Effects of bromocriptine in peripartum cardiomyopathy: a systematic review and meta-analysis

Trongtorsak, Angkawipa; Kittipibul, Veraprapas; Mahabir, Sunita; Ibrahim, Michel A.; Croix, Garly Rushler Saint; Hernandez, Gabriel A.; Chaparro, Sandra

doi:10.1007/s10741-021-10185-8

Cited by 12 publications

(12 citation statements)

References 32 publications

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“…In 2010, the bromocriptine proof‐of‐concept pilot study was published, followed by a multicentre clinical trial in 2017, which encouraged the use of bromocriptine 61,73 . Our results also support the findings of a recent systematic review and meta‐analysis on the effects of bromocriptine in PPCM 74 . This analysis included eight studies (two randomized controlled trials, six observational studies) involving 593 patients and they found that the addition of bromocriptine to guideline‐directed HF therapy was associated with significantly higher survival and higher LVEF improvement 74 …”

Section: Discussionsupporting

confidence: 81%

“…61,73 Our results also support the findings of a recent systematic review and meta-analysis on the effects of bromocriptine in PPCM. 74 This analysis included eight studies (two randomized controlled trials, six observational studies) involving 593 patients and they found that the addition of bromocriptine to guideline-directed HF therapy was associated with significantly higher survival and higher LVEF improvement. 74 It cannot be assumed that prescription rate of HF therapy corresponded with adherence to treatment.…”

Section: Figure 3 Continuedmentioning

confidence: 99%

“…74 This analysis included eight studies (two randomized controlled trials, six observational studies) involving 593 patients and they found that the addition of bromocriptine to guideline-directed HF therapy was associated with significantly higher survival and higher LVEF improvement. 74 It cannot be assumed that prescription rate of HF therapy corresponded with adherence to treatment. Despite effective treatment options, prior studies have found that merely about half of patients with HF are adherent to at least 80% of their prescribed medication.…”

Section: Figure 3 Continuedmentioning

confidence: 99%

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A global perspective on the management and outcomes of peripartum cardiomyopathy: a systematic review and meta‐analysis

Hoevelmann

Engel

Muller

et al. 2022

European J of Heart Fail

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Peripartum cardiomyopathy (PPCM) remains a major contributor to maternal morbidity and mortality worldwide. The disease is associated with various complications occurring mainly early during its course. Reported adverse outcomes include decompensated heart failure, thromboembolic complications, arrhythmias and death. We sought to systematically and comprehensively review published literature on the management and outcome of women with PPCM across different geographical regions and to identify possible predictors of adverse outcomes.

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Section: Discussionsupporting

confidence: 81%

Section: Figure 3 Continuedmentioning

confidence: 99%

Section: Figure 3 Continuedmentioning

confidence: 99%

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A global perspective on the management and outcomes of peripartum cardiomyopathy: a systematic review and meta‐analysis

Hoevelmann

Engel

Muller

et al. 2022

European J of Heart Fail

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“…In recent years, use of the dopamine agonist bromocriptine has become established in the treatment of PPCM 8,23 . Several reports including a prospective randomized trial 10 and meta‐analyses 24 support the potential benefit of bromocriptine in combination with optimized conventional heart failure medication, resulting in high rates of full LV‐recovery and low morbidity and mortality compared with other PPCM cohorts not receiving bromocriptine. All patients needing LVAD support after 2005 received treatment with bromocriptine in our cohort except for one patient who received cabergoline—the alternative dopamine agonist.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and long‐term outcomes in patients with peripartum cardiomyopathy (PPCM) receiving left ventricular assist devices (LVAD)

Berliner

Mariani

et al. 2022

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Background: Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure (HF), presenting with left ventricular (LV) systolic dysfunction either at the end of pregnancy or in the months following delivery. In rare cases, PPCM leads to severe impairment of LV function, refractory cardiogenic shock or advanced HF. LV assist devices (LVAD) have been shown to be a feasible treatment option in advanced HF. However, little is known about long-term outcomes and prognosis of PPCM patients undergoing LVAD implantation. Methods:A retrospective analysis of data from PPCM patients undergoing LVAD implantation in two tertiary centers with respect to long-term outcomes was performed.Results: Twelve patients of median age 30 (18-39) years were included. Eight patients were experiencing cardiogenic shock (INTERMACS 1) at implantation. Seven patients were implanted within 1 month of their PPCM diagnosis. Median duration of LVAD support was 19 (2-92) months with median follow up of 67 (18-136) months (100% complete). In-hospital and 1-year mortality were 0% and 8.3%, respectively. Two patients died on LVAD support, four patients were successfully bridged to transplantation, two patients are still on LVAD, and four were successfully weaned due to sufficient LV recovery (one died after LV function deteriorated again). Conclusion:LVAD treatment of decompensated end-stage PPCM is feasible.Early LVAD provision led to hemodynamic stabilization in our cohort and facilitated safe LV recovery in one third of these young female patients.

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“…Chronic hyperprolactinemia has been related to endothelial dysfunction and atherosclerosis [ 9 ] and its levels have been associated with a worse cardiovascular risk profile in post-menopausal women without prolactinoma [ 10 ]. More recently, PRL has been considered as a possible therapeutic target in peripartum cardiomyopathy, although with controversial benefits [ 11 ]. Despite evidence for a link between PRL and the heart, only a few systematic investigations have been so far performed in conditions of chronic PRL excess.…”

Section: Introductionmentioning

confidence: 99%

Early Left Ventricular Diastolic Dysfunction in Females with Chronic Hyperprolactinemia: A Doppler Echocardiographic Study

Arcopinto

D’Assante

Auriemma

et al. 2023

JCM

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Despite the myocardial prolactin (PRL) binding activity and the known effect of enhancing contractility in the isolated rat heart, little information is available concerning the cardiovascular consequences of hyperprolactinemia in humans. To elucidate the effects of chronic hyperprolactinemia on cardiac structure and function, twenty-four patients with isolated PRL-secreting adenoma and twenty-four controls underwent a complete mono- and two-dimensional Doppler-echocardiography. Blood pressure and heart rate were similar in the two groups, and no significant differences were observed as to left ventricular (LV) geometry between patients and controls. Resting LV systolic function was normal in patients with hyperprolactinemia, as shown by similar values of fractional shortening and cardiac output. Conversely, hyperprolactinemic patients exhibited a slight impairment of LV diastolic filling, as demonstrated by the prolongation of the isovolumetric relaxation time and the increase of the atrial filling wave of mitral Doppler velocimetry (58 ± 13 vs. 47 ± 8 cm/s, p < 0.05) with a subgroup of females (16%) having a clear diastolic dysfunction, and a worse exercise capacity (6 min walking test 452 ± 70 vs. 524 ± 56; p < 0.05). In conclusion, hyperprolactinemia in humans may be associated with a slight impairment of diastolic function, with an overt diastolic dysfunction in a subgroup of females which correlated with poorer exercise performance, in the absence of significant abnormalities of LV structure and systolic function.

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Effects of bromocriptine in peripartum cardiomyopathy: a systematic review and meta-analysis

Cited by 12 publications

References 32 publications

A global perspective on the management and outcomes of peripartum cardiomyopathy: a systematic review and meta‐analysis

A global perspective on the management and outcomes of peripartum cardiomyopathy: a systematic review and meta‐analysis

Clinical characteristics and long‐term outcomes in patients with peripartum cardiomyopathy (PPCM) receiving left ventricular assist devices (LVAD)

Early Left Ventricular Diastolic Dysfunction in Females with Chronic Hyperprolactinemia: A Doppler Echocardiographic Study

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