Prognostic value of echocardiography in peripartum cardiomyopathy.
OBJECTIVE
To estimate whether echocardiography findings at the time of diagnosis of peripartum cardiomyopathy are predictive of persistent cardiac dysfunction.


METHODS
Chart review of patients with peripartum cardiomyopathy between 1988 and 2001 was performed. Data from echocardiography, including fractional shortening and left ventricular end diastolic dimension, were recorded both at the time of diagnosis and at follow-up. Left ventricular dysfunction was defined by echocardiography as fractional shortening less than 30% and left ventricular end diastolic dimension of 4.8 cm or more.


RESULTS
Of 32 patients meeting our definition for peripartum cardiomyopathy and for whom follow-up data were available, 13 (41%) had recovery of ventricular function, while 19 (59%) continued to have persistent left ventricular dysfunction. Those who did not recover cardiac function had a higher left ventricular end diastolic dimension and a lower fractional shortening at diagnosis than those who recovered. A fractional shortening value less than 20% and a left ventricular end diastolic dimension 6 cm or greater at the time of diagnosis was associated with a more than 3-fold higher risk for persistent left ventricular dysfunction.


CONCLUSIONS
Along with being an important diagnostic tool in peripartum cardiomyopathy, echocardiography may provide significant prognostic information with regards to recovery of cardiac function.
Chapa
Jeff B
JB
Departments of Obstetrics and Gynecology and Internal Medicine, University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA. jeff.chapa@uhhs.com
Heiberger
Heather B
HB
Weinert
Lynn
L
Decara
Jeanne
J
Lang
Roberto M
RM
Hibbard
Judith U
JU
D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging*; D011379:Prognosis; D011644:Puerperal Disorders / Q000000981:diagnostic imaging*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis; D016277:Ventricular Function, Left / Q000502:physiology*