1. Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy.
- Author
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Davis EM, Ewald G, Givertz MM, Rajagopalan N, Cooper LT Jr, Briller J, Felker GM, Bozkurt B, Drazner MH, Hanley-Yanez K, Halder I, McTiernan CF, and McNamara DM
- Subjects
- Adult, Body Mass Index, Cardiomyopathies blood, Female, Heart Failure physiopathology, Humans, Leptin blood, Obesity, Maternal blood, Peripartum Period physiology, Pregnancy, Prospective Studies, Stroke Volume, Ventricular Function, Left, Young Adult, Cardiomyopathies physiopathology, Obesity, Maternal physiopathology, Pregnancy Complications, Cardiovascular physiopathology, Ventricular Remodeling physiology
- 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., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2019
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