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Cardiovascular events in pregnancy with hypertrophic cardiomyopathy

Hiroaki Tanaka1, Chizuko Kamiya, Shinji Katsuragi

  • 1Department of Perinatology, National Cerebral and Cardiovascular Center.

Circulation Journal : Official Journal of the Japanese Circulation Society
|August 8, 2014
PubMed

Insights

Pregnancy in women with hypertrophic cardiomyopathy (HCM) carries significant risks, with over half experiencing cardiovascular events, primarily arrhythmia. Pre-pregnancy medication and high risk scores predict these adverse outcomes.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Genetics

Background:

  • Physiological circulatory changes during pregnancy and their impact on hypertrophic cardiomyopathy (HCM) are not well understood.
  • Limited research exists on pregnant women with HCM, particularly within the Japanese population.

Purpose of the Study:

  • To investigate the incidence and nature of cardiovascular events in pregnant women with hypertrophic cardiomyopathy (HCM).
  • To identify risk factors associated with adverse cardiovascular outcomes in this patient group.

Main Methods:

  • Retrospective review of 27 pregnancies involving 23 women diagnosed with hypertrophic cardiomyopathy (HCM).
  • Analysis of cardiovascular events, focusing on type, timing, and correlation with pre-pregnancy medication and risk scores (CARPREG, ZAHARA).

Main Results:

  • 48% of pregnancies (13 out of 27) experienced 18 cardiovascular events, predominantly arrhythmias (76%).
  • Events occurred early in pregnancy (around 30 weeks) or postpartum.
  • High incidence of events in women on pre-pregnancy medication (88%) and those with high CARPREG (70%) or ZAHARA (75%) scores.

Conclusions:

  • Over half of pregnant women with HCM experience cardiovascular events, with arrhythmia being the most common.
  • Pre-pregnancy medication, and CARPREG or ZAHARA scores ≥1 are significant risk factors for cardiac events during pregnancy and postpartum.
Abstract

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