title: Delayed recovery in peripartum cardiomyopathy: an indication for long-term follow-up and sustained therapy.
abstract: OBJECTIVE
  Persistence of left ventricular (LV) systolic dysfunction after 6 months of diagnosis is believed to be a marker of an irreversible cardiomyopathy in peripartum cardiomyopathy (PPCM). We sought to determine the length of time required for recovery of LV systolic function (LVSF) in patients with PPCM.
  
  
  RESULTS
  Forty-two consecutive women with PPCM were enrolled in this prospective study. The minimum required time of follow-up for inclusion was 30 months. Each patient underwent transthoracic echocardiography, and plasma brain natriuretic peptide (BNP) and C-reactive protein measurement at admission, and every 3 months. Early recovery was defined as normalization of LVSF at 6 months post-diagnosis. Delayed recovery was defined if the length of time required for recovery of LVSF was longer than 6 months. Persistent left ventricular dysfunction (PLVD) was defined as an ejection fraction of <50% at the end of follow-up. Twenty patients (47.6%) recovered completely, 10 died (23.8%), and 12 (28.6%) had PLVD. Average time to complete recovery was 19.3 months after initial diagnosis (3-42 months). Early recovery was observed only in six patients (30%), whereas delayed recovery was observed in 14 out of 20 patients (70%). Patients with complete recovery were more likely to have a higher LV ejection fraction and smaller LV end-systolic dimensions at baseline.
  
  
  CONCLUSIONS
  Full recovery of LVSF in PPCM patients often requires longer than 6 months.
authors.affiliation: Department of Cardiology, Haydarpaşa Numune Education and Research Hospital, Turkey. murbit2@yahoo.com
authors.forename: Murat
authors.initials: M
authors.lastname: Biteker
authors.forename: Erkan
authors.initials: E
authors.lastname: Ilhan
authors.forename: Gul
authors.initials: G
authors.lastname: Biteker
authors.forename: Dursun
authors.initials: D
authors.lastname: Duman
authors.forename: Biykem
authors.initials: B
authors.lastname: Bozkurt
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers; D002097:C-Reactive Protein; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D020097:Natriuretic Peptide, Brain; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein