title: Molecular mechanisms of peripartum cardiomyopathy: A vascular/hormonal hypothesis.
abstract: Peripartum cardiomyopathy (PPCM) is characterized by the development of systolic heart failure in the last month of pregnancy or within the first 5 months postpartum. The disease affects between 1:300 and 1:3000 births worldwide. Heart failure can resolve spontaneously but often does not. Mortality rates, like incidence, vary widely based on location, ranging from 0% to 25%. The consequences of PPCM are thus often devastating for an otherwise healthy young woman and her newborn. The cause of PPCM remains elusive. Numerous hypotheses have been proposed, with mixed supporting evidence. Recent work has suggested that PPCM is a vascular disease, triggered by the profound hormonal changes of late gestation. We focus here on these new mechanistic findings, and their potential implication for understanding and treating PPCM.
authors.affiliation: Division of Cardiology, Columbia University Medical Center, New York, NY.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Bello
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: zarany@mail.med.upenn.edu.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Arany
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D054143:Heart Failure, Systolic / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D063130:Maternal Death / Q000639:trends; D008967:Molecular Biology; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011374:Progesterone / Q000378:metabolism*; D035583:Rare Diseases; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000503:physiopathology*
chemical_list: D011374:Progesterone