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Aortic Complications Associated With Pregnancy in Marfan Syndrome: the NHLBI National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC)
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نویسنده
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roman m.j. ,pugh n.l. ,hendershot t.p. ,devereux r.b. ,dietz h. ,holmes k. ,eagle k.a. ,lemaire s.a. ,milewicz d.m. ,morris s.a. ,pyeritz r.e. ,ravekes w.j. ,shohet r.v. ,silberbach m. ,ravekes w. ,dietz h.c. ,habashi j. ,prakash s.k. ,lemaire s.a. ,holmes k.w. ,maslen c.l. ,song h.k. ,silberbach g.m. ,bavaria j.e. ,milewski k. ,weinsaft j.w. ,shohet r. ,mcdonnell n. ,asch f.m. ,tolunay h.e. ,desvigne-nickens p. ,tseng h. ,kroner b.l.
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منبع
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journal of the american heart association - 2016 - دوره : 5 - شماره : 8
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چکیده
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Background: the risk of aortic complications associated with pregnancy in women with marfan syndrome (mfs) is not fully understood. methods and results: mfs women participating in the large national registry of genetically triggered thoracic aortic aneurysms and cardiovascular conditions (gentac) were evaluated. among 184 women with mfs in whom pregnancy information was available,94 (51%) had a total of 227 pregnancies. among the women with pregnancies,10 (10.6%) experienced a pregnancy-related aortic complication (4 type a and 3 type b dissections,1 coronary artery dissection,and 2 with significant [≥3 mm] aortic growth). five of 7 aortic dissections,including all 3 type b,and the coronary dissection (75% of all dissections) occurred in the postpartum period. only 5 of 8 women with pregnancy-associated dissection were aware of their mfs diagnosis. the rate of aortic dissection was higher during the pregnancy and postpartum period (5.4 per 100 person-years vs 0.6 per 100 person-years of nonpregnancy; rate ratio,8.4 [95% ci=3.9,18.4]; p<0.0001). conclusions: pregnancy in mfs is associated with an increased risk of aortic dissection,both types a and b,particularly in the immediate postpartum period. lack of knowledge of underlying mfs diagnosis before aortic dissection is a major contributing factor. these findings underscore the need for early diagnosis,prepregnancy risk counseling,and multidisciplinary peripartum management. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.
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کلیدواژه
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Aneurysm; Aortic disease; Aortic dissection; Marfan syndrome; Pregnancy and postpartum
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آدرس
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division of cardiology,weill cornell medical college,new york,ny,united states,weill cornell medical college, United States, biostatistics and epidemiology division,rti international,rockville,md, United States, biostatistics and epidemiology division,rti international,rockville,md, United States, division of cardiology,weill cornell medical college,new york,ny,united states,weill cornell medical college, United States, department of pediatrics,johns hopkins university school of medicine,baltimore,md, United States, department of pediatrics,oregon health and sciences university,portland,or, United States, division of cardiology,university of michigan health system,ann arbor,mi,united states,university of michigan, United States, division of cardiothoracic surgery,baylor college of medicine,houston,tx, United States, department of internal medicine,mcgovern medical school,university of texas health science center,houston,tx,united states,university of texas,houston, United States, division of pediatric cardiology,department of pediatrics,baylor college of medicine,houston,tx,united states,baylor college of medicine, United States, department of medicine,perelman school of medicine at the university of pennsylvania,philadelphia,pa,united states,university of pennsylvania, United States, department of pediatrics,johns hopkins university school of medicine,baltimore,md, United States, department of medicine,john a. burns school of medicine,honolulu,hi, United States, department of pediatrics,oregon health and sciences university,portland,or, United States, johns hopkins university, United States, johns hopkins university, United States, johns hopkins university, United States, university of texas,houston, United States, baylor college of medicine, United States, oregon health and science university, United States, oregon health and science university, United States, oregon health and science university, United States, oregon health and science university, United States, university of pennsylvania, United States, university of pennsylvania, United States, weill cornell medical college, United States, the queen's medical center, United States, national institute on aging, United States, medstar health research institute, United States, national heart lung and blood institute, United States, national heart lung and blood institute, United States, national institute of arthritis,musculoskeletal and skin diseases, United States, rti international, United States
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Authors
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