Similarities and difference of cardiac function, structure, myocardial deformation, myocardial fibrosis between symptomatic peripartum cardiomyopathy at different clinical stage and dilated cardiomyopathy

Abstract

Background Similarities and differences in imaging phenotype between symptomatic peripartum cardiomyopathy(SPPCM) and dilated cardiomyopathy(DCM) haven’t been fully understood. This study aimed to compare cardiac structure, function, deformation, and myocardial fibrosis between SPPCM at different clinical stage and DCM, and to explore the uniformity of segmental deformation dysfunction furtherly.Methods In this study, 58 acute SPPCM patients(Cardiac Magnetic Resonance(CMR) performed within 6 months), 29 chronic SPPCM(CMR performed beyond 6 months), 45 female DCM patients were retrospectively enrolled parameters of cardiac function, structure, deformation, and fibrosis were compared among them.Results Left ventricle(LV) volume and structure were similar between acute SPPCM and female DCM(all p > 0.05). Chronic SPPCM had higher LV volume(all p < 0.05) and larger transverse LV diameter(70.0 ± 9.2 mm, p < 0.001) than acute SPPCM and female DCM despite LVEF was similar among the three groups. Additionally, female DCM had better right ventricle stroke volume(32.0 ± 10.5 ml/m2, p < 0.001) and ejection fraction(37.1 ± 20.6%, p = 0.006) compared with acute and chronic SPPCM. In terms of myocardial deformation, female DCM tended to had higher global strain indexes than acute and chronic SPPCM, and some segmental strain indexes in female DCM were significantly higher. Prevalence of LGE was significantly lower in acute SPPCM(25.9%) than chronic SPPCM(58.6%) and female DCM(51.1%), p = 0.004. After quantification of LGE, we found that global LGE extent tended to increase in acute PPCM, chronic PPCM, and female DCM gradually(p = 0.581). Female DCM had a more extensive LGE in AHA 9 segments than acute SPPCM. LGE mainly located in basal and middle part of left ventricle.Conclusion Acute SPPCM had similar LV structure and function with female DCM. Chronic SPPCM had a more dilated LV than acute SPPCM. RV systolic function in female DCM was better than acute and chronic SPPCM. Some segmental strain indexes in female DCM were significantly higher. Acute SPPCM patients have lower prevalence of LGE compared with chronic SPPCM and female DCM patients.