title: Reversal of IFN-gamma, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy.
abstract: OBJECTIVE
  Peripartum cardiomyopathy (PPCM) is characterized by acute onset of heart failure of unknown aetiology. We aimed to identify mechanisms involved in initiation and progression of the disease.
  
  
  RESULTS
  Serum markers related to cardiac function, apoptosis, oxidative stress, remodelling, inflammation and the nursing hormone prolactin were analyzed in PPCM patients and healthy controls. The kinetics of these markers were compared between patients who improved cardiac function (IMP) and those patients who did not improve (NIMP), over 6 months follow-up. All patients received ACE-inhibitors, beta-blockers and diuretics. Baseline levels of TGF-beta-1 were significantly lower, MMP-9 and VEGF were not different; all other markers were significantly higher in PPCM compared with controls. Only baseline NT-proBNP levels were higher in NIMP compared with IMP. After 6 months, NT-proBNP, oxLDL and IFN-gamma were significantly lower in IMP and the decrease in oxLDL, IFN-gamma and prolactin was significant in IMP but not in NIMP. Significant correlations were observed between the kinetics of NT-proBNP, oxLDL, prolactin and IFN-gamma in PPCM patients.
  
  
  CONCLUSIONS
  Baseline NT-proBNP and the failure to decrease oxLDL, IFN-gamma and prolactin are associated with poor outcome in PPCM, suggesting a potential role of these factors in the pathophysiology of PPCM and for risk stratification of PPCM patients.
authors.affiliation: Soweto Cardiovascular Research Unit, Department of Cardiology, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Olaf
authors.initials: O
authors.lastname: Forster
authors.forename: Denise
authors.initials: D
authors.lastname: Hilfiker-Kleiner
authors.forename: Aftab A
authors.initials: AA
authors.lastname: Ansari
authors.forename: J Bruce
authors.initials: JB
authors.lastname: Sundstrom
authors.forename: Elena
authors.initials: E
authors.lastname: Libhaber
authors.forename: Winnie
authors.initials: W
authors.lastname: Tshani
authors.forename: Anthony
authors.initials: A
authors.lastname: Becker
authors.forename: Anthony
authors.initials: A
authors.lastname: Yip
authors.forename: Gunnar
authors.initials: G
authors.lastname: Klein
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa