title: The Medical Treatment of New-Onset Peripartum Cardiomyopathy: A Systematic Review of Prospective Studies.
abstract: BACKGROUND
  Peripartum cardiomyopathy (PPCM) is a rare disorder with potentially fatal consequences, which occurs mainly in previously healthy women. The aetiology of PPCM remains unknown and various pathologic mechanisms have been proposed, including immune-mediated injuries and impaired response to oxidative stress and inflammatory cytokines. Several therapies have been studied, but few have been validated in a well-designed randomized controlled trial.
  
  
  METHODS
  In the present study we sought to review the medical treatment intended for acute PPCM. To this end, we performed a systematic review of the literature of randomized and nonrandomized prospective clinical studies.
  
  
  RESULTS
  We identified 2 randomized controlled trials that evaluated the dopamine agonist bromocriptine and the inotrope levosimendan, respectively, and 1 nonrandomized study that evaluated the nonselective phosphodiesterase inhibitor pentoxifylline. We reviewed the pathophysiological, pharmacological, and clinical properties for each treatment option identified. Bromocriptine and pentoxifylline both improved left ventricular systolic function and patient-oriented clinical end points and levosimendan did not improve mortality or echocardiographic findings of PPCM.
  
  
  CONCLUSIONS
  In this review we identified bromocriptine and pentoxifylline, but not levosimendan, as potentially useful agents to improve left ventricle function and outcomes in PPCM.
authors.affiliation: Adult Cardiology Training Program, Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Olivier
authors.initials: O
authors.lastname: Desplantie
authors.affiliation: Adult Cardiology Training Program, Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Maxime
authors.initials: M
authors.lastname: Tremblay-Gravel
authors.affiliation: Adult Cardiology Training Program, Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Avram
authors.affiliation: Adult Cardiology Training Program, Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Marquis-Gravel
authors.affiliation: Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Anique
authors.initials: A
authors.lastname: Ducharme
authors.affiliation: Adult Cardiology Training Program, Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada. Electronic address: marc.jolicoeur@icm-mhi.org.
authors.forename: E Marc
authors.initials: EM
authors.lastname: Jolicoeur
mesh_terms: D001971:Bromocriptine / Q000009:adverse effects / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000401:mortality; D004452:Echocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D006835:Hydrazones / Q000009:adverse effects / Q000627:therapeutic use*; D010431:Pentoxifylline / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000188:drug therapy* / Q000401:mortality; D011724:Pyridazines / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000077464:Simendan; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000401:mortality
chemical_list: D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D001971:Bromocriptine; D010431:Pentoxifylline