Background Women with cardiomyopathy (CM) are often advised against pregnancy due to risk for major adverse cardiovascular events (MACE). However, the impact of CM subtype on maternal MACE is not understood, and so we sought to evaluate the influence of CM phenotype on maternal outcomes, as well as the effect on immediate and late left ventricular function. Methods We evaluated all pregnant women in our high-risk maternal cardiovascular programme (2009–2019). Composite maternal MACE included: death, inotrope use, left ventricular assist device, orthotopic heart transplant and/or escalation in transplant listing status, acute decompensated heart failure and sustained ventricular arrhythmia. Results Among 875 women followed, 32 had CM (29±7 years old, left ventricular ejection fraction (LVEF) 41%±12%): 3 ischaemic CM (ICM), 10 peripartum CM (PPCM) and 19 non-ICM (NICM). MACE events occurred in 6 (18%) women (PPCM: 2 (33%), NICM: 4 (67%)). There was no difference in LVEF at baseline, however, women with MACE had significantly lower LVEF both early (LVEF: 27±5% vs . 41±2%, p<0.05) and late post partum (LVEF: 28±5% vs . 44±2%, p<0.01). Conclusions In this contemporary cohort of women with CM, maternal MACE rates were lower than previously reported, and were less common in PPCM as compared with ICM and NICM. Heart function in women with MACE was negatively impacted immediately after delivery and in late postpartum follow-up, suggesting that pregnancy itself likely has influence on future left ventricular function in women with underlying CM. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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妊娠期心力衰竭：妊娠对心脏功能的长期影响是什么？三级护理中心的经验和系统评价

背景 由于主要不良心血管事件 (MACE) 的风险，通常建议患有心肌病 (CM) 的女性不要怀孕。然而，CM 亚型对母体 MACE 的影响尚不清楚，因此我们试图评估 CM 表型对母体结局的影响，以及对即时和晚期左心室功能的影响。方法 我们评估了高危孕产妇心血管项目（2009-2019）中的所有孕妇。复合孕产妇 MACE 包括：死亡、正性肌力药使用、左心室辅助装置、原位心脏移植和/或移植列表状态升级、急性失代偿性心力衰竭和持续性室性心律失常。结果 在随访的 875 名女性中，32 名患有 CM（29±7 岁，左心室射血分数 (LVEF) 41%±12%）：3 名缺血性 CM (ICM)，10 个围产期 CM (PPCM) 和 19 个非 ICM (NICM)。MACE 事件发生在 6 名（18%）女性（PPCM：2 名（33%），NICM：4 名（67%））。基线时的 LVEF 没有差异，但是，患有 MACE 的女性在产后早期（LVEF：27±5% 对 41±2%，p<0.05）和晚期（LVEF：28±5% 对44±2%，p<0.01)。结论 在这个当代 CM 女性队列中，母亲 MACE 发生率低于先前报告的，并且与 ICM 和 NICM 相比，PPCM 中的发生率较低。患有 MACE 的女性的心脏功能在分娩后立即和产后后期随访中受到负面影响，这表明怀孕本身可能会影响患有潜在 CM 的女性未来的左心室功能。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。