Risk stratification and management of women with cardiomyopathy/heart failure planning pregnancy or presenting during/after pregnancy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy.

Abstract

This position paper focusses on the pathophysiology, diagnosis and management of women diagnosed with a cardiomyopathy, or at risk of heart failure (HF), who are planning to conceive or present with (de novo or previously unknown) HF during or after pregnancy. This includes the heterogeneous group of heart muscle diseases such as hypertrophic, dilated, arrhythmogenic right ventricular and non-classified cardiomyopathies, left ventricular non-compaction, peripartum cardiomyopathy, Takotsubo syndrome, adult congenital heart disease with HF, and patients with right HF. Also, patients with a history of chemo-/radiotherapy for cancer or haematological malignancies need specific pre-, during and post-pregnancy assessment and counselling. We summarize the current knowledge about pathophysiological mechanisms, including gene mutations, clinical presentation, diagnosis, and medical and device management, as well as risk stratification. Women with a known diagnosis of a cardiomyopathy will often require continuation of drug therapy, which has the potential to exert negative effects on the foetus. This position paper assists in balancing benefits and detrimental effects.

• Authors: Karen Sliwa, Peter van der Meer, Mark C Petrie, Alexandra Frogoudaki, Mark R Johnson, Denise Hilfiker-Kleiner, Righab Hamdan, Alice M Jackson, Bassem Ibrahim, Amam Mbakwem, Carsten Tschöpe, Vera Regitz-Zagrosek, Elmir Omerovic, Jolien Roos-Hesselink, Michael Gatzoulis, Oktay Tutarel, Susanna Price, Stephane Heymans, Andrew J S Coats, Christian Müller, Ovidiu Chioncel, Thomas Thum, Rudolf A de Boer, Ewa Jankowska, Piotr Ponikowski, Alexander R Lyon, Giuseppe Rosano, Petar M Seferovic, Johann Bauersachs
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 23 Issue 4 Pg. 527-540 (04 2021) ISSN: 1879-0844 [Electronic] England
• PMID: 33609068 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Topics

• Adult
• Cardiology
• Cardiomyopathies
• Female
• Heart Defects, Congenital
• Heart Failure
• Humans
• Peripartum Period
• Pregnancy
• Pregnancy Complications, Cardiovascular
• Risk Assessment