Heart failure & cardiomyopathies

Impact of pregnancy on the natural history of women with hypertrophic cardiomyopathy

Eur J Prev CardiolPublished Retrospective cohort study

Main finding · MACEResult — go to the resultHazard ratio 0.605 95% CI 0.380–0.963

Authors' conclusion

Pregnancy is not a modifier of long-term outcome in women with HCM and mostly occurs before a cardiac diagnosis.

Study context

Population
Women with hypertrophic cardiomyopathy (HCM), 1970–2021, with pregnancy information and follow-up ≥1 year
Participants
379 women432 pregnancies
Exposure
Pregnancy vs no pregnancy
  • Pregnancyn = 242
Outcome
MACE:
  • CV death
  • SCD
  • Appropriate defibrillator shock
  • Heart failure (HF) progression

Main finding

MACE · 10 ± 9 years of follow-up

Hazard ratio

0.605

95% CI 0.380–0.963

P = 0.034

Pregnancyvs No pregnancy
HR 0.605 (95% CI 0.380–0.963); P = 0.034

As reported in the abstract

Observational data: associations, not effects.

Further findings

Predictors of MACE · 10 ± 9 years of follow-up

HR (95% CI)P value
Age at diagnosis1.034 (1.018–1.050)P < 0.001
OutcomeHR (95% CI)P value
Predictors of MACE · 10 ± 9 years of follow-upNYHA IIvs NYHA I1.944 (0.896–4.218)
Predictors of MACE · 10 ± 9 years of follow-upNYHA IIIvs NYHA I5.291 (2.392–11.705)P < 0.001

Multiple pregnancies (among women with pregnancy)

Multiple occurrences did not modify risk

Safety

Peri-partum MACE in pregnancies after HCM diagnosis · peri-partum (−1 to 6 months after delivery)

Women with pregnancies after HCM diagnosis (39 pregnancies)
29 (7.6%)
MACE in peri-partum period, all carrying likely pathogenic sarcomeric variants
3

Original publication

Impact of pregnancy on the natural history of women with hypertrophic cardiomyopathy. Eur J Prev Cardiol. Published 2 August 2023. doi:10.1093/eurjpc/zwad257

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