Peripartum cardiomyopathy in the hospital Albert Schweitzer district of Haiti

Fett, James D.; Carraway, Robert D.; Dowell, Duane; King, Mary Etta; Pierre, Ronald L. St.

doi:10.1067/mob.2002.122423

Cited by 92 publications

(79 citation statements)

References 19 publications

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“…Although this ethnic representation may be influenced by a referral bias, our findings clearly show that PPCM in the United States is not limited to black women. Although multiparity may be a risk factor for the development of cardiomyopathy in other populations, 5 the present study does not support a strong association in the United States because almost 40% of the cases occurred in association with their first pregnancy and Ͼ50% with the first 2 pregnancies. The present study also shows a strong association between PPCM and gestational hypertension and twin pregnancies.…”

Section: Discussion Clinical Profile Of Ppcmcontrasting

confidence: 46%

“…These investigators defined the condition as peripartum cardiomyopathy (PPCM) and established its diagnostic criteria. Despite the early recognition and because of its relative rarity, 3 geographical differences, and heterogeneous presentation, [3][4][5] this condition continues to be incompletely characterized. 3,6 Classic criteria for the diagnosis of PPCM as established by Demakis et al 2 limited the diagnosis to the last gestational month and first 5 months after delivery.…”

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confidence: 99%

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Pregnancy-Associated Cardiomyopathy

et al. 2005

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Background-Cardiomyopathy associated with pregnancy was first described more than half a century ago. However, because of its rare occurrence and geographical differences, the clinical profile of this condition has remained incompletely defined. Methods and Results-Data obtained from 123 women with a history of cardiomyopathy diagnosed during pregnancy or the postpartum period were reviewed. One hundred women met traditional criteria of peripartum cardiomyopathy; 23 were diagnosed with pregnancy-associated cardiomyopathy earlier than the last gestational month. Peripartum cardiomyopathy patients had a mean age of 31Ϯ6 years and were mostly white (67%). Common associated conditions were gestational hypertension (43%), tocolytic therapy (19%), and twin pregnancy (13%). Left ventricular ejection fraction at the time of diagnosis was 29Ϯ11% and improved to 46Ϯ14% (PՅ0.0001) at follow-up. Normalization of left ventricular ejection fraction occurred in 54% and was more likely in patients with left ventricular ejection fraction Ͼ30% at diagnosis. Maternal mortality was 9%. A comparison between the peripartum cardiomyopathy and early pregnancy-associated cardiomyopathy groups revealed no differences in age, race, associated conditions, left ventricular ejection fraction at diagnosis, its rate and time of recovery, and maternal outcome.

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Section: Discussion Clinical Profile Of Ppcmcontrasting

confidence: 46%

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confidence: 99%

Pregnancy-Associated Cardiomyopathy

et al. 2005

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“…None of the patients with PPCM presented with symptoms during the antepartum period. This is in contrast to studies performed by others (30) and more in keeping with a study from Haiti (24) documenting that 96% of patients with PPCM developed heart failure in the postpartum period. Our failure to include PPCM patients during the prepartum period in the present study was not due to a lack of identifying such patients, since the cardiologists at Chris Hani Baragwanath Hospital are routinely involved in the care of pregnant patients presenting with symptoms and signs of congestive cardiac failure.…”

Section: Translational Approach From Mouse To (Wo)mancontrasting

confidence: 55%

Clinical profi ling of patients with peripartum cardiomyopathy and its value for translational research

Förster

Sliwa

ker-Kleiner

2017

SAHJ

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Postpartum cardiomyopathy (PPCM) is a disease of unknown etiology and exposes women to high risk of mortality after delivery despite optimal medical therapy. Experimental data suggested that enhanced oxidative stress promotes the proteolytical processing of the lactation hormone prolactin into a biologically active derivative, the 16kDa prolactin, which appears to be a major cause for PPCM. We observed increased oxLDL levels in a subset of these PPCM patients, indicative of oxidative stress, enhanced Cathepsin D activity and substantial levels of the cleaved 16kDa form of prolactin. We therefore propose that the excessive generation of 16kDa prolactin mediates PPCM in humans and suggest that inhibition of prolactin release may represent a novel therapeutic strategy for PPCM.

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“…However, it more commonly presents later in pregnancy or postpartum. Moreover, 30% of patients with PPCM experience complete recovery, with partial recovery in many cases, in contrast to rare recovery in idiopathic dilated cardiomyopathy (Fett et al, 2002). Finally, epidemiological data show that PPCM is diagnosed in young women during the peripartum period, whereas idiopathic dilated cardiomyopathy is more common in older patients (Pearson et al, 2000).…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

“…Most studies have been performed in South Africa, Haiti, and USA, but PPCM was also reported in Caucasian, Japanese, Chinese, Indian, and Korean women. Until recently, only small prospective studies reporting the experience of single centers were available to estimate the incidence of the disease (Desai et al, 1995;Fett et al, 2002Fett et al, , 2005aPyatt & Dubey, 2011). Only two large retrospective population-based studies have been conducted in USA to identify cases of PPCM.…”

Section: Epidemiologymentioning

confidence: 99%