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Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities.
- Source :
-
European journal of heart failure [Eur J Heart Fail] 2019 Dec; Vol. 21 (12), pp. 1534-1542. Date of Electronic Publication: 2019 Nov 13. - Publication Year :
- 2019
-
Abstract
- Aims: Peripartum cardiomyopathy (PPCM) establishes late in pregnancy or in the first postpartum months. Many patients recover well within the first year, but long-term outcome studies on morbidity and mortality are rare. Here, we present 5-year follow-up data of a German PPCM cohort.<br />Methods and Results: Five-year follow-up data were available for 66 PPCM patients (mean age 34 ± 5 years) with a mean left ventricular ejection fraction (LVEF) of 26 ± 9% at diagnosis. Ninety-eight percent initially received standard heart failure therapy (beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and/or mineralocorticoid receptor antagonists), and 86% were additionally treated with dopamine D2 receptor agonists (mainly bromocriptine) and anticoagulation. After 1 year, mean LVEF had improved to 50 ± 11% (n = 48) and further increased to 54 ± 7% at 5-year follow-up with 72% of patients having achieved full cardiac recovery (LVEF >50%). At 5-year follow-up, only three patients (5%) displayed no recovery, of whom one had died. However, 20% had arterial hypertension and 17% arrhythmias, including paroxysmal supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation. Moreover, 70% were still on at least one heart failure drug. Subsequent pregnancy occurred in 16 patients with two abortions and 14 uneventful pregnancies. Mean LVEF was 55 ± 7% at 5-year follow-up in these patients.<br />Conclusion: Our PPCM collective treated with standard therapy for heart failure, dopamine D2 receptor agonists, and anticoagulation displays a high and stable long-term recovery rate with low mortality at 5-year follow-up. However, long-term use of cardiovascular medication, persisting or de novo hypertension and arrhythmias were frequent.<br /> (© 2019 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
- Subjects :
- Adult
Cardiomyopathies physiopathology
Comorbidity
Female
Follow-Up Studies
Germany epidemiology
Humans
Pregnancy
Pregnancy Complications, Cardiovascular physiopathology
Prognosis
Prospective Studies
Time Factors
Cardiomyopathies drug therapy
Cardiovascular Agents therapeutic use
Peripartum Period
Pregnancy Complications, Cardiovascular therapy
Recovery of Function
Stroke Volume physiology
Ventricular Function, Left physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0844
- Volume :
- 21
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European journal of heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 31724271
- Full Text :
- https://doi.org/10.1002/ejhf.1624