Clinical Profile and Predictors of Complications in Peripartum Cardiomyopathy

Goland, Sorel; Modi, Kalgi; Bitar, Fahed; Janmohamed, Munir; Mirocha, James; Czer, L.; Illum, Sandra; Hatamizadeh, Parta; Elkayam, Uri

doi:10.1016/j.cardfail.2009.03.008

Cited by 243 publications

(242 citation statements)

References 16 publications

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“…This may lead to a delay in the diagnosis of PPCM. 33 Echocardiography is a valuable tool for the diagnosis and evaluation of suspected cardiac disease in the pregnant patient. Other clinical findings reported include displaced apical impulse, gallop, and electrocardiogram abnormalities.…”

Section: Pregnancy and Peripartum Cardiomyopathymentioning

confidence: 99%

Heart Failure in Women

Shin

Hamad

Murthy

et al. 2012

Clinical Cardiology

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Heart failure (HF) has steadily increased in prevalence and affects both males and females equally. Despite this, there has been a significant underrepresentation of women in large scale HF trials. This disparity has lead to a deficit in understanding important gender-based differences in pathophysiology, diagnosis and treatment strategies. We review these gaps and explore a biological basis for varying outcomes. Endogenous estrogen plays an important role in epidemiology and outcome. The administration of exogenous estrogen has had varied success in treatment and is outlined extensively below. Additionally, we highlight unique HF syndromes through pregnancy and important sex-specific issues concerning transplant and mechanical circulatory support. A central theme remains: there is a clear need for increased female recruitment in clinical trials, and more studies exploring the role of gender-based biology in HF treatment. IntroductionThe prevalence of heart failure (HF) has steadily increased and is now the leading cause of hospital admissions in the adult population in the United States. 1 Women constitute approximately one half of the patients hospitalized for HF, and deaths from HF contribute 35% of the total cardiovascular disease (CVD) mortality in women. 1 -3 Despite this, women have been historically under-represented in clinical HF trials. Although the population estimate of women among patients with HF in the Unites States is about 50%, only 17% to 23% of HF randomized controlled trials enrolled women. 4 This disparity has limited our understanding of gender-related differences in HF. The objective of this article is to review the relationships between sex and the epidemiology, etiology, clinical characteristics, therapeutic management, and outcomes in patients with HF.

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Section: Pregnancy and Peripartum Cardiomyopathymentioning

confidence: 99%

Heart Failure in Women

Shin

Hamad

Murthy

et al. 2012

Clinical Cardiology

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“…2 Outcomes of PPCM are markedly variable ranging from complete recovery to surviving with heart failure or death. 3 Low left ventricular ejection fraction (LVEF) less than 30 percent and left ventricular end diastolic diameter (LVEDD) more than 60 mm were shown to have worse prognosis. 4 Given the low prevalence of the disorder, most single center reports are limited in study number and being retrospective.…”

Section: Introductionmentioning

confidence: 99%

Early outcome of acute peripartum cardiomyopathy in eastern part of Nepal

Nepal¹,

Bista²,

Ghimire

2017

Nepalese Heart J.

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Background and Aims: Peripartum cardiomyopathy (PPCM) is an uncommon complication of pregnancy with variable outcome. There is paucity of data related to its outcomes in Nepal. We studied the clinical and echocardiographic outcome of PPCM patients in eastern part of Nepal.Methods: In this prospectively designed study all patients admitted with the diagnosis of acute severe PPCM at Nobel Medical College, Biratnagar, meeting the inclusion criteria over a period of 14 month, were enrolled and followed up for 3 months post partum.The LVEF and Left ventricular end diastolic dimension (LVEDD) was assessed by echocardiography at baseline and 3 months postpartum. Mortality and survival with normal or depressed ejection fraction were determined. Predictors of outcome were evaluated. Statistical analysis were done using SPSS version 17.Results: Mean age of the study population was 27.6}5.6 years. Ninety five percent of patient had term delivery. Sixty four percent were primigravida. Eighty four percent had the symptoms onset in post partum period. Pulmonary edema was present in 64% during first hospital admission. Mortality was 9% during 3-month follow up period. Thirty six percent had complete recovery of LVEF at 3 months. Fifty five percent survived with depressed LVEF. Age, LVEF less than 30% and LVEDD more than 60 mm at study entry did not correlate significantly with poor clinical recovery at 3 months.Conclusion: This study demonstrates that survival outcome is better even in the patients with severe acute PPCM with early diagnosis and proper management of heart failure.

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“…There have been many studies of the etiology, 7 epidemiology, 8 prognosis 9 and treatment 10 of PPCM, but only a few studies of DCM-complicated pregnancy. 11,12 Bernstein and Magriples 12 compared the cardiac outcomes of DCM-complicated pregnancy with PPCM and Grewal et al 11 compared similar outcomes in cases of DCM, with and without pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for maternal outcome in pregnancy complicated with dilated cardiomyopathy

et al. 2011

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Objective: The goal of the study was to determine risk factors for maternal cardiac failure in pregnancy complicated with dilated cardiomyopathy (DCM).Study Design: The subjects were 29 patients diagnosed with DCM before conception or during the first 7 months of pregnancy. DCM was defined as left ventricle end-diastolic dimension (LVDd)X48 mm and/or fractional shortening (%FS)p30% on echocardiography. Patients were followed until at least 1 year after delivery and were categorized into a poor prognosis group (n ¼ 6; death or end stage heart failure of New York Heart Association (NYHA) class III and IV) and a good prognosis group (n ¼ 23; all other cases).Result: DCM was initially diagnosed during pregnancy in 6/6 and 8/23 patients in the poor and good prognosis groups, respectively (P<0.005). The %FS of the first test during pregnancy was 17.5 ± 6.2 and 27.4±9.3% in the respective groups (P<0.005). In eight abortion cases with %FS 15.2 ± 3.1%, %FS, cardiac function and NYHA class were maintained until 20 months after abortion. There was no relationship between LVDd and maternal outcome. Conclusion:Onset during pregnancy and decreased %FS are risk factors for a poor maternal outcome in patients with DCM. Abortion prevents further deterioration of cardiac function in patients with a very low %FS.

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Clinical Profile and Predictors of Complications in Peripartum Cardiomyopathy

Cited by 243 publications

References 16 publications

Heart Failure in Women

Heart Failure in Women

Early outcome of acute peripartum cardiomyopathy in eastern part of Nepal

Risk factors for maternal outcome in pregnancy complicated with dilated cardiomyopathy

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