Esa M Davis1, Gregory Ewald2, Michael M Givertz3, Navin Rajagopalan4, Leslie T Cooper5, Joan Briller6, G Michael Felker7, Biykem Bozkurt8, Mark H Drazner9, Karen Hanley-Yanez10, Indrani Halder10, Charles F McTiernan10, Dennis M McNamara10. 1. Department of Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 2. Department of Medicine, Washington University, St. Louis, Missouri. 3. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 4. Department of Medicine, University of Kentucky, Lexington, Kentucky. 5. Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida. 6. Department of Medicine, University of Illinois at Chicago, Illinois. 7. Department of Medicine, Duke University, Durham, North Carolina. 8. Department of Medicine, Baylor College of Medicine, Houston, Texas. 9. Department of Medicine, UT Southwestern Medical Center, Dallas, Texas. 10. Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN: This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity. Demographic, clinical, and biomarker variables were compared across weight categories. OUTCOMES: LV end-diastolic diameter (LVEDD) and ejection fraction were measured at entry, 6, and 12 months postpartum. Multivariable regression models examined the relationship between adiposity, LV size, and leptin levels with cardiac recovery at 6 and 12 months postpartum. RESULTS: Obese and nonobese women had similar LV dysfunction at entry. Obese women had greater LV size and less LV recovery at 6 and 12 months postpartum. BMI was positively associated with leptin and ventricular diameter. Greater BMI at entry remained associated with less ventricular recovery at 6 months (p = 0.02) in adjusted race-stratified models. LVEDD at entry predicted lower ejection fraction at 6 months (p < 0.001) and similarly at 12 months. CONCLUSION: Obese women with PPCM had greater cardiac remodeling, higher leptin levels, and diminished cardiac recovery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN: This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity. Demographic, clinical, and biomarker variables were compared across weight categories. OUTCOMES: LV end-diastolic diameter (LVEDD) and ejection fraction were measured at entry, 6, and 12 months postpartum. Multivariable regression models examined the relationship between adiposity, LV size, and leptin levels with cardiac recovery at 6 and 12 months postpartum. RESULTS: Obese and nonobese women had similar LV dysfunction at entry. Obese women had greater LV size and less LV recovery at 6 and 12 months postpartum. BMI was positively associated with leptin and ventricular diameter. Greater BMI at entry remained associated with less ventricular recovery at 6 months (p = 0.02) in adjusted race-stratified models. LVEDD at entry predicted lower ejection fraction at 6 months (p < 0.001) and similarly at 12 months. CONCLUSION: Obese women with PPCM had greater cardiac remodeling, higher leptin levels, and diminished cardiac recovery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Anna E Bortnick; Claudia Lama von Buchwald; Aliaskar Hasani; Christina Liu; Julia L Berkowitz; Shayna Vega; Mohammad Hashim Mustehsan; Diana S Wolfe; Cynthia Taub Journal: Echocardiography Date: 2021-05-08 Impact factor: 1.724