BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare and heterogeneous disease with a higher prevalence in African Americans (AAs) in the USA. The clinical features and prognosis of PPCM in AAs have not been sufficiently characterized. METHODS: We studied 52 AA patients with PPCM and compared clinical characteristics and outcome with those of 104 white patients. RESULTS: AA patients were significantly younger (26 ± 7 vs 30 ± 6 years; P < .001), had a higher prevalence of gestational hypertension (61% vs 41%; P = .03), and were diagnosed more commonly postpartum rather then antepartum (83% vs 64%; P = .03). The rate of left ventricular (LV) recovery (LV ejection fraction [LVEF] ≥50%) was significantly lower in AAs (40% vs 61%; P = .02). AA women also had a larger LV end-diastolic diameter (57 ± 10 vs 51 ± 6 mm; P = .004) as well as lower LVEF (40% ± 16.7% vs 46% ± 14%; P = .002) at the last follow-up. Moreover, AA patients had a significantly higher incidence of the combined end points of mortality and cardiac transplantation (P = .03) and showed a strong trend (P = .09) for increased mortality. CONCLUSIONS: AA patients with PPCM in the USA have a different clinical profile and worse prognosis compared with white patients. Further research to evaluate potentially correctable causes for these differences is warranted.
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare and heterogeneous disease with a higher prevalence in African Americans (AAs) in the USA. The clinical features and prognosis of PPCM in AAs have not been sufficiently characterized. METHODS: We studied 52 AA patients with PPCM and compared clinical characteristics and outcome with those of 104 white patients. RESULTS: AA patients were significantly younger (26 ± 7 vs 30 ± 6 years; P < .001), had a higher prevalence of gestational hypertension (61% vs 41%; P = .03), and were diagnosed more commonly postpartum rather then antepartum (83% vs 64%; P = .03). The rate of left ventricular (LV) recovery (LV ejection fraction [LVEF] ≥50%) was significantly lower in AAs (40% vs 61%; P = .02). AA women also had a larger LV end-diastolic diameter (57 ± 10 vs 51 ± 6 mm; P = .004) as well as lower LVEF (40% ± 16.7% vs 46% ± 14%; P = .002) at the last follow-up. Moreover, AA patients had a significantly higher incidence of the combined end points of mortality and cardiac transplantation (P = .03) and showed a strong trend (P = .09) for increased mortality. CONCLUSIONS: AA patients with PPCM in the USA have a different clinical profile and worse prognosis compared with white patients. Further research to evaluate potentially correctable causes for these differences is warranted.
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Authors: James S Ware; Jian Li; Erica Mazaika; Christopher M Yasso; Tiffany DeSouza; Thomas P Cappola; Emily J Tsai; Denise Hilfiker-Kleiner; Chizuko A Kamiya; Francesco Mazzarotto; Stuart A Cook; Indrani Halder; Sanjay K Prasad; Jessica Pisarcik; Karen Hanley-Yanez; Rami Alharethi; Julie Damp; Eileen Hsich; Uri Elkayam; Richard Sheppard; Angela Kealey; Jeffrey Alexis; Gautam Ramani; Jordan Safirstein; John Boehmer; Daniel F Pauly; Ilan S Wittstein; Vinay Thohan; Mark J Zucker; Peter Liu; John Gorcsan; Dennis M McNamara; Christine E Seidman; Jonathan G Seidman; Zoltan Arany Journal: N Engl J Med Date: 2016-01-06 Impact factor: 91.245