左心室功能受损妇女怀孕:来自ROPAC的数据
Puck N J Peters1, Sahra Ünlütürk1, Avraham Shotan2
1Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
JACC. Advances
|February 26, 2026
概括
患有左心室功能障碍 (LVF) 的女性怀孕存在重大风险,心力衰竭和主要不良心脏事件 (MACE) 发生率高. 仔细监测对于管理这些复杂的怀孕至关重要.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖健康 生殖健康
背景情况:
- 怀孕会给血液动力学带来很大的压力,对于先前患有心脏病的女性来说尤其具有挑战性.
- 左心室功能障碍 (LVF),定义为射出分数<40%,在妊娠期间呈现高风险特征.
研究的目的:
- 在被诊断患有LVF受损的孕妇中调查心脏,产科和胎儿的结果.
- 确定与高风险人群中不良结果相关的风险因素.
主要方法:
- 对251名患有LVF受损的孕妇的前性国际观察队列 (ROPAC) 的分析.
- 主要终点:主要不良心脏事件 (MACE),包括死亡率,心律失常,心力衰竭和血栓栓塞事件.
- 后勤回归用于识别糟糕结果的预测因素.
主要成果:
- 产妇死亡率为2.4%,心力衰竭发生在27%的患者中,心室动脉节律失常发生在4%的患者中.
- 32%的患者在怀孕期间或产后经历了至少一次MACE.
- 产科并发症包括早产 (27%) 和低出生体重 (26%).
- 心肌病患者面临更高的风险:4.3%的死亡率和~40%的MACE风险.
- 怀孕前的心力衰竭症状,心房动和NYHA类>II预测心脏表现不佳.
结论:
- 患有LVF受损的妇女面临心力衰竭,心动节律失常和低出生体重过早分娩的风险增加.
- 早期识别风险因素,如心力衰竭症状和心律失常,对于管理至关重要.
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