Background: Cardiopulmonary exercise testing is often used to evaluate exercise capacity in adults with congenital heart disease including women who are considering pregnancy. The relationship between cardiopulmonary exercise testing parameters and pregnancy outcome has not been defined.
Methods And Results: We conducted a multicenter retrospective observational study of women with congenital heart disease who had undergone cardiopulmonary exercise testing within 2 years of pregnancy or during the first trimester. Cardiopulmonary exercise testing variables included peak oxygen consumption and measures of chronotropic response: peak heart rate, percentage of maximum age predicted heart rate, heart rate reserve (peak heart rate-resting heart rate), and chronotropic index [(peak heart rate-resting heart rate)/(220-age-resting heart rate)]. We identified 89 pregnancies in 83 women. There were 4 spontaneous abortions and 1 termination. One or more adverse cardiac events occurred in 18%; congestive heart failure in 14%, and sustained arrhythmia in 7%. Peak heart rate (odds ratio [OR] 0.71; 95% confidence interval [CI] [0.53, 0.94]; P=0.02), percentage of maximum age predicted heart rate (OR 0.93; 95% CI [0.88, 0.98]; P=0.01), and chronotropic index (OR 0.65; 95% CI [0.47, 0.90]; P=0.01) were associated with a cardiac event. Neonatal events occurred in 20%. Peak heart rate (OR 0.75; 95% CI [0.58, 0.98]; P=0.04), percentage of maximum age predicted heart rate (OR 0.94; 95% CI [0.89, 0.99]; P=0.02), heart rate reserve (OR 0.8; 95% CI [0.64, 0.99]; P=0.04), and chronotropic index (OR 0.73; 95% CI [0.54, 0.98]; P=0.04) correlated with a neonatal event. Peak oxygen consumption was not associated with an adverse pregnancy outcome.
Conclusions: Abnormal chronotropic response correlates with adverse pregnancy outcomes in women with congenital heart disease and should be considered in refining risk stratification schemes.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.110.953380 | DOI Listing |
PLoS One
January 2025
Department of Neonatology/Neonatal Intensive Care Unit, University Hospital of Heraklion, School of Medicine, University of Crete, Heraklion, Crete, Greece.
Preterm births constitute a major public health issue and a chronic, cross-generational condition globally. Psychological and biological factors interact in a way that women from low socio-economic status (SES) are disproportionally affected by preterm delivery and at increased risk for the development of perinatal mental health problems. Low SES constitutes one of the most evident contributors to poor neurodevelopment of preterm infants.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain.
Background: Motor imagery is the mental representation of a movement without physical execution. When motor imagery is performed to enhance motor learning and performance, participants must reach a temporal congruence between the imagined and actual movement execution. Identifying factors that can influence this capacity could enhance the effectiveness of motor imagery programs.
View Article and Find Full Text PDFAm Surg
January 2025
Department of Medicine, Ziauddin Medical College, Karachi, Pakistan.
Aims: The purpose of this systematic review was to assess the safety and effectiveness of beta antagonists for improving clinical care in burn patients, compared to placebo.
Methods: Articles from randomized-controlled trials were identified by a literature search on PubMed and Cochrane. We included relevant trials involving patients with burn.
Medicine (Baltimore)
January 2025
Teaching Office, Second People's Hospital of Shenzhen (First Affiliated Hospital of Shenzhen University), Shenzhen City, China.
Previous studies have provided relatively limited evidence in examining the impact of preoperative serum albumin levels on the length of hospital stay (LOS) in patients with hip fractures. This study aimed to elucidate the association between preoperative serum albumin levels and LOS in elderly patients with hip fractures. This retrospective cohort study included 1444 elderly patients undergoing surgical treatment for hip fractures at the Second People's Hospital of Shenzhen from January 2012 to December 2021.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Precision Medical Center, Wuhan Childrens Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China.
Understanding the differences between children with severe and non-severe types of neonatal pneumonia is crucial for clinical treatment and disease management. In this study, we retrospectively analyzed the clinical data of infants with neonatal pneumonia diagnosed as respiratory syncytial virus infection at Wuhan Children's Hospital between December 1, 2022 and November 30, 2023. Further, the recruited subjects were categorized into severe and non-severe groups based on the severity score.
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