Document Detail


Myocarditis and long-term survival in peripartum cardiomyopathy.
MedLine Citation:
PMID:  11054626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The reported mortality rate of peripartum cardiomyopathy (PPCM) is high, although the potential for spontaneous recovery of ventricular function is well established. The prevalence of myocarditis in PPCM has varied widely between studies. The purposes of this study were to define the long-term prognosis in a referral population of patients with PPCM, to determine the prevalence of myocarditis on endomyocardial biopsy in this population, and to identify clinical variables associated with poor outcome. METHODS: We analyzed clinical, echocardiographic, hemodynamic, and histologic features of 42 women with PPCM evaluated at our institution over a 15-year period. Each patient underwent an extensive evaluation, including echocardiography, endomyocardial biopsy, and right heart catheterization. Data were analyzed to identify features at initial examination associated with the combined end point of death or cardiac transplantation by the use of Kaplan-Meier survival curves and a Cox proportional hazards model. RESULTS: Three (7%) patients died and 3 (7%) patients underwent heart transplantation during a median follow-up of 8.6 years. Endomyocardial biopsy demonstrated a high prevalence of myocarditis (62%), but the presence or absence of myocarditis was not associated with survival. Of the prespecified variables assessed, only decreased left ventricular stroke work index was associated with worsened outcome. CONCLUSIONS: In patients with PPCM, (1) long-term survival is better than has been historically reported, (2) the prevalence of myocarditis is high, and (3) decreased left ventricular stroke work index is associated with worse clinical outcomes.
Authors:
G M Felker; C J Jaeger; E Klodas; D R Thiemann; J M Hare; R H Hruban; E K Kasper; K L Baughman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  140     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-16     Completed Date:  2000-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  785-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Cardiology, and the Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD 21287, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Cardiomyopathies / mortality*,  pathology,  physiopathology,  ultrasonography
Confounding Factors (Epidemiology)
Echocardiography
Female
Heart Catheterization
Hemodynamics
Humans
Maryland / epidemiology
Myocarditis / mortality*,  pathology,  physiopathology,  ultrasonography
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Puerperal Disorders / mortality*,  pathology,  physiopathology,  ultrasonography
Risk Factors
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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