Clinical Sciences Lund, Lund University, Lund, Sweden.
Department of Pediatric Cardiology, Lund University, Skåne University Hospital, Lund, Sweden.
Cardiol Young. 2024 Jul;34(7):1514-1520. doi: 10.1017/S1047951124000374. Epub 2024 Mar 11.
Pregnancy-related physiological adaptations result in increased heart rate as well as electrocardiographic changes such as a mean QTc prolongation of 27 ms. Pregnant women with CHD are at increased risk for cardiovascular complications. The aim of this study was to identify risk factors for abnormally prolonged QTc interval-a risk factor for ventricular arrhythmias-in pregnant women with CHD.
Retrospective longitudinal single-centre study. Pre-pregnancy demographic and electrocardiographic risk factors for abnormal QTc duration during pregnancy of (a) > 460 ms and (b) >27 ms increase were analyzed.
Eighty-three pregnancies in 63 women were included, of which three had documented arrhythmias. All five Modified World Health Organization Classification of Maternal Cardiovascular Risk (mWHO) classes were represented, with 15 pregnancies (18.1%) in mWHO class I, 26 (31.3%) in mWHO II, 28 (33.7%) in mWHO II-III, 11 (13.3%) in mWHO III, and three pregnancies (3.6%) in mWHO class IV. Heart rate and QTc interval increased, while QRS duration and PR interval shortened during pregnancy. QTc duration of > 460 ms was associated with increased pre-pregnancy QTc interval, QRS duration, and weight, as well as body mass index. QTc increase of > 27 ms was associated with increased heart rate prior to pregnancy. No significant associations of electrocardiographic changes with mWHO class or CHD type were identified.
Increased QTc in pregnant women with CHD was associated with being overweight or having higher heart rate, QRS, or QTc duration prior to pregnancy. These patients should be monitored closely for arrhythmias during pregnancy.
妊娠相关的生理适应性导致心率增加，以及心电图变化，如平均 QTc 延长 27 毫秒。患有 CHD 的孕妇发生心血管并发症的风险增加。本研究旨在确定 CHD 孕妇异常延长 QTc 间期（室性心律失常的危险因素）的危险因素。
回顾性纵向单中心研究。分析了（a）>460ms 和（b）>27ms 妊娠期间异常 QTc 持续时间的孕前心电图和心血管危险因素。
纳入 63 名女性的 83 例妊娠，其中 3 例有记录的心律失常。所有 5 种改良世界卫生组织孕产妇心血管风险分类（mWHO）均有代表，mWHO I 类 15 例（18.1%），mWHO II 类 26 例（31.3%），mWHO II-III 类 28 例（33.7%），mWHO III 类 11 例（13.3%），mWHO IV 类 3 例（3.6%）。心率和 QTc 间期在妊娠期间增加，而 QRS 持续时间和 PR 间隔缩短。QTc 持续时间>460ms 与孕前 QTc 间隔、QRS 持续时间和体重以及体重指数增加有关。QTc 增加>27ms 与孕前心率增加有关。未发现心电图变化与 mWHO 类别或 CHD 类型之间存在显著相关性。
CHD 孕妇的 QTc 增加与超重或孕前心率、QRS 或 QTc 持续时间较高有关。这些患者在怀孕期间应密切监测心律失常。
