Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy.
Peripartum cardiomyopathy (PPCM) is a cause of pregnancy-associated heart failure. It typically develops during the last month of, and up to 6 months after, pregnancy in women without known cardiovascular disease. The present position statement offers a state-of-the-art summary of what is known about risk factors for potential pathophysiological mechanisms, clinical presentation of, and diagnosis and management of PPCM. A high index of suspicion is required for the diagnosis, as shortness of breath and ankle swelling are common in the peripartum period. Peripartum cardiomyopathy is a distinct form of cardiomyopathy, associated with a high morbidity and mortality, but also with the possibility of full recovery. Oxidative stress and the generation of a cardiotoxic subfragment of prolactin may play key roles in the pathophysiology of PPCM. In this regard, pharmacological blockade of prolactin offers the possibility of a disease-specific therapy.
Sliwa
Karen
K
Hatter Cardiovascular Research Institute, University of Cape Town, Cape Town, South Africa. sliwa-hahnlek@mdh-africa.org
Hilfiker-Kleiner
Denise
D
Petrie
Mark C
MC
Mebazaa
Alexandre
A
Pieske
Burkert
B
Buchmann
Eckhart
E
Regitz-Zagrosek
Vera
V
Schaufelberger
Maria
M
Tavazzi
Luigi
L
van Veldhuisen
Dirk J
DJ
Watkins
Hugh
H
Shah
Ajay J
AJ
Seferovic
Petar M
PM
Elkayam
Uri
U
Pankuweit
Sabine
S
Papp
Zoltan
Z
Mouquet
Frederic
F
McMurray
John J V
JJ
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002309:Cardiology / Q000639:trends*; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D002402:Cathepsin D; D005060:Europe; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation; D020097:Natriuretic Peptide, Brain; D018384:Oxidative Stress; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D011379:Prognosis; D011388:Prolactin / Q000037:antagonists & inhibitors / Q000187:drug effects; D012307:Risk Factors; D012955:Societies, Medical / Q000639:trends
D000959:Antihypertensive Agents; D020097:Natriuretic Peptide, Brain; D011388:Prolactin; D002402:Cathepsin D