BACKGROUND: Clinical profile and predictors of major adverse events (MAE) associated with peripartum cardiomyopathy (PPCM) have not been characterized. METHODS AND RESULTS: A retrospective review and analysis of clinical data of 182 patients with PPCM. Forty-six patients had >or=1 MAE, including death (13), heart transplantation (11), temporary circulatory support (4), cardiopulmonary arrest (6), fulminant pulmonary edema (17), thromboembolic complications (4), and defibrillator or pacemaker implantation (10). Diagnosis of PPCM was delayed >or=1 week in 48% of patients with MAE that preceded the diagnosis in 50% of these patients. Seven (32%) of the surviving patients who had MAE and did not undergo heart transplantation had residual brain damage. Significant predictors of MAE were: left ventricular ejection fraction <or=25% (HR 4.20, CI 2.04-8.64) and non-Caucasian background(HR 2.16, CI 1.17- 3.97). These predictors in addition to diagnosis delay (HR 5.51, CI 1.21-25.04) were also associated with death or heart transplantation. CONCLUSIONS: 1. PPCM may be associated with mortality or severe and lasting morbidity. 2. Incidence of MAE is higher in non-Caucasians and in women with left ventricular ejection fraction <or=25%. 3. Diagnosis of PPCM is often delayed and preceded by MAE. 4. Increased awareness of PPCM is required for early diagnosis and aggressive therapy in an attempt to prevent complications.
BACKGROUND: Clinical profile and predictors of major adverse events (MAE) associated with peripartum cardiomyopathy (PPCM) have not been characterized. METHODS AND RESULTS: A retrospective review and analysis of clinical data of 182 patients with PPCM. Forty-six patients had >or=1 MAE, including death (13), heart transplantation (11), temporary circulatory support (4), cardiopulmonary arrest (6), fulminant pulmonary edema (17), thromboembolic complications (4), and defibrillator or pacemaker implantation (10). Diagnosis of PPCM was delayed >or=1 week in 48% of patients with MAE that preceded the diagnosis in 50% of these patients. Seven (32%) of the surviving patients who had MAE and did not undergo heart transplantation had residual brain damage. Significant predictors of MAE were: left ventricular ejection fraction <or=25% (HR 4.20, CI 2.04-8.64) and non-Caucasian background(HR 2.16, CI 1.17- 3.97). These predictors in addition to diagnosis delay (HR 5.51, CI 1.21-25.04) were also associated with death or heart transplantation. CONCLUSIONS: 1. PPCM may be associated with mortality or severe and lasting morbidity. 2. Incidence of MAE is higher in non-Caucasians and in women with left ventricular ejection fraction <or=25%. 3. Diagnosis of PPCM is often delayed and preceded by MAE. 4. Increased awareness of PPCM is required for early diagnosis and aggressive therapy in an attempt to prevent complications.
Authors: Dennis M McNamara; Uri Elkayam; Rami Alharethi; Julie Damp; Eileen Hsich; Gregory Ewald; Kalgi Modi; Jeffrey D Alexis; Gautam V Ramani; Marc J Semigran; Jennifer Haythe; David W Markham; Josef Marek; John Gorcsan; Wen-Chi Wu; Yan Lin; Indrani Halder; Jessica Pisarcik; Leslie T Cooper; James D Fett Journal: J Am Coll Cardiol Date: 2015-08-25 Impact factor: 24.094
Authors: B Löser; S Tank; G Hillebrand; B Goldmann; W Diehl; D Biermann; J Schirmer; D A Reuter Journal: Anaesthesist Date: 2013-05 Impact factor: 1.041
Authors: Julie Damp; Michael M Givertz; Marc Semigran; Rami Alharethi; Gregory Ewald; G Michael Felker; Biykem Bozkurt; John Boehmer; Jennifer Haythe; Hal Skopicki; Karen Hanley-Yanez; Jessica Pisarcik; Indrani Halder; John Gorcsan; Sarosh Rana; Zoltan Arany; James D Fett; Dennis M McNamara Journal: JACC Heart Fail Date: 2016-03-09 Impact factor: 12.035