Fluorinated steroids do not improve outcome of isolated atrioventricular block

被引：28

作者：

Van den Berg, N. W. E. ^{[1
,2
]}

Slieker, M. G. ^{[1
,3
]}

van Beynum, I. M. ^{[4
]}

Bilardoo, C. M. ^{[15
]}

de Bruijn, D. ^{[13
]}

Clur, S. A. ^{[6
]}

Cornette, J. M. J. ^{[14
]}

Frohn-Mulder, I. M. E. ^{[4
]}

Haak, M. C. ^{[7
]}

van Loo-Maurus, K. E. H. ^{[8
]}

Manten, G. T. R. ^{[12
]}

Rackowitz, A. B. M. H. ^{[5
]}

Rammeloo, L. A. J. ^{[9
]}

Reimer, A. ^{[3
]}

Rijlaarsdam, M. E. B. ^{[10
]}

Freund, M. W. ^{[1
,11
]}

机构：

[1] Univ Med Ctr Utrecht, Dept Pediat Cardiol, Utrecht, Netherlands

[2] Acad Med Ctr Amsterdam, Ctr Heart, Dept Cardiol, Amsterdam, Netherlands

[3] Radboud Univ Nijmegen, Med Ctr Nijmegen, Dept Pediat Cardiol, Nijmegen, Netherlands

[4] Erasmus Univ, Med Ctr Rotterdam, Dept Pediat Cardiol, Rotterdam, Netherlands

[5] Univ Groningen, Univ Med Ctr Groningen, Dept Pediat Cardiol, Groningen, Netherlands

[6] Acad Med Ctr Amsterdam, Dept Pediat Cardiol, Amsterdam, Netherlands

[7] Leiden Univ, Med Ctr, Dept Obstet & Gynecol, Leiden, Netherlands

[8] Maastricht Univ, Med Ctr, Dept Pediat Cardiol, Maastricht, Netherlands

[9] Vrije Univ Amsterdam, Med Ctr, Dept Pediat Cardiol, Amsterdam, Netherlands

[10] Leiden Univ, Med Ctr, Dept Pediat Cardiol, Leiden, Netherlands

[11] Carl von Ossietzky Univ Oldenburg, Dept Pediat Cardiol, Campus Klinikum Oldenburg, Oldenburg, Germany

[12] Univ Med Ctr Utrecht, Dept Obstet & Gynecol, Utrecht, Netherlands

[13] Radboud Univ Nijmegen, Dept Obstet & Gynecol, Med Ctr Nijmegen, Nijmegen, Netherlands

[14] Erasmus Univ, Med Ctr Rotterdam, Dept Obstet & Gynecol, Rotterdam, Netherlands

[15] Univ Groningen, Univ Med Ctr Groningen, Dept Obstet & Gynecol, Groningen, Netherlands

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2016年 / 225卷

关键词：

Heart block; Antibodies; Cardiomyopathy; Congenital atrioventricular block; CONGENITAL HEART-BLOCK; NEONATAL LUPUS; IN-UTERO; NATURAL-HISTORY; ANTI-RO; FETAL; THERAPY; DEXAMETHASONE; DISEASE; CARDIOMYOPATHY;

D O I：

10.1016/j.ijcard.2016.09.119

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Congenital atrioventricular block (CAVB) is a rare disorder with a significant morbidity and mortality. Consensus regarding the prescription and efficacy of prenatal corticosteroids is lacking. This nationwide study was initiated to evaluate the effects of prenatal treatment with corticosteroids on the outcome of CAVB in The Netherlands. Methods: All fetuses identified with isolated congenital AVB-II degrees or AVB-III degrees in any of the eight academic fetal heart centers of The Netherlands between 2003 and 2013 were included and reviewed. Results: Fifty-six fetuses were included. Fourteen (25%) fetuses were treated with dexamethasone. We found no differences between the steroid-treated and untreated cases regarding in utero progression of the AVB (63% vs 67% respectively), survival to birth (86% vs 84%), pacemaker implantations (74% vs 58%) or long-term dilated cardiomyopathy (13% vs 17%). Steroid treated fetuses demonstrated more in utero growth restriction (38% vs 11%). Conclusion: No benefit from prenatal corticosteroid treatment was demonstrated for fetuses with isolated CAVB in this study. However, we found negative side effects. Our data provide no evidence to support the routine administration of corticosteroids for the treatment of fetal CAVB. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：167 / 171

页数：5

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