Clinical Characteristics and Long-term Predictors of Persistent Left Ventricular Systolic Dysfunction in Peripartum Cardiomyopathy.

Peripartum cardiomyopathy (PPCM) is a potentially life-threatening dilated cardiomyopathy that occurs in previously well women during pregnancy or postpartum. The predictors of persistent left ventricular (LV) systolic dysfunction (LVSD) in PPCM are poorly understood and were the subject of this study. Patients with PPCM (n = 71), who were admitted to Beijing Friendship Hospital from 2004 to 2011, were retrospectively analyzed. Data including electrocardiographic and echocardiographic measurements at diagnosis (baseline) and at the last follow-up visit were collected. Data on plasma brain natriuretic peptide (BNP) and C-reactive protein (CRP) levels were also collected at baseline. A receiver operating characteristic curve was used to determine the cutoff values. Univariate and multivariate analyses were used to assess the significant predictive variables for persistent LVSD. Thirty-one patients (44%) did not recover completely at the last follow-up visit (LV nonrecovery group), and 40 patients (56%) had good LV recovery (LV recovery group). Baseline BNP level was positively correlated with LV end-diastolic diameter (r = 0.559; P < 0.001), and inversely correlated with LV ejection fraction (LVEF) (r = -0.548; P < 0.001) and fractional shortening (r = -0.542; P < 0.001). There was no difference in CRP levels between the 2 groups. Receiver operating characteristic curves indicated the cutoff value in terms of predicting persistent LVSD was 34% for LVEF, 64 mm for LV end-diastolic diameter, 16% for fractional shortening, and 1860 pg/mL for BNP. Univariate and multivariate analyses confirmed that LVEF < 34% (95% CI, 1.38-7.30; P = 0.007) and BNP > 1860 pg/mL (95% CI, 1.18-6.99; P = 0.020) were independent prognostic factors in predicting persistent LVSD. LVEF and plasma BNP levels have good predictive value in long-term cardiac dysfunction.

Li W ，Li H ，Long Y 《-》

A novel marker of persistent left ventricular systolic dysfunction in patients with peripartum cardiomyopathy: monocyte count- to- HDL cholesterol ratio.

Ekizler FA ，Cay S 《BMC Cardiovascular Disorders》

Right Ventricular Function in Peripartum Cardiomyopathy at Presentation Is Associated With Subsequent Left Ventricular Recovery and Clinical Outcomes.

Peripartum cardiomyopathy has variable disease progression and left ventricular (LV) recovery. We hypothesized that baseline right ventricular (RV) size and function are associated with LV recovery and outcome. Investigations of Pregnancy-Associated Cardiomyopathy was a prospective 30-center study of 100 peripartum cardiomyopathy women with LV ejection fraction (LVEF) <45% within 13 weeks after delivery. Baseline RV function was assessed by echocardiographic end-diastolic area, end-systolic area, fractional area change, tricuspid annular plane excursion, and RV speckle-tracking longitudinal strain. LV recovery was defined as LVEF of ≥50% at 1 year, persistent severe LV dysfunction as LVEF of ≤35%, and major events as death, transplant, or LV assist device implantation. RV measurements were feasible for 90 of the 96 patients (94%) with echocardiograms available. Mean baseline LVEF was 36±9%. RV fractional area change was <35% in 38% of patients. Of 84 patients with 1-year follow-up data, 63 (75%) had LV recovery and 11 (13%) had LVEF of ≤35% or a major event (4 LV assist devices and 2 deaths). Tricuspid annular plane excursion and RV strain did not predict outcome. Baseline RV fractional area change by multivariable analysis was independently associated with subsequent LV recovery and clinical outcome. Peripartum cardiomyopathy patients had a high incidence of LV recovery, but a significant minority had persistent LV dysfunction or a major clinical event by 1 year. RV function per echocardiographic fractional area change at presentation was associated with subsequent LV recovery and clinical outcomes and thus is prognostically important.

Blauwet LA ，Delgado-Montero A ，Ryo K ，Marek JJ ，Alharethi R ，Mather PJ ，Modi K ，Sheppard R ，Thohan V ，Pisarcik J ，McNamara DM ，Gorcsan J 3rd ，IPAC Investigators* ... -  《-》

Value of the neutrophil-to-lymphocyte ratio in predicting left ventricular recovery in patients with peripartum cardiomyopathy.

Gürkan U ，Akgöz H ，Aksoy Ş ，Can Gürkan Ö ，Osken A ，Unal Dayi S ，Oz D ，Haci R ... -  《-》

Value of brain natriuretic peptide after acute myocardial infarction.

Güneş Y ，Okçün B ，Kavlak E ，Erbaş C ，Karcier S ... -  《-》