<div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1948829807" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{10}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">Fetal</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>right ventricular (RV) dilation and dysfunction may<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">a “red flag” for</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>genetic d</span><span class="NormalTextRun SCXW106665150 BCX0">ilated cardiomyopathy (DCM)</span><span class="NormalTextRun SCXW106665150 BCX0">, according to a new report following 4 neonates.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="160358569" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{12}"><span class="NormalTextRun SCXW106665150 BCX0">The findings were published Monday online ahead of print in<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">JACC: Heart Failure</span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">, led by<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">Francesca Bonanni, MD</span><span class="NormalTextRun SCXW106665150 BCX0">, from the M</span><span class="NormalTextRun SCXW106665150 BCX0">eyer Children’s Hospital<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">in Italy.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="762952537" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{14}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">RV dominance and dilation are common findings during<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">fetal</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>echocardiography, the researcher noted, adding that these observations are often seen as predictors of<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">left ventricular (LV) outflow obstruction</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>and</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>abnormalitie</span><span class="NormalTextRun SCXW106665150 BCX0">s</span><span class="NormalTextRun SCXW106665150 BCX0">.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="681236288" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{16}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">The</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>current report's</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>hypothesis was that</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>in utero RV dilation may constitute</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>the first signal<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">of<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">myocardial frailty in the context of a genetic predisposition to DCM,<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">which may become clinically overt following the transition to adult circulation</span><span class="NormalTextRun SCXW106665150 BCX0">,” the authors wrote.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1361303921" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{18}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">The study<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">included 4 neonates with significant RV dilation with systolic RV dy</span><span class="NormalTextRun SCXW106665150 BCX0">sfunction<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">identified</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>by echocardiography during the third trimester of pregnancy,</span><span> </span><span class="NormalTextRun SCXW106665150 BCX0">followed by normalization of right-sided cham</span><span class="NormalTextRun SCXW106665150 BCX0">bers, but<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">subsequent</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>LV dilation and dysfunction after birth.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="89548966" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{20}"><span class="NormalTextRun SCXW106665150 BCX0">There was isolated RV involvement in 2 cases, which was in turn associated with mild LV dysfunction in 1 case. </span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="408754228" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{22}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">After birth, the</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>4</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>cases</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>followed the pattern of<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">prenatal RV dilatation and dysfunction in the absence of structural abnormalities with postnatal normalization,<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">then</span><span> </span><span class="NormalTextRun SCXW106665150 BCX0">subsequent</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>emergence of LV systolic impairment</span><span class="NormalTextRun SCXW106665150 BCX0">. </span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1313027241" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{24}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">In<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">fetal</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>life, the RV operates under higher afterload conditions than the LV, producing two-thirds of the cardiac output, and is exposed to greater wall stress, potentially making it more susceptible to dilatation and systolic impairment in the presence of a frail myocardium</span><span class="NormalTextRun SCXW106665150 BCX0">,” the researchers said.</span><span class="NormalTextRun SCXW106665150 BCX0"> </span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="660562733" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{34}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">At birth, the hemodynamic balance shifts: pulmonary vascular resistance falls, the ductus arteriosus closes, and the LV becomes solely responsible for systemic output. In this transition, LV dysfunction is<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">arguably unmasked</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>and becomes clinically<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">apparent</span><span class="NormalTextRun SCXW106665150 BCX0">,<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">whereas</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>the RV, relieved of its prenatal workload, seems to regain normal dimensions and function</span><span class="NormalTextRun SCXW106665150 BCX0">.”</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1105719452" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{36}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">The researchers added that for neonates with a history of<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">fetal</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>RV dominance (where congenital heart diseases have been excluded) the “</span><span class="NormalTextRun SCXW106665150 BCX0">postnatal shift to LV dysfunction should raise suspicion of underlying myocardial frailty, particularly when associated with a positive family history of cardiomyopathy</span><span class="NormalTextRun SCXW106665150 BCX0">.”</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1630127420" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{38}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">They recommended that a<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">detailed 3-generation pedigree should be collected with attention to sudden cardiac death,<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">cardiomyopathy</span><span> </span><span class="NormalTextRun SCXW106665150 BCX0">and unexplained heart failur</span><span class="NormalTextRun SCXW106665150 BCX0">e. </span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1153109979" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{40}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">They also cautioned that these infants should be closely watched for early clinical signs of heart failure (HF) including<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">feeding difficulties,<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">tachypnea</span><span class="NormalTextRun SCXW106665150 BCX0">, growth<span> </span></span><span class="NormalTextRun SCXW106665150 BCX0">delay</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>or poor peripheral perfusion.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="117307121" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{42}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">For these tiny patients, “s</span><span class="NormalTextRun SCXW106665150 BCX0">erial echocardiograms evaluating both LV and RV systolic function are essential during the first week of life</span><span class="NormalTextRun SCXW106665150 BCX0">,” the researchers stressed</span><span class="NormalTextRun SCXW106665150 BCX0">. </span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="403812087" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{44}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">Early identification of postnatal LV dysfunction may allow timely initiation of medical therapy, alleviating symptoms, stabilizing<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">hemodynamics</span><span class="NormalTextRun SCXW106665150 BCX0">, mitigating pathological<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">remodeling</span><span class="NormalTextRun SCXW106665150 BCX0">.</span><span class="NormalTextRun SCXW106665150 BCX0">”</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="83194195" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{47}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">The researchers went on to warn that such an early onset of a DCM phenotype could raise concerns when it comes to long-term outcomes</span><span class="NormalTextRun SCXW106665150 BCX0">.<span> </span></span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1843464697" paraeid="{afe8adce-c107-4b16-b10d-597eda20417a}{196}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">Notably, the detection of a pathogenic variant provides diagnostic precision clarifies prognosis and enables cascade genetic screening and<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">counseling</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>of family members</span><span class="NormalTextRun SCXW106665150 BCX0">.”</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1886216215" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{49}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">“</span><span class="NormalTextRun SCXW106665150 BCX0">These observations expand the clinical spectrum of RV dilatation in the<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">fetus</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>and warrant specific surveillance to exclude early-onset DCM during follow-u</span><span class="NormalTextRun SCXW106665150 BCX0">p,” the researchers stressed.</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1200648901" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{51}"><span class="NormalTextRun SCXW106665150 BCX0">They went on to push for broader multicenter studies on their hypothesis-generating findings, </span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="1404762557" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{53}"><strong><span class="NormalTextRun SCXW106665150 BCX0">Sources:</span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" paraid="980238158" paraeid="{c1ae495b-adc8-4593-8ab1-fbee0f5f9e9f}{55}"><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">Bonanni F, Cordisco A, Calibri G, et al.<span> </span></span><span class="NormalTextRun SpellingErrorV2Themed SCXW106665150 BCX0">Fetal</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>Right Ventricular Dilatation and Dysfunction as a Precursor of Dilated Cardiomyopathy</span><span class="NormalTextRun SCXW106665150 BCX0">:</span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>A Diagnostic Pitfall and a Call for Vigilance</span><span class="NormalTextRun SCXW106665150 BCX0">.<span> </span></span></span><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun SCXW106665150 BCX0"><em><span class="NormalTextRun SCXW106665150 BCX0">JACC: Heart Fail</span></em><span class="NormalTextRun SCXW106665150 BCX0">.</span></span><span class="NormalTextRun SCXW106665150 BCX0"><span> </span>2026; DOI: 10.1016/j.jch.2026.103048.</span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW106665150 BCX0"> <p class="Paragraph SCXW106665150 BCX0" xml:lang="EN-US" lang="EN-US" paraid="2123663356" paraeid="{f3802b0e-169b-4c76-a254-6ede16b5665c}{47}"><strong><span data-contrast="auto" xml:lang="EN-GB" lang="EN-GB" class="TextRun MacChromeBold SCXW106665150 BCX0"><span class="NormalTextRun SCXW106665150 BCX0">Image Credit: </span><span class="NormalTextRun SCXW106665150 BCX0">Richelle</span><span class="NormalTextRun SCXW106665150 BCX0"> – stock.adobe.com</span></span><span class="EOP Selected SCXW106665150 BCX0" data-ccp-props="{}"> </span></strong></p> </div>