Fluorinated steroids do not improve outcome of isolated atrioventricular block

N. W E Van den Berg; M. G. Slieker; I. M. van Beynum; C. M. Bilardo; D. de Bruijn; S. A. Clur; J. M J Cornette; I. M E Frohn-Mulder; M. C. Haak; K. E H van Loo-Maurus; G. T R Manten; A. B M H Rackowitz; L. A J Rammeloo; A. Reimer; M. E B Rijlaarsdam; M. W. Freund

doi:10.1016/j.ijcard.2016.09.119

Fluorinated steroids do not improve outcome of isolated atrioventricular block

N. W E Van den Berg, M. G. Slieker, I. M. van Beynum, C. M. Bilardo, D. de Bruijn, S. A. Clur, J. M J Cornette, I. M E Frohn-Mulder, M. C. Haak, K. E H van Loo-Maurus, G. T R Manten, A. B M H Rackowitz, L. A J Rammeloo, A. Reimer, M. E B Rijlaarsdam, M. W. Freund^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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° or AVB-III° 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.

Original language	English
Pages (from-to)	167-171
Number of pages	5
Journal	International Journal of Cardiology
Volume	225
DOIs	https://doi.org/10.1016/j.ijcard.2016.09.119
Publication status	Published - 15 Dec 2016

Keywords

Antibodies
Cardiomyopathy
Congenital atrioventricular block
Heart block

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Van den Berg, N. W. E., Slieker, M. G., van Beynum, I. M., Bilardo, C. M., de Bruijn, D., Clur, S. A., Cornette, J. M. J., Frohn-Mulder, I. M. E., Haak, M. C., van Loo-Maurus, K. E. H., Manten, G. T. R., Rackowitz, A. B. M. H., Rammeloo, L. A. J., Reimer, A., Rijlaarsdam, M. E. B., & Freund, M. W. (2016). Fluorinated steroids do not improve outcome of isolated atrioventricular block. International Journal of Cardiology, 225, 167-171. https://doi.org/10.1016/j.ijcard.2016.09.119

@article{243dcf8eff39412ca30a163fdd0c2775,

title = "Fluorinated steroids do not improve outcome of isolated atrioventricular block",

abstract = "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° or AVB-III° 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.",

keywords = "Antibodies, Cardiomyopathy, Congenital atrioventricular block, Heart block",

author = "{Van den Berg}, {N. W E} and Slieker, {M. G.} and {van Beynum}, {I. M.} and Bilardo, {C. M.} and {de Bruijn}, D. and Clur, {S. A.} and Cornette, {J. M J} and Frohn-Mulder, {I. M E} and Haak, {M. C.} and {van Loo-Maurus}, {K. E H} and Manten, {G. T R} and Rackowitz, {A. B M H} and Rammeloo, {L. A J} and A. Reimer and Rijlaarsdam, {M. E B} and Freund, {M. W.}",

year = "2016",

month = dec,

day = "15",

doi = "10.1016/j.ijcard.2016.09.119",

language = "English",

volume = "225",

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journal = "International Journal of Cardiology",

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publisher = "Elsevier Ireland Ltd",

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Van den Berg, NWE, Slieker, MG, van Beynum, IM, Bilardo, CM, de Bruijn, D, Clur, SA, Cornette, JMJ, Frohn-Mulder, IME, Haak, MC, van Loo-Maurus, KEH, Manten, GTR, Rackowitz, ABMH, Rammeloo, LAJ, Reimer, A, Rijlaarsdam, MEB & Freund, MW 2016, 'Fluorinated steroids do not improve outcome of isolated atrioventricular block', International Journal of Cardiology, vol. 225, pp. 167-171. https://doi.org/10.1016/j.ijcard.2016.09.119

TY - JOUR

T1 - Fluorinated steroids do not improve outcome of isolated atrioventricular block

AU - Van den Berg, N. W E

AU - Slieker, M. G.

AU - van Beynum, I. M.

AU - Bilardo, C. M.

AU - de Bruijn, D.

AU - Clur, S. A.

AU - Cornette, J. M J

AU - Frohn-Mulder, I. M E

AU - Haak, M. C.

AU - van Loo-Maurus, K. E H

AU - Manten, G. T R

AU - Rackowitz, A. B M H

AU - Rammeloo, L. A J

AU - Reimer, A.

AU - Rijlaarsdam, M. E B

AU - Freund, M. W.

PY - 2016/12/15

Y1 - 2016/12/15

N2 - 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° or AVB-III° 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.

AB - 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° or AVB-III° 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.

KW - Antibodies

KW - Cardiomyopathy

KW - Congenital atrioventricular block

KW - Heart block

UR - http://www.scopus.com/inward/record.url?scp=84989925438&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2016.09.119

DO - 10.1016/j.ijcard.2016.09.119

M3 - Article

C2 - 27728859

AN - SCOPUS:84989925438

SN - 0167-5273

VL - 225

SP - 167

EP - 171

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

Fluorinated steroids do not improve outcome of isolated atrioventricular block

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Keywords

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