1. Breastfeeding, Cellular Immune Activation, and Myocardial Recovery in Peripartum Cardiomyopathy
- Author
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Agnes Koczo, Amy Marino, Arun Jeyabalan, Uri Elkayam, Leslie T. Cooper, James Fett, Joan Briller, Eileen Hsich, Lori Blauwet, Charles McTiernan, Penelope A. Morel, Karen Hanley-Yanez, Dennis M. McNamara, Dennis M McNamara, James D. Fett, Jessica Pisarcik, John Gorcsan, Erik Schelbert, Rami Alharethi, Kismet Rasmusson, Kim Brunisholz, Amy Butler, Deborah Budge, A.G. Kfoury, Benjamin Horne, Joe Tuinei, Heather Brown, Julie Damp, Allen J. Naftilan, Jill Russell, Darla Freehardt, Cynthia Oblak, Greg Ewald, Donna Whitehead, Jean Flanagan, Anne Platts, Jorge Caro, Stephanie Mullin, Michael M. Givertz, M. Susan Anello, Navin Rajagopalan, David Booth, Tiffany Sandlin, Wendy Wijesiri, Lori A. Blauwet, Joann Brunner, Mary Phelps, Ruth Kempf, Kalgi Modi, Tracy Norwood, Decebal Sorin Griza, G. Michael Felker, Robb Kociol, Patricia Adams, Gretchen Wells, Vinay Thohan, Deborah Wesley-Farrington, Sandra Soots, Richard Sheppard, Caroline Michel, Nathalie Lapointe, Heather Nathaniel, Angela Kealey, Marc Semigran, Maureen Daher, John Boehmer, David Silber, Eric Popjes, Patricia Frey, Todd Nicklas, Jeffrey Alexis, Lori Caufield, John W. Thornton, Mindy Gentry, Vincent J.B. Robinson, Gyanendra K. Sharma, Joan Holloway, Maria Powell, David Markham, Mark Drazner, Lynn Fernandez, Mark Zucker, David A. Baran, Martin L. Gimovsky, Natalia Hochbaum, Bharati Patel, Laura Adams, Gautam Ramani, Stephen Gottlieb, Shawn Robinson, Stacy Fisher, Joanne Marshall, Jennifer Haythe, Donna Mancini, Rachel Bijou, Maryjane Farr, Marybeth Marks, Henry Arango, Biykem Bozkurt, Mariana Bolos, Paul Mather, Sharon Rubin, Raphael Bonita, Susan Eberwine, Hal Skopicki, Kathleen Stergiopoulos, Ellen McCathy-Santoro, Jennifer Intravaia, Elizabeth Maas, Jordan Safirstein, Audrey Kleet, Nancy Martinez, Christine Corpoin, Donna Hesari, Sandra Chaparro, Laura J. Hudson, Jalal K. Ghali, Zora Injic, and Ilan S. Wittstein
- Subjects
0301 basic medicine ,Cardiac function curve ,endocrine system ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Peripartum cardiomyopathy ,breastfeeding ,CLINICAL RESEARCH ,Breastfeeding ,peripartum cardiomyopathy ,030204 cardiovascular system & hematology ,immune activation ,BF, breastfeeding ,Flow cytometry ,03 medical and health sciences ,0302 clinical medicine ,Immunophenotyping ,Internal medicine ,LVEF, left ventricular ejection fraction ,medicine ,reproductive and urinary physiology ,medicine.diagnostic_test ,business.industry ,medicine.disease ,female genital diseases and pregnancy complications ,Prolactin ,NBF, nonbreastfeeding ,030104 developmental biology ,lcsh:RC666-701 ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,PPCM, peripartum cardiomyopathy ,hormones, hormone substitutes, and hormone antagonists ,CD8 ,Immune activation - Abstract
Visual Abstract, Highlights • The impact of breastfeeding on prolactin, cellular immune activation, and myocardial recovery was analyzed in 100 women with peripartum cardiomyopathy • Cardiac function was assessed by echocardiography at presentation and at serial intervals over the first year postpartum • The levels of circulating prolactin were assessed by ELISA, and cellular immunophenotyping by flow cytometry, and compared between breastfeeding and nonbreastfeeding women • Prolactin levels were higher in breastfeeding women and correlated with significant increases in CD8+ T cells • Despite significantly higher prolactin levels and increased CD8+ cells, myocardial recovery was similar in breastfeeding and nonbreastfeeding women, Summary The etiology of peripartum cardiomyopathy remains unknown. One hypothesis is that an increase in the 16-kDa form of prolactin is pathogenic and suggests that breastfeeding may worsen peripartum cardiomyopathy by increasing prolactin, while bromocriptine, which blocks prolactin release, may be therapeutic. An autoimmune etiology has also been proposed. The authors investigated the impact of breastfeeding on cellular immunity and myocardial recovery for women with peripartum cardiomyopathy in the IPAC (Investigations in Pregnancy Associated Cardiomyopathy) study. Women who breastfed had elevated prolactin, and prolactin levels correlated with elevations in CD8+ T cells. However, despite elevated prolactin and cytotoxic T cell subsets, myocardial recovery was not impaired in breastfeeding women.
- Published
- 2019
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