Clinical profile and predictors of complications in peripartum cardiomyopathy.
BACKGROUND
Clinical profile and predictors of major adverse events (MAE) associated with peripartum cardiomyopathy (PPCM) have not been characterized.


RESULTS
A retrospective review and analysis of clinical data of 182 patients with PPCM. Forty-six patients had >or=1 MAE, including death (13), heart transplantation (11), temporary circulatory support (4), cardiopulmonary arrest (6), fulminant pulmonary edema (17), thromboembolic complications (4), and defibrillator or pacemaker implantation (10). Diagnosis of PPCM was delayed >or=1 week in 48% of patients with MAE that preceded the diagnosis in 50% of these patients. Seven (32%) of the surviving patients who had MAE and did not undergo heart transplantation had residual brain damage. Significant predictors of MAE were: left ventricular ejection fraction <or=25% (HR 4.20, CI 2.04-8.64) and non-Caucasian background(HR 2.16, CI 1.17- 3.97). These predictors in addition to diagnosis delay (HR 5.51, CI 1.21-25.04) were also associated with death or heart transplantation.


CONCLUSIONS
1. PPCM may be associated with mortality or severe and lasting morbidity. 2. Incidence of MAE is higher in non-Caucasians and in women with left ventricular ejection fraction <or=25%. 3. Diagnosis of PPCM is often delayed and preceded by MAE. 4. Increased awareness of PPCM is required for early diagnosis and aggressive therapy in an attempt to prevent complications.
Goland
Sorel
S
Department of Cardiology and Biostatistics Division, Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Modi
Kalgi
K
Bitar
Fahed
F
Janmohamed
Munir
M
Mirocha
James M
JM
Czer
Lawrence S C
LS
Illum
Sandra
S
Hatamizadeh
Parta
P
Elkayam
Uri
U
D000328:Adult; D009202:Cardiomyopathies / Q000150:complications* / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality* / Q000503:physiopathology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D055815:Young Adult