Peripartum Cardiomyopathy: Current Understanding of Pathophysiology, Diagnostic Workup, Management, and Outcomes

Koziol, Klaudia J.; Aronow, Wilbert S.

doi:10.1016/j.cpcardiol.2023.101716

Cited by 7 publications

(6 citation statements)

References 58 publications

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“…It is believed that about 15-20% of PPCM cases may involve a genetic predisposition, with mutations in genes like TTN , FLNC , DSP , and BAG3 , which interacts with environmental factors such as low serum selenium levels. This electrolyte is crucial for antioxidant enzyme function, and its deficiency can promote oxidative stress and myocardial injury, potentially exacerbating other contributing factors like viral infections such as myocarditis [ 5 , 6 ]. Other research suggests that one prominent pathophysiologic theory implicates prolactin, which can undergo enzymatic changes, leading to vasoconstriction, inflammation, and impaired heart muscle function.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, higher gravidity, parity, and multigestational pregnancies increase the likelihood of PPCM. Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, are strongly linked too, consequently, managing hypertensive disorders during pregnancy is crucial in reducing the risk of PPCM [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Management strategies for PPCM are currently based on general heart failure protocols [ 5 ], with bromocriptine emerging as a specific treatment by inhibiting PRL secretion from the pituitary gland [ 1 , 4 ]. However, the response to treatment varies among patients, highlighting the need for further research into alternative pathophysiological pathways and novel therapeutic targets [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition

Perea Rojas,

Seni Hernandez,

Rojas Torres

et al. 2024

J Med Cases

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Peripartum cardiomyopathy (PPCM) poses a significant challenge in maternal health, characterized by heart failure with reduced ejection fraction during late pregnancy or early postpartum. Despite advances in understanding PPCM, it remains life-threatening with substantial maternal morbidity and mortality. This article reviews the epidemiology, etiology, diagnostic challenges, management strategies, and outcomes associated with PPCM. A case report of a 29-year-old woman with PPCM is presented, emphasizing the importance of early recognition and tailored management. The patient’s presentation was marked by atypical symptoms, including dysuria, lumbar pain, persistent fever, and oral intake intolerance. Despite aggressive medical intervention, the patient experienced a tragic outcome, succumbing to cardiopulmonary arrest within 48 h of admission. This case underscores the challenges in diagnosing and managing PPCM, particularly when presenting with nonspecific symptoms and emphasizes the urgent need for improved diagnostic criteria and therapeutic interventions to mitigate adverse outcomes in affected individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition

Perea Rojas,

Seni Hernandez,

Rojas Torres

et al. 2024

J Med Cases

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“… 21 Additional genes include the beta-myosin heavy chain (MYH7), a sodium voltage-gated channel alpha subunit 5 (SCN5A), and myosin binding protein C (MYBPC3). 48 Truncating variants of the TTN gene have been shown to carry a worse prognosis in PPCM. Given our understanding, genetic testing may be a useful screening tool in patients with a family history of PPCM.…”

Section: Risk Factorsmentioning

confidence: 99%

Peripartum Cardiomyopathy: Risks Diagnosis and Management

Carlson¹,

Schultz²,

Ramu³

et al. 2023

JMDH

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Peripartum cardiomyopathy is a rare cause of heart failure that occurs during late pregnancy or in the early postpartum period. Delays in diagnosis may occur as symptoms of heart failure mimic those of normal pregnancy. The diagnosis should be considered in any pregnant or postpartum woman with symptoms concerning for heart failure. If there are clinical concerns, labs including N-terminal pro-BNP should be checked, and an echocardiogram should be ordered to assess for systolic dysfunction. Prompt medical treatment tailored for pregnancy and lactation is essential to prevent adverse events. Outcomes are variable, including complete recovery, persistent myocardial dysfunction with heart failure symptoms, arrhythmias, thromboembolic events, and/or rapid deterioration requiring mechanical circulatory support and cardiac transplantation. It is essential that care is provided as part of a multidisciplinary cardio-obstetrics team including obstetrics, cardiology, maternal fetal medicine, anesthesiology, and nursing. All women with peripartum cardiomyopathy should have close follow-up with a cardiologist, although optimal duration of medical therapy following complete recovery is unknown. Women considering a subsequent pregnancy require preconception counseling and close collaboration between obstetrics and cardiology throughout pregnancy.

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“…Однако к аналогичным нарушениям миокарда могут приводить воздействия как внешних, так и внутренних средовых факторов (например, лекарственно-индуцированная, диабетическая, перипартальная, стресс-индуцированная, воспалительная (миокардит) КМП и др.). И у пациентов с данными состояниями также выявляют патогенные варианты в генах, которые рассматриваются в качестве причинных для КМП [9][10][11]. В некоторых случаях наблюдается сочетание нескольких типов КМП или переход от одной к другой форме по мере прогрессирования болезни [12][13][14], а также КМП могут выступать в качестве симптома других сложных патологических фенотипов [11,15].…”

Section: Introductionunclassified

Monogenic diseases associated with cardiomyopathy genes and their phenotypic manifestations

Kucher,

Nazarenko

2024

Bûll. sib. med.

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The aim of the present study was to summarize the data on the spectrum of genetic diseases and their phenotypic manifestations in case of structural and functional defects in 75 genes, pathogenic variants of which are associated with the formation of different types of cardiomyopathy (CMP). The search for scientific publications was carried out in foreign (PubMed) and Russian (eLibrary) digital libraries. The data analysis was performed using the Simple ClinVar, An Online Catalog of Human Genes and Genetic Disorders, and STRING databases.It was shown that the vast majority of CMP genes are pleiotropic. Monogenic diseases caused by mutations in CMP genes are characterized by a wide range of pathological manifestations in various organs and systems (cardiovascular, nervous, endocrine, musculoskeletal systems, connective tissue, skin and appendages, organs of vision and hearing, kidneys) as well as by metabolic and immune disorders. Therefore, if a patient (regardless of the primary diagnosis) has pathogenic / likely pathogenic variants or variants of uncertain significance in the CMP genes, we recommend a detailed and comprehensive clinical examination. This is important for clarifying the effects of rare genetic variants, identifying significant clinical and prognostic features for CMP and monogenic diseases associated with CMP genes, and identifying risk groups and controllable triggers that contribute to the manifestation of pathogenic genetic variants.

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Peripartum Cardiomyopathy: Current Understanding of Pathophysiology, Diagnostic Workup, Management, and Outcomes

Cited by 7 publications

References 58 publications

Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition

Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition

Peripartum Cardiomyopathy: Risks Diagnosis and Management

Monogenic diseases associated with cardiomyopathy genes and their phenotypic manifestations

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