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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Does Pregnancy Increase Cardiac Risk for LQT1 Patients With the KCNQ1-A341V Mutation?
Journal of the American College of Cardiology, Volume 48, No. 7, Year 2006
Notification
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Description
Objectives: The purpose of this study was to assess the pregnancy-related cardiovascular risk in LQT1 patients. Background: Only 1 study addressed this issue in genotyped patients and reported that the highest risk is for LQT2 patients. Methods: This case-control study, performed in a cohort of patients from 22 families affected by LQT1 and all sharing the common KCNQ1-A341V mutation, involved 36 mutation carriers and 24 of their unaffected sisters for a total of 182 pregnancies. Results: There were 3 (2.6%) cardiac events (2 cardiac arrests) in the 115 LQT1 pregnancies. Because they occurred only among the 27 mothers with previous symptoms, all off-therapy, the risk for symptomatic patients is 11%, but decreases to 0 in symptomatic patients treated with beta-blockers. Carriers and control subjects did not differ for the incidence of miscarriage (10% vs. 15%). Cesarean sections (C-sections), elective or owing to fetal distress, were performed more often in carriers than in non-carriers (27% vs. 14%). Beta-blocker therapy did not influence the prevalence of fetal distress. Among the infants born to carriers, all those with fetal distress were carriers of the A341V mutation (10 of 10, 100%). Among the offspring of the carriers, 48 of 92 (52%) were mutation carriers, and of those, 15% died suddenly at age 14 ± 6 years. Conclusions: Women affected by the common KCNQ1-A341V mutation are at low risk for cardiac events during pregnancy and without excess risk of miscarriage; their infants delivered by C-section because of fetal distress are extremely likely to also be mutation carriers. Beta-blockers remain recommended. These conclusions likely apply to most LQT1 patients. © 2006 American College of Cardiology Foundation.
Authors & Co-Authors
Heradien, Marshall J.
South Africa, Stellenbosch
Stellenbosch University
Goosen, Althea
South Africa, Stellenbosch
Stellenbosch University
CROTTI, L.
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Durrheim, Glenda A.
South Africa, Stellenbosch
Stellenbosch University
Corfield, Valérie Ann
South Africa, Stellenbosch
Stellenbosch University
Brink, Paul A.
South Africa, Stellenbosch
Stellenbosch University
Schwartz, Peter J.
South Africa, Stellenbosch
Stellenbosch University
Italy, Pavia
Fondazione Irccs Policlinico San Matteo
Statistics
Citations: 49
Authors: 7
Affiliations: 2
Identifiers
Doi:
10.1016/j.jacc.2006.05.060
ISSN:
07351097
Research Areas
Cancer
Maternal And Child Health
Noncommunicable Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Participants Gender
Female