Epidemiology of Peripartum Cardiomyopathy

Gunderson, Erica P.; Croen, Lisa; Chiang, Vicky; Yoshida, Cathleen K.; Walton, David; Go, Alan S.

doi:10.1097/aog.0b013e318229e6de

Cited by 137 publications

(60 citation statements)

References 29 publications

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“…9 There was a trend toward an increase in the incidence of PPCM in the United States from 1990 through 1993 to 2000 through 2002, which has been ascribed to a rise in maternal age. 10 In a prospective cohort of PPCM, 13% of women had major events (death, cardiac transplantation, or implantation of an LVAD) or persistent severe cardiomyopathy at 12 months.…”

Section: Cardiomyopathy and Heart Failurementioning

confidence: 99%

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Benjamin¹,

Blaha²,

Chiuve³

et al. 2017

Circulation

7,440

5,040

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Section: Cardiomyopathy and Heart Failurementioning

confidence: 99%

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Benjamin¹,

Blaha²,

Chiuve³

et al. 2017

Circulation

7,440

5,040

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“…Incidence varies geographically and in the Unites States is estimated at 1 in 1,000–4,000 live births (2,3,4,5,6). Presentation, clinical course, and outcomes are heterogeneous and can be associated with significant morbidity and mortality (1).…”

Section: Introductionmentioning

confidence: 99%

Relaxin-2 and Soluble Flt1 Levels in Peripartum Cardiomyopathy

Damp

Givertz

Semigran

et al. 2016

JACC: Heart Failure

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Background Peripartum cardiomyopathy (PPCM) is an uncommon disorder with unknown etiology. Angiogenic imbalance may contribute to its pathophysiology. We explore the association of vascular hormones with myocardial recovery and clinical outcomes in PPCM. Methods and Results In 98 women with newly diagnosed PPCM enrolled in the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study, serum was obtained at baseline for analysis of relaxin-2, prolactin, soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF). Left ventricular ejection fraction (LVEF) was assessed by echocardiography at baseline and 2, 6 and 12 months. Mean age was 30 ± 6 years, with baseline LVEF 0.35 ± 0.09. Relaxin-2, prolactin, and sFlt1 were elevated in women presenting early postpartum, but declined rapidly and were inversely correlated with time from delivery to presentation. In tertile analysis, higher relaxin-2 was associated with smaller left ventricular systolic diameter (p=0.006) and higher LVEF at 2 months (p=0.01). This was particularly evident in women presenting soon after delivery (p=0.02). No relationship was evident for myocardial recovery and prolactin, sFlt1 or VEGF levels. sFlt1 levels were higher in women with higher New York Heart Association (NYHA) functional class (p=0.01) and adverse clinical events (p=0.004). Conclusions In women with newly diagnosed PPCM, higher relaxin-2 levels soon after delivery were associated with myocardial recovery at 2 months. In contrast, higher sFlt1 levels correlated with more severe symptoms and major adverse clinical events. Vascular mediators may contribute to development of PPCM and influence subsequent myocardial recovery. Clinical Trial Registration Information NCT01085955 https://clinicaltrials.gov/ct2/show/NCT01085955

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“…In the US, its incidence has been estimated at between one in 900 and one in 4000 live births 9101112. A recent study using the US Nationwide Inpatient Sample found that its incidence increased from one in 1181 live births in 2004 to one in 849 live births in 2011 (fig 1).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Peripartum cardiomyopathy

Honigberg

Givertz

2019

BMJ

124

154

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Peripartum cardiomyopathy (PPCM) is a rare, often dilated, cardiomyopathy with systolic dysfunction that presents in late pregnancy or, more commonly, the early postpartum period. Although the condition is prevalent worldwide, women with black ancestry seem to be at greatest risk, and the condition has a particularly high incidence in Nigeria and Haiti. Other risk factors include pre-eclampsia, advanced maternal age, and multiple gestation pregnancy. Although the complete pathophysiology of peripartum cardiomyopathy remains unclear, research over the past decade suggests the importance of vasculo-hormonal pathways in women with underlying susceptibility. At least some women with the condition harbor an underlying sarcomere gene mutation. More than half of affected women recover systolic function, although some are left with a chronic cardiomyopathy, and a minority requires mechanical support or cardiac transplantation (or both). Other potential complications include thromboembolism and arrhythmia. Currently, management entails standard treatments for heart failure with reduced ejection fraction, with attention to minimizing potential adverse effects on the fetus in women who are still pregnant. Bromocriptine is one potential disease specific treatment under investigation. In this review, we summarize the current literature on peripartum cardiomyopathy, as well as gaps in the understanding of this condition and future research directions.

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Epidemiology of Peripartum Cardiomyopathy

Abstract: II.

Cited by 137 publications

References 29 publications

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Relaxin-2 and Soluble Flt1 Levels in Peripartum Cardiomyopathy

Peripartum cardiomyopathy

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