Risks of Pregnancy in Women with Cardiomyopathy

Data from a small case series suggest that advanced symptoms, low LVEF, or both are associated with adverse maternal and fetal outcomes.

Peripartum cardiomyopathy is relatively well studied, but little is known about outcomes of pregnancy in women with preexisting LV systolic dysfunction (LVSD). Managing heart failure in pregnancy is particularly challenging because ACE inhibitors and angiotensin-receptor blockers are contraindicated in this setting. Faced with scant data, experts generally recommend that women with severe LVSD avoid pregnancy.

Investigators studied outcomes of 36 pregnancies in 32 women with idiopathic or chemotherapy-induced dilated cardiomyopathy whom they followed through 6 months postpartum. Women with peripartum cardiomyopathy were excluded. Twenty-four pregnancies occurred in women who were essentially asymptomatic (NYHA class I) at baseline, and 18 oc…

Reviewing Author

Frederick A. Masoudi, MD, MSPH

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)