Different Characteristics of Peripartum Cardiomyopathy Between Patients Complicated With and Without Hypertensive Disorders  - Results From the Japanese Nationwide Survey of Peripartum Cardiomyopathy -

Kamiya, Chizuko; Kitakaze, Masafumi; Ishibashi‐Ueda, Hatsue; Nakatani, Satoshi; Murohara, Toyoaki; Tomoike, Hitonobu; Ikeda, Tomoaki

doi:10.1253/circj.cj-10-1214

Cited by 174 publications

(175 citation statements)

References 29 publications

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“…In the present system, we placed the server in the Department of Information at the National Cerebral and Cardiovascular Center (formerly, National Cardiovascular Center) where the security of the database was highly guaranteed. 6, 7 The study was conducted in accordance with the Declaration of Helsinki, and was approved by the ethics committee of the National Cerebral and Cardiovascular Center.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Recent Picture of Infective Endocarditis in Japan

Nakatani

Mitsutake

Ohara

et al. 2013

Circ J

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on behalf of the CADRE investigators Background: It is important to manage a potentially fatal disease such as infective endocarditis (IE) based on evidence and guidelines for treatment published by academic societies. To clarify the current status of IE in Japan, we conducted a nationwide survey of IE (CArdiac Disease REgistration-Infective Endocarditis [CADRE-IE]). Methods and Results:We collected data on every aspect of IE using web-based survey. Only a Japanese Circulation Society-certified cardiologists who had managed a case of IE could register the patient when the outcome was known. There were 513 cases (320 men, 193 women) from 114 institutions. The median age was 61 years and more than 80% of the patients had underlying cardiac diseases. The majority was valvular heart disease, in which mitral regurgitation was a leading cause. Most of the patients had some predisposing factors, among which, decayed teeth or periodontitis was a leading factor. Streptococci were found in approximately 52% and staphylococci were found in 32% in positive-culture cases. Methicillin-resistant Staphylococcus aureus was found in 7.5%. Congestive heart failure was found in 43% and intracranial complications were found in 31%. Most of the patients were discharged (65%) but in-hospital death occurred in 11%.Conclusions: IE is still a lethal disease affecting older patients. The information obtained from the survey should be very helpful for physicians. (Circ J 2013; 77: 1558 -1564

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Section: Clinical Characteristicsmentioning

confidence: 99%

Recent Picture of Infective Endocarditis in Japan

Nakatani

Mitsutake

Ohara

et al. 2013

Circ J

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“…In a US survey conducted between 2004 and 2011, the incidence of PPCM was 1 in 968 births [1], more than the Japanese rate of 1 in 20,000 births [2]. The definition of PPCM includes the following criteria [3]: 1) onset of new congestive heart failure between 1 month before and up to 5 months after; 2) history of cardiac condition, 3) no other causes of heart failure; and 4) LVEF < 45-50%, LV fractional shortening of < 30%, and LV end-diastolic dimension/body mass index of > 27 mm/m 2 .…”

Section: Discussionmentioning

confidence: 97%

A Case of Peripartum Cardiomyopathy Affected by Left Ventricle Thrombus

Takeuchi¹,

Emori²,

Soneda³

et al. 2016

J Med Cases

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Peripartum cardiomyopathy (PPCM) mimicking dilated cardiomyopathy is defined as an idiopathic cardiomyopathy affecting perinatal or postnatal women with no cardiac history. It occurs in 1 in 20,000 births in Japan. A 25-year-old female without cardiology diseases presented to our hospital's emergency department with upper abdominal pain, exertional dyspnea, and leg edema. One month prior, she gave birth to her first child via vaginal delivery. At 36 weeks of gestation, she was diagnosed with pregnancy hypertension by an obstetrician. Ultrasonography and non-contrast computed tomography were performed and revealed an edematous gallbladder as well as dilated hepatic and inferior jugular veins. Chest X-ray revealed cardiomegaly, lung edema, and pleural effusion. She was diagnosed with congestive heart failure. Transthoracic echocardiogram (TTE) revealed a dilated left ventricle with a reduced ejection fraction (EF) of 17%. Immediately after admission, diuretic agents, including furosemide and carperitide, were administered. Although her heart failure improved with sufficient diuretic treatment, thromboses measuring 16 × 8 and 29 × 11 mm in her left ventricle were revealed by TTE on day 10. Heparin sodium and warfarin potassium were initiated, which reduced the thromboses. Her symptoms improved, although EF was not restored to normal function. She was discharged on day 40 and an outpatient clinic follow-up was scheduled. Long-term prognosis of PPCM is currently unknown, and meticulous follow-up of the patient is required. Here we present a case of PPCM that was affected by a left ventricular thrombus.

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“…16,17) Several reasons, including ethnicity and lifestyle, might underlie this discrepancy, and there is also a possibility that some patients are undiagnosed. 17) Demakis proposed the following diagnostic criteria for PPCM: 1) Development of heart failure in the final 5 postpartum months; and 2) Absence of a determinable etiology for cardiac failure, and presence of diagnostic echocardiographic criteria including left ventricular fractional shortening < 30%, left ventricular ejection fraction < 45%, and end-diastolic dimension > 27 cm/m 2 . 18,19) The vast majority of PPCM patients are diagnosed during the first month of postpartum.…”

Section: Discussionmentioning

confidence: 99%

Detection of Peripartum Myocardial Burden by Vector-Projected 187 Channel Electrocardiography and Serum NT-proBNP

et al. 2013

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SummaryThere is no reliable method of screening for pregnant women at high risk of developing severe myocardial disorders. In this study, we used vector-projected 187 channel electrocardiography (DREAM-ECG) and serum biochemical markers to evaluate peripartum myocardial burden in pregnant women. Forty-one pregnant women were examined at 36-37 weeks gestation (GW36), 7 days postpartum (PPD7), and 1 month postpartum (PPM1). Ten non-pregnant control women were assessed at a single time point. Heart rate, sympathetic index, and repolarization index (RTc dispersion) were quantified using the DREAM-ECG system, and serum levels of NT-proBNP, cardiac troponin T, estrogen, and progesterone were determined. Heart rate and the sympathetic index decreased from GW36 to PPM1 (P = 0.0031). The repolarization index decreased over time and was greater than in non-pregnant controls (31 ± 13 ms). Estrogen and progesterone at PPD7 and PPM1 were significantly lower than those at GW36 (P < 0.0001, P < 0.001). NT-proBNP at PPD7 was greater than at GW36 (median 29 pg/mL at GW36, 86 pg/mL at PPD7), and decreased at PPM1 in comparison to PPD7 (median 18.5 pg/mL). Troponin T was in the normal range during the whole period (< 0.003 ng/mL). In conclusion, these results indicate that the peripartum myocardial burden in pregnant women does not return to normal nonpregnant levels by PPM1. We propose that both repolarization indexes such as RTc dispersion by DREAM-ECG and serum biochemical markers may identify pregnant women at high risk of developing severe myocardial damage in the peripartum period. (Int Heart J 2013; 54: 140-145)

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Different Characteristics of Peripartum Cardiomyopathy Between Patients Complicated With and Without Hypertensive Disorders - Results From the Japanese Nationwide Survey of Peripartum Cardiomyopathy -

Cited by 174 publications

References 29 publications

Recent Picture of Infective Endocarditis in Japan

Recent Picture of Infective Endocarditis in Japan

A Case of Peripartum Cardiomyopathy Affected by Left Ventricle Thrombus

Detection of Peripartum Myocardial Burden by Vector-Projected 187 Channel Electrocardiography and Serum NT-proBNP

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