Comparison of Patients With Peripartum Heart Failure and Normal (≥55%) Versus Low (&lt;45%) Left Ventricular Ejection Fractions

Afonso, Luís; Arora, Natasha Purai; Mahajan, Nitin; Kottam, Anupama; Ballapuram, Kalyani; Toosi, Mehrdad Seilanian; Bhandare, Deepti; Gunasekaran, Prasad; Mitiku, Teferi; Williams, Kim A.

doi:10.1016/j.amjcard.2014.04.037

Cited by 10 publications

(10 citation statements)

References 10 publications

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“…Echocardiography plays a key role in the differential diagnosis between PPCM and other pregnancy-related cardiac diseases such as preeclampsia (25), in which LV systolic function is mostly unaffected, valvular heart diseases (VHDs), and congenital heart diseases (CHDs), and enables long-term monitoring of cardiac function (26) ( Table 2). Although LV systolic dysfunction is observed in the vast majority of PPCM patients, as reduced LVEF is a major criterion for the diagnosis (5), several studies reported unexplained HF with preserved LVEF in peripartum women, suggesting the possibility of progressive myocardial disease development across different clinical stages (27)(28)(29) and raising the challenge for early diagnosis.…”

Section: Echocardiographymentioning

confidence: 99%

The Role of Multimodality Cardiovascular Imaging in Peripartum Cardiomyopathy

Ricci

Innocentiis

Verrengia

et al. 2020

Front. Cardiovasc. Med.

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Ricci et al. Multimodality Imaging in Peripartum Cardiomyopathy KEY POINTS-Peripartum cardiomyopathy is a rare but potentially fatal disease requiring prompt identification and treatment. -Cardiac imaging plays a pivotal role for the diagnosis, risk stratification, and follow-up of peripartum cardiomyopathy and related complications. -Cardiovascular magnetic resonance is a high-throughput imaging modality providing relevant information for clinical decision-making and understanding of the pathophysiology underlying peripartum cardiomyopathy.

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Section: Echocardiographymentioning

confidence: 99%

The Role of Multimodality Cardiovascular Imaging in Peripartum Cardiomyopathy

Ricci

Innocentiis

Verrengia

et al. 2020

Front. Cardiovasc. Med.

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“…These patients demonstrated preserved systolic function based on 2D transthoracic echocardiogram (TTE) and met the Framingham criteria for (HF) diagnosis. These patients with preserved EF and PPCM‐like symptoms (labeled as pPPCM in our manuscript) show attenuated mitral annular velocities compared with classic PPCM patients with reduced EF (labeled as rPPCM in our manuscript) …”

Section: Introductionmentioning

confidence: 99%

“…These patients with preserved EF and PPCM-like symptoms (labeled as pPPCM in our manuscript) show attenuated mitral annular velocities compared with classic PPCM patients with reduced EF (labeled as rPPCM in our manuscript). 11 We sought to study the prognosis and recovery of a cohort of predominantly African American patients with rPPCM. Additionally, we characterized and compared regional and global LV longitudinal systolic strain patterns obtained using speckle tracking echocardiography in patients with rPPCM and pPPCM and referenced them to normal healthy peripartum controls.…”

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confidence: 99%

Longitudinal systolic strain profiles and outcomes in peripartum cardiomyopathy

et al. 2016

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Objective Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure that develops in the last month of pregnancy or within 5 months of delivery. Longitudinal systolic strain has been shown to be impaired in HF patients with both preserved and depressed EF, but has not previously characterized in patients with PPCM. Methods The purpose of our study was to investigate the prognosis and recovery in patients with PPCM and use 2D strain imaging to characterize regional and global LV strain in patients with PPCM. Between 2009 and 2014, we identified 47 newly diagnosed patients with PPCM and reduced EF (rPPCM), and 14 patients within the first 4 weeks postpartum who presented with signs and symptoms of HF, and elevated BNP/pro‐NT‐BNP, but preserved LVEF (pPPCM). We compared the echocardiographic characteristics of the patients with rPPCM and pPPCM with 14 healthy controls. Results All‐cause mortality was 10.6% (5/47) and rehospitalization for HF rate was 31.9% (15/47) at a median follow‐up of 12.5 months (range: 1–60 months) in the rPPCM group. In 25.5% (12/47) of patients with rPPCM, there was no recovery or worsening of LVEF, while complete and partial (more than 10% increase but less than 55%) recovery was seen in 57.4% (27/47) and 17% (8/47) of patients, respectively. Global and longitudinal strain (GLS) values were not independent predictors of all‐cause mortality or the composite endpoint of all‐cause mortality, rehospitalization, or no LVEF recovery in these patients. GLS and segmental strain were significantly lower in the preserved EF group compared with controls but higher compared with PPCM with reduced EF. Conclusion Global and segmental longitudinal strain parameters were significantly reduced in PPCM patients.

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“…Acute heart failure in pregnancy without systolic dysfunction in the absence of pre-eclampsia, eclampsia, or hypertension has been infrequently described ( 7 , 8 , 9 ). As in our patient, in these case descriptions, heart failure generally occurred in the first week after delivery and resolved in follow-up.…”

Section: Discussionmentioning

confidence: 99%