Mitral valve prolapse: arrhythmic risk during pregnancy and postpartum

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00084818" target="_blank" >RIV/00023001:_____/24:00084818 - isvavai.cz</a>

Result on the web

<a href="https://academic.oup.com/eurheartj/article/45/20/1831/7671160" target="_blank" >https://academic.oup.com/eurheartj/article/45/20/1831/7671160</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/eurheartj/ehae224" target="_blank" >10.1093/eurheartj/ehae224</a>

Result language

angličtina

Original language name

Mitral valve prolapse: arrhythmic risk during pregnancy and postpartum

Original language description

Background and Aims Arrhythmic mitral valve prolapse (AMVP) is linked to life-threatening ventricular arrhythmias (VAs), and young women are considered at high risk. Cases of AMVP in women with malignant VA during pregnancy have emerged, but the arrhythmic risk during pregnancy is unknown. The authors aimed to describe features of women with high-risk AMVP who developed malignant VA during the perinatal period and to assess if pregnancy and the postpartum period were associated with a higher risk of malignant VA.Methods This retrospective international multi-centre case series included high-risk women with AMVP who experienced malignant VA and at least one pregnancy. Malignant VA included ventricular fibrillation, sustained ventricular tachycardia, or appropriate shock from an implantable cardioverter defibrillator. The authors compared the incidence of malignant VA in non-pregnant periods and perinatal period; the latter defined as occurring during pregnancy and within 6 months after delivery.Results The authors included 18 women with AMVP from 11 centres. During 7.5 (interquartile range 5.8-16.6) years of follow-up, 37 malignant VAs occurred, of which 18 were pregnancy related occurring in 13 (72%) unique patients. Pregnancy and 6 months after delivery showed increased incidence rate of malignant VA compared to the non-pregnancy period (univariate incidence rate ratio 2.66, 95% confidence interval 1.23-5.76).Conclusions The perinatal period could impose increased risk of malignant VA in women with high-risk AMVP. The data may provide general guidance for pre-conception counselling and for nuanced shared decision-making between patients and clinicians. Structured Graphical Abstract In this international multi-centre retrospective case series, we contacted 27 centres from four different continents for possible collaboration, and we included 18 women with AMVP from 11 centres. Malignant ventricular arrhythmia occurred 37 times, of which 18 (48%) occurred during pregnancy and 6 months postpartum. This period showed higher incidence rate of malignant VA, suggesting increased arrhythmic risk during the perinatal period. The findings from this study provide guidance for shared decision-making in high-risk AMVP women wanting to become pregnant. AMVP, arrhythmic mitral valve prolapse; CI, confidence interval; ICD, implantable cardioverter defibrillator; VA, ventricular arrhythmia; VT, ventricular tachycardia. The image graphics were generated using the Midjourney AI application, Midjourney.com.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European heart journal

ISSN

0195-668X

e-ISSN

1522-9645

Volume of the periodical

45

Issue of the periodical within the volume

20

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

1831-1839

UT code for WoS article

001220176200001

EID of the result in the Scopus database

2-s2.0-85194477524