title: Natural history, management, and outcomes of peripartum cardiomyopathy: an Irish single-center cohort study.
abstract: OBJECTIVE
  To describe the natural history, management and outcomes of peripartum cardiomyopathy (PPCM) in an unselected Northern European population.
  
  
  METHODS
  A retrospective single-center observational study was performed at a tertiary referral heart failure and transplantation unit. Outcomes measured were baseline demographics, clinical presentation, course, and treatment. Echocardiographic findings were compared at baseline, 2 months, and 6 months.
  
  
  RESULTS
  Twelve cases of PPCM were identified between 2002 and 2008. Mean age was 34.7 years. Nine patients were multiparous and nine had preeclampsia. Ten patients presented in the first week postpartum. Two patients required inotropic support. Mean ejection fraction (EF) at presentation was 27% (SD = 8%) which improved to 47% (SD = 13%) at 6 months. At this time, 10 patients were asymptomatic and 6 had recovered normal cardiac function. Left ventricular (LV) function improved but did not reach normal limits in five cases. One case with persistent severe LV dysfunction required cardiac transplantation. One patient suffered an arrhythmic death several years after the 6 months follow-up period.
  
  
  CONCLUSIONS
  PPCM is a rare condition. With appropriate therapy, a good clinical outcome is common but not universal. Continued deterioration requiring ventricular support and cardiac transplantation can occur. In our cohort, older maternal age, multiparity, and preeclampsia appeared to be risk factors.
authors.affiliation: Department of Cardiology, Mater Misericordiae University Hospital and University College Dublin, Dublin, Ireland.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Horgan
authors.forename: Ronan
authors.initials: R
authors.lastname: Margey
authors.forename: Donal J
authors.initials: DJ
authors.lastname: Brennan
authors.forename: Colm
authors.initials: C
authors.lastname: O'Herlihy
authors.forename: Niall G
authors.initials: NG
authors.lastname: Mahon
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D058725:Peripartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome