Familial occurrence of peripartum cardiomyopathy presages a genetic rather than an environmental cause.
Peripartum cardiomyopathy (PPCM) is an uncommon form of left ventricular dysfunction associated with pregnancy and triggered by a number of obstetric factors including pre-eclampsia, plural gestations and multiparity. PPCM is the most frequent cause of pregnancy-related maternal death. Although the clinical outcome of PPCM has been determined, its patho-etiology has not been elucidated. Two recent studies have demonstrated for the first time in a small proportion of patients, convincing evidence of a genetic predisposition for PPCM, activated by modifier genes responding to biochemical and hemodynamic signals during mid to late pregnancy.
St John Sutton
Martin
M
Division of Cardiovascular Medicine, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA. suttonm@mail.med.upenn.edu
D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000453:epidemiology / Q000235:genetics; D015331:Cohort Studies; D004777:Environment; D005260:Female; D020022:Genetic Predisposition to Disease; D020073:Gravidity; D006801:Humans; D010298:Parity; D010375:Pedigree; D058725:Peripartum Period; D011225:Pre-Eclampsia; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000235:genetics; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000209:etiology