Abstract 16811: In-Utero Coxsackievirus Type B Infection is Associated With Congenital Pulmonary Atresia

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Vipul Sharma ◽  
Lisa S Goessling ◽  
Horacio G Carvajal ◽  
Anoop K Brar ◽  
Pirooz Eghtesady
Keyword(s):  
Pregnant Women ◽  
Neutralizing Antibodies ◽  
Septal Defect ◽  
Heart Defects ◽  
Pulmonary Atresia ◽  
In Utero ◽  
Maternal Serum ◽  
Coxsackievirus B ◽  
A Prospective Study ◽  
Left Heart Syndrome

Introduction: Maternal exposure to various pathogens during pregnancy has been well established as a cause of congenital heart defects (CHD). Suggestive, although inconclusive, data exists of an association between Coxsackievirus B (CVB) infection during pregnancy and CHD. Therefore, this study was undertaken to examine association between perinatal infection with CVB and CHD. Hypothesis: CVB infection during pregnancy may play a role in the pathogenesis of CHD. Methods: In a prospective study of 122 pregnant women with pregnancies affected with CHD, circulating CVB IgG and IgM antibodies in the maternal serum were quantified. To determine specific CVB serotypes involved, Neutralizing antibodies (NA) were measured against three CVB serotypes: CVB1-Chi07, CVB3, Nancy, and CVB4, J.V.B. Results: A significant number of the women were positive for CVB antibodies; 31.1% for IgG and 6.6% for IgM. Elevated levels of IgG were seen in 50% of women carrying babies with Pulmonary Atresia (PA) (p=0.04). In addition, 55.6% (p=0.100) of moms carrying babies with Hypoplastic Left Heart Syndrome (HLHS), aortic atresia/mitral stenosis (AA/MS) variant and 47.1% (p=0.127) of HLHS AA/mitral atresia (MA) had positive IgG levels. Among babies of women with positive IgM titers, 75% (p=0.001) had isolated Ventricular Septal Defect (VSD), comprising 26.1% (6/23) of all babies with isolated VSD in the cohort.We also show a possible association between CVB4 and CHD in the cohort. All mothers with positive IgM titers whose babies were born with a VSD had elevated CVB4 NA (p=0.001). Among women with elevated IgG having babies with PA, 40.0% (p=0.061) had elevated CVB1 NA, 70.0% (p=0.014) had elevated CVB3 NA, and 40.0% (p=0.876) had elevated CVB4 NA. Conclusion: We present data from a clinical study suggesting that CVB infection during pregnancy may contribute to the burden of CHD in affected babies. Our data demonstrates not only an association of CVB with CHD in pregnant women but this is the first report showing significant association between in-utero CVB infection and PA. Our study has broad implications for the future understanding and potential management of CHD as well as introduces a new avenue of research for cardiac defects.

scholarly journals In Utero Infection with Coxsackievirus-B is Associated with Congenital Pulmonary Atresia

2020 ◽  
Author(s):  
Vipul Sharma ◽  
Lisa S. Goessling ◽  
Anoop K. Brar ◽  
Pirooz Eghtesady
Keyword(s):  
Pregnant Women ◽  
Heart Defects ◽  
Pulmonary Atresia ◽  
Neutralizing Antibody ◽  
In Utero ◽  
Perinatal Infection ◽  
P Values ◽  
Coxsackievirus B ◽  
Antibody Titers ◽  
A Prospective Study

AbstractThe research for this study was undertaken to examine association between perinatal infection with Coxsackievirus B (CVB) and congenital heart defects (CHD). Suggestive, although inconclusive, data exists of an association between CVB infection during pregnancy and CHD. We present data from a clinical study showing that CVB infection in early pregnancy induces heart defects. In a prospective study of 123 pregnant women with pregnancies affected with CHD we found circulating CVB IgG and IgM in the serum. A significant number of the women were positive for CVB antibodies; 30.9% for IgG and 6.5% for IgM. Our data demonstrates not only an association of CVB with CHD in pregnant women but this is the first report showing significant association between in-utero CVB infection and Pulmonary Atresia (PA) and HLHS (AA/MS variant). Elevated levels of IgG were seen in 55.5% of women carrying babies with PA and 60% of women carrying babies with HLHS (AA/MS), with p-values of 0.01 and 0.03 respectively. To determine specific CVB serotypes involved, neutralizing antibody titers to CVB1, CVB3, and CVB4 were analyzed on samples with positive IgG/IgM levels, and showed a possible association between CVB4 and CHD in the cohort. Our study has broad implications for the future understanding and potential management of CHD as well as introduces a new avenue of research for cardiac defects.

Coronary anomalies

2018 ◽  
Author(s):  
Cristina Basso ◽  
José Maria Perèz-Pomares ◽  
Gaetano Thiene ◽  
Lucile Houyel
Keyword(s):  
Coronary Artery ◽  
Heart Defects ◽  
Pulmonary Atresia ◽  
Great Artery ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Left Heart Syndrome ◽  
Congenitally Corrected Transposition ◽  
Arterial Anatomy ◽  
Corrected Transposition

Coronary artery anomalies occur either in isolation or in the context of congenital heart defects (CHD). Isolated coronary artery anomalies include anomalies of connection to the pulmonary artery or to the aorta, anomalies of the intrinsic coronary arterial anatomy including anomalous orifices, and anomalies of myocardial/coronary arterial interaction including myocardial bridges and fistulae. Such defects are of major significance in clinical cardiology and cardiac surgery because of their association with myocardial ischaemia and sudden death. Coronary anomalies associated with CHD can result from three types of developmental perturbation: (1) anomalous epicardial course (in congenitally corrected transposition of the great arteries and L-looped ventricles), (2) anomalous communication with a high-pressure ventricular cavity (pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome), or (3) anomalous connection to the aorta. Outflow tract defects represents 30–40% of CHD, and their main characteristic is great artery defects influencing coronary arterial anatomy.

scholarly journals Possible Association of Pulmonary Atresia with In-Utero Coxsackievirus B Exposure

2022 ◽  
Author(s):  
Horacio G. Carvajal ◽  
Vipul Sharma ◽  
Lisa S. Goessling ◽  
Taylor C. Merritt ◽  
Anoop K. Brar ◽  
...  
Keyword(s):  
Pulmonary Atresia ◽  
In Utero ◽  
Coxsackievirus B

The Accuracy of Single Progesterone, Single β-hCG, and Their Combination Measurement in Predicting Early Miscarriage: A Prospective Study in Outpatient Setting

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Eli Sia
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Good Predictor ◽  
First Trimester ◽  
Outpatient Setting ◽  
Maternal Serum ◽  
Serum Progesterone ◽  
First Trimester Of Pregnancy ◽  
Β Hcg ◽  
A Prospective Study

<p><strong>Introduction:</strong> Most of miscarriage events occurred during the first trimester of pregnancy. Recent studies found the beneficial effects of maternal serum markers to predict pregnancy outcomes. However, study in Indonesian setting was still limited, especially in outpatient setting. The aim of this study was to evaluate serum progesterone and β-hCG measurement  as a beneficial predictor of miscarriage.</p><p><strong>Materials &amp; Methods:</strong> This was a prospective study recruiting outpatients pregnant women in Aceh who seek first medical attention for their pregnancy during January 2013 to January 2015. Serum progesterone and β-hCG level were measured beside routine obstetric procedure. The discrimination attained between miscarriage and non-miscarriage groups of pregnant women at the end of first trimester was evaluated using logistic regression and receiver operating curve analysis.</p><p><strong>Results: </strong>Among 70 pregnant recruited in this study, nineteen of them (27.1%) experienced miscarriage. Serum progesterone level of women in miscarriage group was lower than non-miscarriage group (17.85 (IQR 13.26-21.15) ng/dl vs 33.67 (IQR 21.83-44.14), p&lt;0.001). Serum β-hCG level was also lower in miscarriage group (10 681 (IQR 5 787.5-26 577.5) mIU/ml vs 48 109 (IQR 17 137-93 915) mIU/ml, p=0.001). Single progesterone measurement gave a good predictor ability for miscarriage with 82.2% accuracy, 86.3% sensitivity and 73.7% specificity if 19.5 ng/dl was used as a cut-off point.</p><strong>Conclusion: </strong>Maternal serum progesterone level could be a good predictor for miscarriage during the first trimester of pregnancy. Single β-hCG serum in combination with progesterone serum measurement only had little added value for predicting miscarriage.

scholarly journals Spectrum of congenital heart disease in Down syndrome at Faisalabad institute of cardiology: A retrospective study.

2020 ◽  
Vol 27 (03) ◽  
pp. 660-666
Author(s):  
Abdul Razzaq Mughal ◽  
Zaigham Rasool Khalid ◽  
Bisma Safdar ◽  
Safia Mughal
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Pulmonary Atresia ◽  
Case Series ◽  
Cardiac Defects ◽  
Study Results

Congenital heart disease (CHD) is the most common structural anomaly in Down syndrome children with a variable spectrum all over the world including Pakistan. Objectives: To determine the spectrum of congenital heart disease in Down syndrome at Faisalabad Institute of cardiology (FIC) Faisalabad. Study Design: Retrospective descriptive case series. Setting: Pediatric Cardiology Department of FIC, Faisalabad. Period: From January 2013 to June 2019. Material & Methods: All Consecutive patients of Down syndrome who underwent diagnostic Echocardiography at FIC were enrolled. Those having confirmed diagnosis of CHD were included in the study. Results: Out of 321Down syndrome children77.6% (n=249) had CHD and were enrolled for study. Male were 53.8% (n=134) while 46.2% were female (n=115). Majority of patients were below one year of age (57%, n=142). Acyanotic CHD was seen in 83.1 % of patients (n=207) while 16.9 % (n=42) had cyanotic CHD. Isolated cardiac defects was seen in 73.1% of patients (n=182) while 26.9 % had mixed cardiac lesions (n=67). Ventricular septal defect (VSD) was the most common (22.1%, n=55) solitary lesion followed by 14.5% cases of atrioventricular septal defect (AVSD), PDA (13.3%) and ASD (8.8%). Tetralogy of Fallot (TOF) was seen in 8.4%, AS in 1.2% while TGA, Tricuspid atresia, pulmonary valve stenosis, coarctation and Ebstein anomaly (0.8% each) were less common solitary defects. In mixed cardiac defects VSD with PDA was the most common (n=13, 5.22%) followed by VSD with ASD (n=12, 4.81%) and VSD with RVOTO (n=8, 3.21%). In AVSD cases, RVOTO was present in 2.81% (n=7), PDA with ASD was seen in 2% cases (n=5) while CcTGA, DORV, Pulmonary atresia were least common. Pulmonary Hypertension was present in 54.2% cases of left to right shunt lesions. Conclusion: Incidence of CHD in referred cases of Down syndrome is high (77.6%) at our setup. Acyanotic congenital heart defects are more common. VSD is the most common acyanotic CHD followed by AVSD while TOF is the most common cyanotic CHD.

scholarly journals Maternal Serum Levels of TNF-Alpha and IL-6 Long after Delivery in Preeclamptic and Normotensive Pregnant Women

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
N. Vitoratos ◽  
E. Economou ◽  
C. Iavazzo ◽  
K. Panoulis ◽  
G. Creatsas
Keyword(s):  
Pregnant Women ◽  
Serum Levels ◽  
Maternal Serum ◽  
The Other ◽  
Tnf Alpha ◽  
Blood Samples ◽  
Inflammatory Stress ◽  
Before And After ◽  
A Prospective Study ◽  
Normal Controls

Aim. To evaluate maternal TNF-alpha and IL-6 plasma levels in normotensive pregnant women, women with preeclampsia, and to examine the temporal changes in their levels from theantepartum to the postpartum period correlated with the regression of preeclampsia.Method. A prospective study was performed in the 2nd Department of Obstetrics and Gynecology, University of Athens. Blood samples were obtained: (1) antepartum at the time of clinical diagnosis of the syndrome, 2. 12-14 weeks postpartum.Results. No statistically significant differences were found in IL-6 levels, whereas a difference was found in TNF-alpha levels between preeclamptic and controls in antepartum period (0.80 pg/ml versus 0.60 pg/ml, ). Long after delivery, TNF-alpha levels were significantly higher in preeclamptic compared to normotensive controls (0.86 pg/ml versus 0.60 pg/ml, ). No difference was observed in TNF-alpha before and after delivery in both groups. No difference was noticed in IL-6 levels in women of normotensive group long after delivery compared to that before delivery. Long after delivery IL-6 levels were statistically significant higher in preeclamptic women compared to normal controls (3.53 ± 0.52 pg/ml versus 1.69 ± 0.48 pg/ml, ).Conclusion. Preeclamptic women remain under a status of increased inflammatory stress up to 12-14 weeks postpartum despite the fact that all the other signs of preeclampsia are resolved.

scholarly journals Creation of an Atrial Septal Defect In Utero for Fetuses With Hypoplastic Left Heart Syndrome and Intact or Highly Restrictive Atrial Septum

Circulation ◽  
2004 ◽  
Vol 110 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Audrey C. Marshall ◽  
Mary E. van der Velde ◽  
Wayne Tworetzky ◽  
Carlen A. Gomez ◽  
Louise Wilkins-Haug ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Hypoplastic Left Heart Syndrome ◽  
Septal Defect ◽  
In Utero ◽  
Atrial Septum ◽  
Left Heart ◽  
Hypoplastic Left Heart ◽  
Left Heart Syndrome
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