ISSN: 2148-4902 | E-ISSN: 2536-4553
Northern Clinics of Istanbul Preconception Consultation Using Treadmill Exercise Stress Echocardiography for Pregnant Women with Left-Sided Heart Valve Stenosis: A Preliminary Report [North Clin Istanb]
North Clin Istanb. Ahead of Print: NCI-67809 | DOI: 10.14744/nci.2021.67809

Preconception Consultation Using Treadmill Exercise Stress Echocardiography for Pregnant Women with Left-Sided Heart Valve Stenosis: A Preliminary Report

Nasibeh Mohammadi1, Maryam Shojaeifard2, Fahimeh Kashfi3, Farnoosh Larti1, Maryam Chenaghlou4, Yousef Rezaei3, Niloufar Samiei3
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
3Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
4Cardiovascular research center, Tabriz university of medical sciences, Tabriz, Iran

Background: Pregnancy can increase gradients across the heart valves, and consequently deteriorates maternal and fetoneonatal conditions. So, pregnancy during heart valve diseases can be challenging and we need to risk stratify patients before conception. We tried to assess the role of preconception consultation using treadmill stress echocardiography (TSE) testing for identifying pregnancy outcomes in women with mitral valve stenosis (MS) or aortic valve stenosis (AS).
Methods: Pregnant patients with a diagnosis of MS or AS were evaluated from January 2015 to December 2018. First group included patients undergoing the TSE testing and they were permitted to get pregnant if they met pre-defined criteria. Second group comprised of women who did not undergo TSE testing. Maternal and fetoneonatal outcomes were also recorded.
Results: A total of 29 and 18 patients with MS and AS, respectively, were recruited. Among MS patients, individuals without TSE had more functional deterioration (11.1% versus 35%) and more fetoneonatal events (22.2% versus 55%) compared with those undergoing TSE. The rates of maternal events and mitral valvuloplasty during pregnancy were significantly higher in patients without TSE compared with those undergoing TSE (p = 0.015 and p = 0.042, respectively). Among AS patients, maternal and fetoneonatal events were higher in patients without TSE compared with those undergoing TSE, but those were comparable.
Conclusions: Pregnant patients with left-sided valvular stenosis who received preconception TSE testing had better outcomes compared with those who did not undergo preconception consultation. This underscores the utility of stress echocardiography in the risk stratification of pregnancies. (NCI-2021-5-4/R2)

Keywords: Mitral valve, Aortic valve, Valvular stenosis, Stress echocardiography, Pregnancy



Corresponding Author: Niloufar Samiei
Manuscript Language: English
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