Department of Cardiology and Experimental Cardiology, Heart Failure Research Centre, Amsterdam, Netherlands.
Eur J Heart Fail. 2011 Jun;13(6):584-94. doi: 10.1093/eurjhf/hfr040. Epub 2011 Apr 11.
Pregnancy exposes women with inherited cardiomyopathies to increased risk for heart failure and arrhythmias. In this paper, we review the clinical course and management of pregnant women with the following inherited cardiomyopathies: hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, left ventricular non-compaction cardiomyopathy, and restrictive cardiomyopathy. We also discuss peripartum cardiomyopathy. Pregnancy is generally well tolerated in asymptomatic patients with inherited cardiomyopathies. However, worsening of the clinical condition can occur during pregnancy, despite intensive medical treatment. If prior cardiac events, poor functional class (New York Heart Association class III or IV), or advanced left ventricular systolic dysfunction are present, the risk of maternal cardiac complications during pregnancy are markedly increased. The postpartum condition is generally no worse than the antepartum condition, but no long-term follow-up studies have been reported. Preconception evaluation and counselling are important aspects of managing women with inherited cardiomyopathies. Genetic counselling and DNA testing should be offered to all women following the diagnosis of an inherited cardiomyopathy.
妊娠使患有遗传性心肌病的女性面临心力衰竭和心律失常风险增加。本文综述了以下遗传性心肌病孕妇的临床过程和处理方法：肥厚型心肌病、扩张型心肌病、致心律失常性右室心肌病、左室致密化不全心肌病和限制型心肌病。我们还讨论了围产期心肌病。无症状遗传性心肌病孕妇一般能较好耐受妊娠。然而，尽管接受了强化治疗，妊娠期间临床病情仍可能恶化。如果存在既往心脏事件、心功能较差（纽约心脏协会心功能分级 III 或 IV 级）或左心室收缩功能障碍较严重，孕妇发生心脏并发症的风险显著增加。产后情况一般不比产前差，但尚无长期随访研究报道。孕前评估和咨询是管理遗传性心肌病女性的重要方面。遗传性心肌病诊断后，应向所有女性提供遗传咨询和 DNA 检测。
