Long-term Outcomes of Cardiac Transplantation for Peri-partum Cardiomyopathy: A Multiinstitutional Analysis

Rasmusson, Kismet; Stehlik, Josef; Brown, Robert N.; Renlund, Dale G.; Wagoner, Lynne E.; Torre‐Amione, Guillermo; Folsom, Jan W.; Silber, David; Kirklin, James K.

doi:10.1016/j.healun.2007.08.002

Cited by 48 publications

(25 citation statements)

References 10 publications

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“…1,191 Mechanical circulatory support (MCS), either as temporary or bridge to transplantation, and heart transplantation have been used successfully in patients with PPCM for whom medical therapy has failed and who require continuous inotropic therapy. 1,158,[209][210][211] Given the hypercoagulable state known to exist during pregnancy, anticoagulation can be considered in patients with PPCM with severe LV dysfunction (LVEF <30%) to prevent thrombus formation, 158,174,193,212 but warfarin should not be used during pregnancy.…”

Section: Treatmentmentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Treatmentmentioning

confidence: 99%

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

View full text Add to dashboard Cite

show abstract

“…689 Cardiopulmonary exercise testing helps refine candidate selection. [690][691][692][693][694][695][696] Data suggest acceptable posttransplant outcomes in patients with reversible pulmonary hypertension, 697 hypertrophic cardiomyopathy, 698 peripartum cardiomyopathy, 699 restrictive cardiomyopathy, 700,701 and muscular dystrophy. 702 Selected patients with stage D HF and poor prognosis should be referred to a cardiac transplantation center for evaluation and transplant consideration.…”

Section: Classmentioning

confidence: 99%

2013 ACCF/AHA Guideline for the Management of Heart Failure

et al. 2013

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“…Other authors supported the hypothesis of an overactive immunological response in "myocarditis-like" PPCM, which predisposes to recurrent severe rejection, and subsequent development of fatal transplantassociated complications. A recent prospective study demonstrated that survival and freedom from cardiac allograft vasculopathy in PPCM was similar to that of women with other indications for heart transplantation (Rasmusson et al, 2007). At the present time, based on available data, 0-11% PPCM patients undergo heart transplantation, with a similar outcome compared with other etiologies of heart failure (Sliwa et al, 2010a).…”

Section: Management Of Acute Heart Failurementioning

confidence: 65%