| Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. | |
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MedLine Citation:
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PMID: 16143707 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Peripartum cardiomyopathy (PPCM) is a disorder of unknown aetiology with a course and outcome that is largely unpredictable. We evaluated the prognostic role of multiple inflammatory markers in the plasma of a large cohort of African patients with PPCM. METHODS AND RESULTS: The study of 100 patients with newly diagnosed PPCM was single-centred, prospective, and longitudinal. Clinical assessment, echocardiography, and blood analysis were done at baseline and after 6 months of standard therapy. Inflammatory markers were measured at baseline only. Fifteen patients died. Left ventricular ejection fraction (LVEF) improved from 26.2+/-8.2 to 42.9+/-13.6% at 6 months (P<0.0001). However, normalization of LVEF (>50%) was only observed in 23%. Baseline levels of C-reactive protein correlated positively with baseline LV end-diastolic (rs=0.33, P=0.0026) and end-systolic (rs=0.35, P=0.0012) diameters and inversely with LVEF (rs=-0.27, P=0.015). Patients who died presented with significantly lower mean EF and higher Fas/Apo-1 plasma values (P<0.05). Fas/Apo-1 and New York Heart Association functional class (NYHA FC) predicted mortality at baseline. CONCLUSION: Plasma markers of inflammation were significantly elevated and correlated with increased LV dimensions and lower LVEF at presentation. Baseline Fas/Apo-1 and higher NYHA FC were the only predictors of mortality. Normalization of LVEF was only observed in 23% of this African cohort. |
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Authors:
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Karen Sliwa; Olaf Förster; Elena Libhaber; James D Fett; Jay Bruce Sundstrom; Denise Hilfiker-Kleiner; Aftab A Ansari |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2005-09-05 |
Journal Detail:
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Title: European heart journal Volume: 27 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-02-01 Completed Date: 2006-07-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 441-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Chris Hani Baragwanath Hospital, University of the Witwatersrand, PO Bertsham 2013, Johannesburg, South Africa. silwa-hahnlek@mdh-africa.org |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antigens, CD95 / metabolism* Arrhythmias, Cardiac / blood, mortality, pathology Biological Markers / blood C-Reactive Protein / metabolism* Female Heart Failure / blood, mortality*, pathology Heart Ventricles / pathology Humans Longitudinal Studies Pregnancy Pregnancy Complications, Cardiovascular / blood, mortality*, pathology Prognosis Prospective Studies Regression Analysis South Africa / epidemiology Stroke Volume / physiology Tumor Necrosis Factor-alpha / metabolism* Ventricular Dysfunction, Left / blood, mortality, pathology |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD95; 0/Biological Markers; 0/Tumor Necrosis Factor-alpha; 9007-41-4/C-Reactive Protein |
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