Cardio-oncology & otherCohort study

Pregnancy in Women With Impaired Left Ventricular Function

JACC AdvPublished

  • international, prospective, observational cohort
  • registry (ROPAC)

Authors' conclusion

Women with impaired LVF are at increased risk of complications, particularly heart failure, tachyarrhythmias, and premature delivery with low birth weight.

Study context

Population
Pregnant women with impaired left ventricular function (left ventricular ejection fraction <40%)patients with impaired left ventricular function (LVF)
Participants
251 women
Outcome
MACE:
  • Maternal death
  • Supraventricular or ventricular arrhythmias
  • Heart failure
  • Aortic dissection
  • Endocarditis
  • Ischemic coronary event
  • Other thromboembolic events
Follow-up
During pregnancy or up to 6 months postpartum

Main finding

As reported in the abstract

Patients with at least one major adverse cardiac events (MACE)

81 of 251 (32%, 27%-38%)

Observational data: associations, not effects.

Further findings

Maternal mortality

Maternal mortality
6/251 (2.4%, 1%-5%)

Heart failure

Heart failure
67/251 (27%, 21%-33%)

Ventricular tachyarrhythmias

Ventricular tachyarrhythmias
11/251 (4%, 2%-8%)

Obstetric complications

Preterm birth
67/251 (27%, 22%-33%)
Low birthweight
65/251 (26%, 21%-32%)

Cardiovascular complications in patients with cardiomyopathy · during pregnancy

Mortality
4.3%
Risk of MACE
nearly 40%

Variables associated with poor cardiac outcomes

Prepregnancy signs of heart failure, OR
2.67; 1.3-5.6
Atrial fibrillation, OR
6.32; 3.0-13.3
NYHA functional class >II, OR
6.06; 2.2-16.6
  • logistic regression

Follow-up duration

Median follow-up duration
7 (6-11) months

Original publication

Pregnancy in Women With Impaired Left Ventricular Function. JACC Adv. Published 25 February 2026. doi:10.1016/j.jacadv.2026.102605

Summarised from the published abstract; every number is checked against it