title: Rest left ventricular function and contractile reserve by dobutamine stress echocardiography in peripartum cardiomyopathy.
abstract: OBJECTIVE
  To assess whether contractile reserve during dobutamine stress echocardiography (DSE) can predict left ventricular functional recovery in patients with peripartum cardiomyopathy and to assess myocardial fibrosis by magnetic resonance imaging (MRI) in these patients.
  
  
  METHODS
  Nine patients with peripartum cardiomyopathy were enrolled. All patients underwent DSE and were followed for six months, when a rest Doppler echocardiogram was repeated. MRI was also performed at the beginning of follow-up to identify myocardial fibrosis.
  
  
  RESULTS
  Mean age was 29±7.9 years and mean left ventricular ejection fraction at baseline was 39.4±8.6% (range 24-49%). Eight of the nine patients showed left ventricular functional recovery with mean ejection fraction at follow-up of 57.1±13.8%. The ejection fraction response to DSE did not predict recovery at follow-up. On the other hand, left ventricular ejection fraction at baseline correlated with ejection fraction at follow-up. Mild fibrosis was detected in only one patient.
  
  
  CONCLUSIONS
  Left ventricular ejection fraction at baseline was a predictor of left ventricular functional recovery in patients with peripartum cardiomyopathy. Dobutamine stress echocardiography at presentation of the disease did not predict recovery at follow-up. Myocardial fibrosis appeared to be uncommon in this cardiomyopathy.
authors.affiliation: ECOCENTER, Hospital Socor, Belo Horizonte, MG, Brazil.
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Barbosa
authors.forename: Cláudia M V
authors.initials: CM
authors.lastname: Freire
authors.forename: Bruno Ramos
authors.initials: BR
authors.lastname: Nascimento
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rochitte
authors.forename: Marly C
authors.initials: MC
authors.lastname: Silva
authors.forename: Maria H A
authors.initials: MH
authors.lastname: Siqueira
authors.forename: Maria Carmo P
authors.initials: MC
authors.lastname: Nunes
mesh_terms: D000293:Adolescent; D000328:Adult; D025401:Echocardiography, Stress; D005260:Female; D005355:Fibrosis; D006321:Heart / Q000503:physiopathology; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D011644:Puerperal Disorders / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D016277:Ventricular Function, Left; D055815:Young Adult