Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy

Riccardo Bariani; Maria Bueno Marinas; Ilaria Rigato; Paola Veronese; Rudy Celeghin; Alberto Cipriani; Marco Cason; Valeria Pergola; Giulia Mattesi; Petra Deola; Alessandro Zorzi; Giuseppe Limongelli; Sabino Iliceto; Domenico Corrado; Cristina Basso; Kalliopi Pilichou; Barbara Bauce

doi:10.3390/jcm11226735

Journal of Clinical Medicine (Nov 2022)

Pregnancy in Women with Arrhythmogenic Left Ventricular Cardiomyopathy

Riccardo Bariani,
Maria Bueno Marinas,
Ilaria Rigato,
Paola Veronese,
Rudy Celeghin,
Alberto Cipriani,
Marco Cason,
Valeria Pergola,
Giulia Mattesi,
Petra Deola,
Alessandro Zorzi,
Giuseppe Limongelli,
Sabino Iliceto,
Domenico Corrado,
Cristina Basso,
Kalliopi Pilichou,
Barbara Bauce

Affiliations

Riccardo Bariani: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Maria Bueno Marinas: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Ilaria Rigato: Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy
Paola Veronese: Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy
Rudy Celeghin: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Alberto Cipriani: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Marco Cason: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Valeria Pergola: Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy
Giulia Mattesi: Azienda Ospedaliera di Padova, Via Giustiniani, 2, 35128 Padova, Italy
Petra Deola: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Alessandro Zorzi: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Giuseppe Limongelli: Department of Translational Sciences, University della Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Sabino Iliceto: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Domenico Corrado: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Cristina Basso: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Kalliopi Pilichou: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy
Barbara Bauce: Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy

DOI: https://doi.org/10.3390/jcm11226735
Journal volume & issue: Vol. 11, no. 22
p. 6735

Abstract

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Background: In the last few years, a phenotypic variant of arrhythmogenic cardiomyopathy (ACM) labeled arrhythmogenic left ventricular cardiomyopathy (ALVC) has been defined and researched. This type of cardiomyopathy is characterized by a predominant left ventricular (LV) involvement with no or minor right ventricular (RV) abnormalities. Data on the specific risk and management of pregnancy in women affected by ALVC are, thus far, not available. We have sought to characterize pregnancy course and outcomes in women affected by ALVC through the evaluation of a series of childbearing patients. Methods: A series of consecutive female ALVC patients were analyzed in a cross-sectional, retrospective study. Study protocol included 12-lead ECG assessments, 24-h Holter ECG evaluations, 2D-echocardiogram tests, cardiac magnetic resonance assessments, and genetic analysis. Furthermore, the long-term disease course of childbearing patients was compared with a group of nulliparous ALVC women. Results: A total of 35 patients (mean age 45 ± 9 years, 51% probands) were analyzed. Sixteen women (46%) reported a pregnancy, for a total of 27 singleton viable pregnancies (mean age at first childbirth 30 ± 9 years). Before pregnancy, all patients were in the NYHA class I and none of the patients reported a previous heart failure (HF) episode. No significant differences were found between childbearing and nulliparous women regarding ECG features, LV dimensions, function, and extent of late enhancement. Overall, 7 patients (20%, 4 belonging to the childbearing group) experienced a sustained ventricular tachycardia and 2 (6%)—one for each group—showed heart failure (HF) episodes. The analysis of arrhythmia-free survival patients did not show significant differences between childbearing and nulliparous women. Conclusions: In a cohort of ALVC patients without previous episodes of HF, pregnancy was well tolerated, with no significant influence on disease progression and degree of electrical instability. Further studies on a larger cohort of women with different degrees of disease extent and genetic background are needed in order to achieve a more comprehensive knowledge regarding the outcome of pregnancy in ALVC patients.

Published in Journal of Clinical Medicine

ISSN: 2077-0383 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine
Website: http://www.mdpi.com/journal/jcm

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