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 language | English |
|---|---|
| Pages (from-to) | 1847-1852 |
| Number of pages | 6 |
| Journal | International Journal of Cardiology |
| Volume | 168 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Oct 3 2013 |
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Keywords
- Cardiovascular magnetic resonance
- Congenital heart disease
- Pregnancy
- Right ventricle
- Tetralogy of Fallot
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
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
PY - 2013/10/3
Y1 - 2013/10/3
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/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.
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.
KW - Cardiovascular magnetic resonance
KW - Congenital heart disease
KW - Pregnancy
KW - Right ventricle
KW - Tetralogy of Fallot
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UR - http://www.scopus.com/inward/citedby.url?scp=84885678377&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.12.071
DO - 10.1016/j.ijcard.2012.12.071
M3 - Article
VL - 168
SP - 1847
EP - 1852
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -