{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:04:03Z","timestamp":1786122243932,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Fetal cardiomyopathy is a rare condition, often with an unknown cause and associated with high perinatal mortality. Recent years have seen improvement in fetal cardiac screening, genetic testing, and management. We sought to investigate genetic associations and clinical outcomes of fetal cardiomyopathy in the contemporary era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A single-arm (descriptive) retrospective cohort study of fetal cardiomyopathy cases diagnosed from January 2017 to December 2021 at 26 North American centers in the Fetal Heart Society Research Collaborative was undertaken. Cases attributable to maternal diabetes, extra-cardiac conditions, structural heart disease, or arrhythmias were excluded. Genetic testing results, extra-cardiac structural anomalies, and outcomes were collected. Logistic regression was performed to determine prenatal risk factors for death or cardiac transplantation by 1-year of age. Descriptive competing-risk analyses (cumulative incidence functions) and Kaplan-Meier survival estimates were used to describe outcomes. Multivariable logistic regression with 5 prespecified covariates was performed to identify prenatal factors associated with death or cardiac transplantation by 1-year of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In 148 cases of fetal cardiomyopathy, 6.7% (10\/148) opted for pregnancy termination, 8.6% (12\/138) of continuing pregnancies experienced fetal death, and 1.4% (2\/138) were lost to follow-up. Among continuing pregnancies, overall 1-year survival was 61.5% (85\/138) with 1-year transplant-free survival of 50.0% (69\/138). Of live births, 8.8% (11\/124) received palliative care from the outset, and 21.2% (24\/113) of those with intention to treat were listed for cardiac transplant, of whom 75.0% (18\/24) received transplantation by age 1-year. Genetic etiologies were found in 34.0% (50\/147) of the cohort, with variants of uncertain significance detected in an additional 27.2% (40\/147). Fetal hydrops at the time of prenatal diagnosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001) and a prenatal diagnosis of extracardiac structural anomalies (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.001) were significantly associated with death or transplant by 1-year of age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Fetal cardiomyopathy outcomes have improved in the current era, although only half achieve 1-year cardiac transplant-free survival. Genetic testing identifies a cause in one-third of cases. Hydrops at the time of fetal cardiomyopathy diagnosis and a prenatal diagnosis of extra-cardiac structural anomalies remain important risk factors for mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.126.014394","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T09:00:18Z","timestamp":1786093218000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fetal Cardiomyopathy in the Contemporary Era: A Multicenter Fetal Heart Society Research Collaborative Study"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9733-5795","authenticated-orcid":true,"given":"Angela","family":"McBrien","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8783-2195","authenticated-orcid":true,"given":"Astha","family":"Burande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3396-6456","authenticated-orcid":true,"given":"Oana","family":"Caluseriu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-2185","authenticated-orcid":true,"given":"Jennifer","family":"Conway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-544X","authenticated-orcid":true,"given":"Shabnam","family":"Peyvandi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of California San Francisco (S.P., A.J.M.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6805-2611","authenticated-orcid":true,"given":"Elijah","family":"Bolin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children\u2019s Hospital, Fayetteville (E.B., A.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3027-6246","authenticated-orcid":true,"given":"Tiscar","family":"Cavall\u00e9-Garrido","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Montreal Children\u2019s Hospital, McGill University Health Centre (T.C.-G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6732-8949","authenticated-orcid":true,"given":"James","family":"Cnota","sequence":"additional","affiliation":[{"name":"The Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Pediatric Cardiology, OH (J. Cnota)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8066-9421","authenticated-orcid":true,"given":"Sara","family":"Creighton","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Herma Heart Institute and Children\u2019s Wisconsin, Milwaukee (S. Creighton)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9085-0882","authenticated-orcid":true,"given":"Bettina F.","family":"Cuneo","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Surgery, University of Arizona School of Medicine, Tucson (B.F.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlayna","family":"Despres","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Primary Children\u2019s Hospital, Salt Lake City (M.D., W.H., C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8256-1535","authenticated-orcid":true,"given":"Tam T.","family":"Doan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Texas Children\u2019s Hospital, Department of Pediatrics, Baylor College of Medicine, Houston (T.T.D., J.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Scott","family":"Doucet","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Texas Children\u2019s Hospital, Department of Pediatrics, Baylor College of Medicine, Houston (T.T.D., J.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-081X","authenticated-orcid":true,"given":"Lindsay R.","family":"Freud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Grenier","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Denver, CO (M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-0213","authenticated-orcid":true,"given":"Whitnee","family":"Hogan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Primary Children\u2019s Hospital, Salt Lake City (M.D., W.H., C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-2626","authenticated-orcid":true,"given":"Michelle","family":"Kaplinski","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Chidlren\u2019s Hospital, Palo Alto, CA (M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7363-2477","authenticated-orcid":true,"given":"Ann","family":"Kavanaugh-McHugh","sequence":"additional","affiliation":[{"name":"Fetal Cardiology Program, Division of Pediatric Cardiology, The Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville, TN (A.K.-M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Keller","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Seattle Children\u2019s Hospital, University of Washington (S.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1781-1614","authenticated-orcid":true,"given":"Elena N.","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Cohen Children\u2019s Medical Center, Northwell, NY (E.N.K., H.G.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinal","family":"Lad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Leslie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amara","family":"Majeed","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, Morgan Stanley Children\u2019s Hospital, NY (A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitanjali","family":"Mansukhani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of Western Ontario and London Health Science Centre, Canada (G.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6423-1874","authenticated-orcid":true,"given":"Amanda M","family":"McIntosh","sequence":"additional","affiliation":[{"name":"Ward Family Heart Center, Children\u2019s Mercy Hospital, University of Missouri-Kansas City School of Medicine (A.M.M.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-1894","authenticated-orcid":true,"given":"Deani","family":"McVadon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Michelfelder","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Children\u2019s Healthcare of Atlanta, GA (E.M., S.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, The Heart Institute at Johns Hopkins All Children\u2019s Hospital, St Petersburg, FL (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-4400","authenticated-orcid":true,"given":"Caitlin","family":"Milligan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, University of Utah, Primary Children\u2019s Hospital, Salt Lake City (M.D., W.H., C.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Montes Gil","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, NY 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