Document Detail

Peripartum cardiomyopathy: prognostic factors for long-term maternal outcome.
MedLine Citation:
PMID:  18722572     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of the study was to assess the prognostic value of ejection fraction (EF) at index and subsequent pregnancy on long-term outcome in patients with peripartum cardiomyopathy (PPCM). STUDY DESIGN: Seventy PPCM patients met inclusion criteria. Patients had echocardiography evaluations at the index pregnancy, at interval follow-up (F/U) or at the beginning of a subsequent pregnancy and the last F/U study available. Outcome data were echocardiographic parameters and the subsequent need for cardiac transplant. RESULTS: Patients were categorized on the basis of their initial EF into EF of 25% or less and EF greater than 25% and stratified on the basis of their pregnancy into the following groups: group 1 (n = 33), no subsequent pregnancy; group 2 (n = 16), subsequent pregnancy with early termination; and group 3 (n = 21), successful subsequent pregnancy. F/U from index pregnancy to final F/U was 3.4+/-1.9 (range, 1-6 years). Groups 1 and 2 had persistent left ventricular dysfunction at all echocardiographic evaluations. In group 3, despite a mean EF greater than 40% at a subsequent pregnancy, 29% had worsening cardiac symptoms. Among 28 patients with EF of 25% or less, 16 (57%) had end-stage cardiac disease. One had a transplant and 15 were on a transplant list. All 16 had a baseline EF 25% or less at index pregnancy: 4 had improved (EF greater than 40%) at interval F/U and 3 at last F/U available. CONCLUSION: Women with a history of PPCM had a higher rate of progression of symptoms of heart failure in a subsequent pregnancy. A baseline left ventricular EF 25% or less at index pregnancy is associated with a higher rate of cardiac transplant.
Mounira Habli; Thomas O'Brien; Elizabeth Nowack; Saeb Khoury; John R Barton; Baha Sibai
Publication Detail:
Type:  Journal Article     Date:  2008-08-22
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  199     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-13     Revised Date:  2009-12-08    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  415.e1-5     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH 45219, USA.
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MeSH Terms
Disease Progression
Heart Failure / epidemiology,  physiopathology*,  surgery,  ultrasonography
Heart Transplantation
Pregnancy Complications, Cardiovascular / epidemiology,  physiopathology*,  surgery,  ultrasonography
Pregnancy Outcome
Retrospective Studies
Stroke Volume*
Ventricular Dysfunction, Left / epidemiology
Comment In:
Am J Obstet Gynecol. 2009 Dec;201(6):e9; author reply e9-10   [PMID:  19961984 ]

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

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