Effect of systolic pulmonary arterial pressure on the prognosis of pregnant women with shunt-related congenital heart disease-associated pulmonary hypertension
Sun Tiantian
Che Hao
Lyu Yufang
Liu Yaguang
Liu Daqi
Zhao Liyun
Abstract：Objective To investigate the relationship between systolic pulmonary arterial pressure(SPAP)and prognosis in pregnant women with shunt-related congenital heart disease-associated pulmonary hyper-tension(PH).Methods The clinical data of 254 pregnant women with shunt-related congenital heart disease-associated PH in Beijing Anzhen Hospital,Capital Medical University from January 2010 to July 2020 were retro-spectively analyzed.The patients were divided into non-drug treatment group(131 cases)and drug treatment group(123 cases)according to whether they needed postoperative drug treatment.The basic characteristics and perioperative management data of the two groups were compared.SPAP was estimated by echocardiography,and the correlation between SPAP and postoperative medication was evaluated by regression model,curve fitting and threshold saturation effect analysis.Results The body mass index and gestational age of the drug treatment group were less than those of the non-drug treatment group,the intraoperative infusion volume was less than that of the non-drug treatment group,and the proportion of New York Heart Association heart function grades Ⅲ-Ⅳ,SPAP levels,and the proportion of tricuspid valve regurgitation were higher than those in the non-drug treatment group(all P＜0.001).After adjusting for possible confounding factors,there was a non-linear correlation between SPAP and postoperative medication,and the turning point of SPAP was 90 mmHg.When SPAP≤90 mmHg,the risk of postoperative drug therapy increased with the increase of SPAP(odds ratio=1.06,95％confidence interval:1.02-1.09,P=0.001).When SPAP＞90 mmHg,there was no significant correlation between SPAP and postoperative medication(odds ratio=0.99,95％confidence interval:0.96-1.02,P=0.478).Compared with women with SPAP≤90 mmHg,those with SPAP＞90 mmHg have a higher risk of postoperative drug therapy(odds ratio=3.06,95％confidence interval:1.14-8.06,P=0.023).Conclusions Puerperae with severe PH have a high risk of requiring drug therapy after surgery.For mild to moderate patients,it is necessary to be vigilant,prepare for drug treatment and improve pulmonary artery pressure as soon as possible to reduce the risk of pregnancy.For these patients,individualized assessment of multiple factors is more important.
Keywords：Shunt-related congenital heart diseasePregnancyPulmonary hypertensionPostoperative drug therapy
Publication Date：2024-11-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1636-1639 )