Peripartum cardiomyopathy: a systematic literature review

Ersbøll, Anne S.; Damm, Peter; Gustafsson, Finn; Vejlstrup, Niels; Johansen, Marianne

doi:10.1111/aogs.13005

Cited by 23 publications

(18 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PPCM is a rare disease, which occurred with a frequency of 1 case/3189 live births and an estimated mortality of 1.36–2.05% (confidence interval 0.29–10.8%) from 1990 to 2002 in the United States ( 35 ). Age, race, multiple gestations, and geographical region are associated factors recently reviewed and not discussed here ( 36 – 39 ). As mentioned in the above definition of PPCM, the disease is idiopathic, meaning that no specific causal pathological mechanism could be identified.…”

Section: Discussionmentioning

confidence: 99%

Human Prolactin Point Mutations and Their Projected Effect on Vasoinhibin Generation and Vasoinhibin-Related Diseases

et al. 2017

View full text Add to dashboard Cite

BackgroundA dysregulation of the generation of vasoinhibin hormones by proteolytic cleavage of prolactin (PRL) has been brought into context with diabetic retinopathy, retinopathy of prematurity, preeclampsia, pregnancy-induced hypertension, and peripartum cardiomyopathy. Factors governing vasoinhibin generation are incompletely characterized, and the composition of vasoinhibin isoforms in human tissues or compartments, such as the circulation, is unknown. The aim of this study was to determine the possible contribution of PRL point mutations to the generation of vasoinhibins as well as to project their role in vasoinhibin-related diseases.MethodsProlactin sequences, point mutations, and substrate specificity information about the PRL cleaving enzymes cathepsin D, matrix metalloproteinases 8 and 13, and bone-morphogenetic protein 1 were retrieved from public databases. The consequences of point mutations in regard to their possible effect on vasoinhibin levels were projected on the basis of a score indicating the suitability of a particular sequence for enzymatic cleavage that result in vasoinhibin generation. The relative abundance and type of vasoinhibin isoforms were estimated by comparing the relative cleavage efficiency of vasoinhibin-generating enzymes.ResultsSix point mutations leading to amino acid substitutions in vasoinhibin-generating cleavage sites were found and projected to either facilitate or inhibit vasoinhibin generation. Four mutations affecting vasoinhibin generation in cancer tissues were found. The most likely composition of the relative abundance of vasoinhibin isoforms is projected to be 15 > 17.2 > 16.8 > 17.7 > 18 kDa vasoinhibin.ConclusionProlactin point mutations are likely to influence vasoinhibin levels by affecting the proteolysis efficiency of vasoinhibin-generating enzymes and should be monitored in patients with vasoinhibin-related diseases. Attempts to characterize vasoinhibin-related diseases should include the 15, 17.2, 16.8, 17.7, and 18 kDa vasoinhibin isoforms.

show abstract

Section: Discussionmentioning

confidence: 99%

Human Prolactin Point Mutations and Their Projected Effect on Vasoinhibin Generation and Vasoinhibin-Related Diseases

et al. 2017

View full text Add to dashboard Cite

show abstract

“…[ 24 ] Since PPCM is a diagnosis of exclusion an accurate medical history, appropriate diagnostic tools are important to identify alternative etiologies of heart failure. [ 25 ]…”

Section: Discussionmentioning

confidence: 99%

Peripartum women with dyspnea in the emergency department

Wang

2018

Medicine

View full text Add to dashboard Cite

Peripartum cardiomyopathy (PPCM) is life-threatening and its diagnosis is a challenge. We highlight the clinical characteristics and bio-markers of PPCM and the proper differential diagnosis of peripartum dyspnea to aim to make an early diagnosis available.We analyzed 262 peripartum patients with dyspnea, and summed up the final diagnosis. The clinical data of the control group and the PPCM group as well as before and after the treatment of the PPCM group were compared.In total, 147 (56%) of the perinatal patients were physiologic dyspnea of pregnancy; only 11 (4%) patients met the PPCM diagnostic criteria. Compared with the basic baseline characteristics between the PPCM group and control group, patients with PPCM had a higher heart rate, and the white blood cell, high-sensitivity C-reactive protein (hs-CRP), and B-type natriuretic peptide (BNP) levels were markedly elevated, whereas PaO2 and left ventricular ejection fraction (LVEF) were lower. The heart rate, CRP and BNP levels were lower at the follow-up compared with the pretreatment. Patients who were followed up showed significant improvements in the LVEF and New York Heart Association function class.We standardized the symptoms of dyspnea for calculating, and analyzed the diagnostic efficacy of laboratory indicators. The research highlighted that the use of echocardiography and disease-specific bio-markers may aid in the diagnosis and management.

show abstract

“…Viral infections, selenium deficiency, autoimmunity, and genetic predisposition are some of the factors predisposing to PPCM. 8 Advanced maternal age, multiple gestation, chronic hypertension, and assisted reproductive techniques may contribute to the increased incidence. Recently the role of Fms-like tyrosine kinase 1 (sFlt-1) and the hormone prolactin in PPCM is being evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…Recently the role of Fms-like tyrosine kinase 1 (sFlt-1) and the hormone prolactin in PPCM is being evaluated. 8 Awareness of the condition, early echocardiography, availability of obstetric anesthesia, and critical care services improved the outcome in this rare condition.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management and Perioperative Events of Peripartum Cardiomyopathy during Cesarean Delivery a Series of Five Cases

2018

View full text Add to dashboard Cite

Peripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy having an incidence of less than 0.1%. PPCM is associated with high morbidity and mortality rates ranging from 5 to 32%. In this review, the authors report a series of five PPCM cases. The case reports included pregnant women with PPCM, admitted in the hospital from October 1, 2017 to June 1, 2018 over a period of 9 months who required cesarean section. The authors aim to discuss the presentation, optimization, anesthetic management, and postoperative care of this rare condition. One of the cases was a booked case. The remaining four pregnant patients were referred in late pregnancy with features of congestive cardiac failure. One patient was in acute pulmonary edema, required intubation, and subsequently had cesarean section under general anesthesia. Four patients were managed with incremental epidural anesthesia. The need for proper preoperative optimization and intra- and postoperative management was discussed. The authors had one maternal mortality in our series. There was no neonatal mortality. Early diagnosis of PPCM, prompt treatment of heart failure, planning the delivery, and postpartum care can decrease maternal morbidity and mortality. Incremental epidural dosing can be used for cesarean section and has the advantage of stable hemodynamic status without the risks associated with general anesthesia.

show abstract

Peripartum cardiomyopathy: a systematic literature review

Abstract: PPCM has a huge impact on cardiovascular health and reproductive life perspective. New insights into genetics, molecular pathophysiological mechanisms and clinical studies have resulted in potential disease-specific therapies, but many questions remain unanswered.

Cited by 23 publications

References 84 publications

Human Prolactin Point Mutations and Their Projected Effect on Vasoinhibin Generation and Vasoinhibin-Related Diseases

Human Prolactin Point Mutations and Their Projected Effect on Vasoinhibin Generation and Vasoinhibin-Related Diseases

Peripartum women with dyspnea in the emergency department

Anesthetic Management and Perioperative Events of Peripartum Cardiomyopathy during Cesarean Delivery a Series of Five Cases

Contact Info

Product

Resources

About