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An update on treatments and outcomes in peripartum cardiomyopathy
Richard Sheppard*,1, Navin Rajagopalan2, Jordan Safirstein3 & Joan Briller4
ABSTRACT: Peripartum cardiomyopathy (PPCM) is a well-established complication of pregnancy. Criteria include heart failure that presents with reduced left ventricular function, signs and symptoms of heart failure either late in pregnancy or early in the postpartum period. The incidence varies widely depending geography and ethnicity. The pathophysiology of PPCM is still an area of active investigation, but includes immune and inflammatory mechanisms, which are the subject of several investigations. Therapies for chronic heart failure from PPCM are similar to those patients with nonischemic cardiomyopathy from different etiologies, however novel therapies may include bromocriptine, pentoxifylline or other potential therapies influencing the immune system. The need for implantable defibrillators, left ventricular assist devices and cardiac transplant in women with PPCM is rare, and prognosis is better than other forms of nonischemic cardiomyopathy. Despite this, further information about the epidemiology, prognosis and potential therapies are required to better manage and diagnose PPCM in women with signs and symptoms of heart failure. Background Peripartum cardiomyopathy (PPCM) is an important and clinically significant potential cardiovascular complication of pregnancy and delivery. Historically, PPCM was determined to be a form of myocardial dysfunction in the early 20th century and later in the century was further defined by investigators who coined the term ‘peripartum cardiomyopathy’ [1] . These same investigators and others elaborated a number of diagnostic criteria (Box 1) , essentially referring to PPCM as the development of heart failure (HF) late in pregnancy or within a few months of delivery [2] . While the presence of a left ventricular ejection fraction (LVEF) of
An update on treatments and outcomes in peripartum cardiomyopathy
Richard Sheppard*,1, Navin Rajagopalan2, Jordan Safirstein3 & Joan Briller4
ABSTRACT: Peripartum cardiomyopathy (PPCM) is a well-established complication of pregnancy. Criteria include heart failure that presents with reduced left ventricular function, signs and symptoms of heart failure either late in pregnancy or early in the postpartum period. The incidence varies widely depending geography and ethnicity. The pathophysiology of PPCM is still an area of active investigation, but includes immune and inflammatory mechanisms, which are the subject of several investigations. Therapies for chronic heart failure from PPCM are similar to those patients with nonischemic cardiomyopathy from different etiologies, however novel therapies may include bromocriptine, pentoxifylline or other potential therapies influencing the immune system. The need for implantable defibrillators, left ventricular assist devices and cardiac transplant in women with PPCM is rare, and prognosis is better than other forms of nonischemic cardiomyopathy. Despite this, further information about the epidemiology, prognosis and potential therapies are required to better manage and diagnose PPCM in women with signs and symptoms of heart failure. Background Peripartum cardiomyopathy (PPCM) is an important and clinically significant potential cardiovascular complication of pregnancy and delivery. Historically, PPCM was determined to be a form of myocardial dysfunction in the early 20th century and later in the century was further defined by investigators who coined the term ‘peripartum cardiomyopathy’ [1] . These same investigators and others elaborated a number of diagnostic criteria (Box 1) , essentially referring to PPCM as the development of heart failure (HF) late in pregnancy or within a few months of delivery [2] . While the presence of a left ventricular ejection fraction (LVEF) of
