, T, Schreier, J, Graham, D, Volpe, M, Barker, N, Economy, K & Valente, AM 2013, 'The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot', International Journal of Cardiology, vol. 168, no. 3, pp. 1847-1852. https://doi.org/10.1016/j.ijcard.2012.12.071
Egidy Assenza, Gabriele ; Cassater, Daiana ; Landzberg, Michael ; Geva, Tal ; Schreier, Jenna ; Graham, Dionne ; Volpe, Massimo ; Barker, Nancy ; Economy, Katherine ; Valente, Anne Marie. / The effects of pregnancy on right ventricular remodeling in women with repaired tetralogy of Fallot. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 3. pp. 1847-1852.
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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/m2/year vs. 1.6 ± 0.6 ml/m2/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.",
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AU - Graham, Dionne

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AU - Valente, Anne Marie

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AB - 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/m2/year vs. 1.6 ± 0.6 ml/m2/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.

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KW - Congenital heart disease

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KW - Right ventricle

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