Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy

Hu, Cheng Lin; Li, Yan Bo; Zou, Yong Guang; Zhang, Jia Ming; Chen, Jiang Bing; Li, Jun; Tang, Yan; Tang, Qi; Huang, Chuanhe

doi:10.1136/hrt.2006.087387

Cited by 82 publications

(24 citation statements)

References 23 publications

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“…164 Other potential predictors of recovery include higher initial EF, presence of gestational hypertension, breastfeeding, postpartum diagnosis, lack of troponin elevation, lower BNP, absence of LV thrombus, and nonblack ethnicity. 173,174,[178][179][180][181] In a small study of 7 women, the presence of contractile reserve was associated with recovery of LV function. 182 Of note, withdrawal of HF therapy did not appear to be associated with clinical deterioration over a follow-up period of 29 months in a single-center study.…”

Section: Recovery Of LV Functionmentioning

confidence: 99%

“…180 Measurement of cardiac troponin at the time of diagnosis can be considered, because it has moderate predictive ability for ventricular recovery, and levels correlate inversely with LV function recovery at follow-up. 181 Markers of inflammation such as C-reactive protein, high-sensitivity C-reactive protein, oxidatively modified low-density lipoprotein, interferon-γ, and Fas/apolipoprotein 1 are usually elevated in patients with PPCM, 172,180 but their role in diagnosis or prognosis is uncertain at this time.…”

Section: Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

612

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Recovery Of LV Functionmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

612

663

View full text Add to dashboard Cite

show abstract

“…Lower levels of plasma troponin or brain natriuretic peptide have also been associated with improved outcomes. 90 However, like LVEF, their predictive accuracy is not sufficient to affect clinical decisions.…”

Section: Predictors Of Recoverymentioning

confidence: 99%

Peripartum Cardiomyopathy

2016

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Abstract-Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period and is marked by left ventricular dysfunction and heart failure. The disease is relatively uncommon, but its incidence is rising. Women often recover cardiac function, but long-lasting morbidity and mortality are not infrequent. Management of peripartum cardiomyopathy is largely limited to the same neurohormonal antagonists used in other forms of cardiomyopathy, and no proven disease-specific therapies exist yet. Research in the past decade has suggested that peripartum cardiomyopathy is caused by vascular dysfunction, triggered by late-gestational maternal hormones. Most recently, information has also indicated that many cases of peripartum cardiomyopathy have genetic underpinnings. We review here the known epidemiology, clinical presentation, and management of peripartum cardiomyopathy, as well as the current knowledge of the pathophysiology of the disease.

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“…Unlike in normal pregnancy, B-type natriuretic peptide (BNP) and N-terminal pro-BNP are usually raised 79. Troponin may be slightly raised 7580…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Peripartum cardiomyopathy

Honigberg

Givertz

2019

BMJ

141

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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Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy

Cited by 82 publications

References 23 publications

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Peripartum Cardiomyopathy

Peripartum cardiomyopathy

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