Improved outcomes in peripartum cardiomyopathy with contemporary

Amos, Ankie M.; Jaber, Wissam; Russell, Stuart D.

doi:10.1016/j.ahj.2006.02.008

Cited by 277 publications

(334 citation statements)

References 19 publications

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“…With appropriate medical therapy, approximately 50% of patients with PPCM will recover cardiac function, usually within six months (112,113). If symptoms persist longer than this, myocardial damage is more likely irreversible, although recovery can occur with optimal medical therapy up to and beyond 12 months (114,115).…”

Section: Prognosismentioning

confidence: 99%

“…Mortality rates range between 10% and 23%, with death being attributed to pump failure, sudden cardiac death and thromboembolic events (117). Recovery is less likely in women with increased left ventricular dimension (larger than 5.6 cm) and those with left ventricular thrombus (112). The outcome of PPCM requiring cardiac transplantation (4% to 7% of patients) is good, with survival similar to patients undergoing transplantation for idiopathic dilated cardiomyopathy.…”

Section: Prognosismentioning

confidence: 99%

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The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Howlett¹,

McKelvie²,

Costigan³

et al. 2010

Canadian Journal of Cardiology

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Section: Prognosismentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Howlett¹,

McKelvie²,

Costigan³

et al. 2010

Canadian Journal of Cardiology

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“…38,39 A left ventricular enddiastolic dimension >5.6 cm, the presence of intracardiac thrombus, and African American race may be predictive of lack of recovery in PPCM patients. 40 It may be safe to withdraw HF medications in those PPCM that recover ventricular function. Eventual recovery of left ventricular systolic function occurred more frequently in women who had an EF of >30% at original diagnosis of PPCM.…”

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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“…Prolactine may also play a role, as has been recently demonstrated in animal studies. [1][2][3][4] Furthermore, autoimmunity and inflammation are potential causative factors, although the incidence of histologically proven myocarditis is variable. Mortality from severe heart failure is reported to be up to 20% in patients with PPCM, with the majority of deaths being sudden.…”

mentioning

confidence: 99%

“…1,3 Predictors of complete recovery (EF >50%) are: left ventricular end-diastolic diameter <56 mm, mean left ventricular ejection fraction at two months after delivery >45% and the absence of thrombus in the left ventricle at the time of diagnosis. 2 Medical therapy for PPCM consists mainly of regular heart failure therapy. In some cases intra-aortic balloon counterpulsation, inotropes and eventually heart transplantation is necessary.…”

mentioning

confidence: 99%

Left ventricular assist device as a bridge to recovery in a young woman admitted with peripartum cardiomyopathy

Oosterom¹,

Jonge²,

Kirkels³

et al. 2008

NHJL

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Left ventricular assist device as a bridge to recovery in a young woman admitted with peripartum cardiomyopathy Left ventricular assist devices (LVAD) are an effective therapeutic option for end-stage heart failure patients as a bridge to cardiac transplantation in those who deteriorate despite maximal therapy and when a donor heart is not ready available. In some patients, cardiac recovery has been reported while supported by an LVAD. In this case report, we describe a 29-year-old female who was admitted to our centre because of peripartum cardiomyopathy (PPCM). Despite intensive treatment with intravenous inotropes and intra-aortic balloon counterpulsation she had a persisting low cardiac index and an LVAD was implanted. In the months following implantation the left ventricular systolic function improved and the left ventricular dimensions normalised. Eventually the LVAD could be explanted nine months after implantation. At this moment, three years after explantation, echocardiography shows a normal-sized left ventricle and almost completely recovered systolic function. (Neth Heart J 2008;16:426-8).

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Improved outcomes in peripartum cardiomyopathy with contemporary

Cited by 277 publications

References 19 publications

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Heart Failure in Women

Left ventricular assist device as a bridge to recovery in a young woman admitted with peripartum cardiomyopathy

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