Document Detail

Risk of heart failure relapse in subsequent pregnancy among peripartum cardiomyopathy mothers.
MedLine Citation:
PMID:  19945699     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To quantify the level of risk for heart failure relapse in a subsequent pregnancy in women who have had peripartum cardiomyopathy (PPCM), and to test the hypothesis that meeting additional criteria may help lower the risk. METHODS: Prospectively-identified PPCM patients volunteering between 2003 and 2009 were identified from the PPCM Registry of H?pital Albert Schweitzer, Deschapelles, Haiti, and an internet support group. Data were assessed for full adherence to monitoring and diagnostic criteria, clinical data, statistical analysis, and reporting. RESULTS: Of 61 post-PPCM pregnancies identified, there were 18 relapses (29.5%) of heart failure. Of 26 pregnancies with a left ventricular ejection fraction (LVEF) of less than 0.55 prior to the pregnancy, relapse occurred in 12 (46.2%) pregnancies. Of 35 pregnancies with an LVEF of 0.55 or greater prior to the pregnancy, relapse occurred in 6 (17.1%) (P<0.01). No relapses occurred in 9 women who also demonstrated adequate contractile reserve. CONCLUSION: The most important criterion associated with reduced risk for heart failure relapse in a post-PPCM pregnancy is recovery defined by an LVEF 0.55 or greater before the subsequent pregnancy. Exercise stress echocardiography showing adequate contractile reserve may help to identify women at an even lower risk of relapse.
James D Fett; Karie L Fristoe; Serena N Welsh
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Publication Detail:
Type:  Journal Article     Date:  2009-11-30
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  109     ISSN:  1879-3479     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-05-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  34-6     Citation Subset:  IM    
Copyright Information:
Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Peripartum Cardiomyopathy Research Project, Department of Adult Medicine, H?pital Albert Schweitzer, Deschapelles, Haiti.
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MeSH Terms
Haiti / epidemiology
Heart Failure / diagnosis,  epidemiology*
Pregnancy Complications, Cardiovascular / epidemiology*
Prospective Studies
Risk Factors
Stroke Volume
United States / epidemiology

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