Global Left Ventricular Strain at Presentation Is Associated with Subsequent Recovery in Patients with Peripartum Cardiomyopathy.

Background: Peripartum cardiomyopathy (PPCM) is a serious complication of pregnancy associated with variable degrees of left ventricular (LV) recovery. The aim of this study was to test the hypothesis that global LV strain at presentation has prognostic value in patients with PPCM.

Methods: One hundred patients with PPCM aged 30 ± 6 years were enrolled in the multicenter Investigation in Pregnancy Associated Cardiomyopathy study along with 21 normal female control subjects.

Myocardial Damage Detected by Late Gadolinium Enhancement Cardiac Magnetic Resonance Is Uncommon in Peripartum Cardiomyopathy.

Background: In peripartum cardiomyopathy, the prevalence of focal myocardial damage detected by late gadolinium enhancement (LGE) cardiovascular magnetic resonance is important to elucidate mechanisms of myocardial injury and cardiac dysfunction. LGE equates irreversible myocardial injury, but LGE prevalence in peripartum cardiomyopathy is uncertain.

Methods And Results: Among 100 women enrolled within the Investigations of Pregnancy Associated Cardiomyopathy cohort, we recruited 40 women at 13 centers to undergo LGE cardiovascular magnetic resonance, enrolled within the first 13 weeks postpartum.

Peripartum cardiomyopathy: challenges in diagnosis and management.

Introduction: Peripartum cardiomyopathy (PPCM) is one of the leading causes of maternal mortality all over the world. Fortunately, some of the most important answers to the "PPCM puzzle" are emerging:

Areas Covered: This is an update that includes current and recent research results. These developments hold promise to importantly decrease mortality from PPCM and increase recovery rates.

Relaxin-2 and Soluble Flt1 Levels in Peripartum Cardiomyopathy: Results of the Multicenter IPAC Study.

Objectives: This study explored the association of vascular hormones with myocardial recovery and clinical outcomes in peripartum cardiomyopathy (PPCM).

Background: PPCM is an uncommon disorder with unknown etiology. Angiogenic imbalance may contribute to its pathophysiology.

GNB3 C825T Polymorphism and Myocardial Recovery in Peripartum Cardiomyopathy: Results of the Multicenter Investigations of Pregnancy-Associated Cardiomyopathy Study.

Background: Black women are at greater risk for peripartum cardiomyopathy (PPCM). The guanine nucleotide-binding proteins β-3 subunit (GNB3) has a polymorphism C825T. The GNB3 TT genotype more prevalent in blacks is associated with poorer outcomes.

Clinical Outcomes for Peripartum Cardiomyopathy in North America: Results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy).

Background: Peripartum cardiomyopathy (PPCM) remains a major cause of maternal morbidity and mortality.

Objectives: This study sought to prospectively evaluate recovery of the left ventricular ejection fraction (LVEF) and clinical outcomes in the multicenter IPAC (Investigations of Pregnancy Associated Cardiomyopathy) study.

Methods: We enrolled and followed 100 women with PPCM through 1 year post-partum.

Discoveries in peripartum cardiomyopathy.

The past decade has seen remarkable gains for outcomes in peripartum cardiomyopathy (PPCM), one of the leading causes of maternal mortality and morbidity in the USA and many other countries, including the high-incidence areas of Haiti and South Africa. This review article emphasizes the importance of continuing the process of increasing awareness of PPCM and presents details of this evolving picture, including important discoveries that point the way to full recovery for almost all PPCM subjects. In addition, new interventions will be highlighted, which may facilitate recovery.

Why do some recovered peripartum cardiomyopathy mothers experience heart failure with a subsequent pregnancy?

After concerns about survival and recovery from peripartum cardiomyopathy (PPCM), the question commonly asked is, "Is it safe to have another pregnancy?" While important advances have been made in the past decade in the recognition and treatment of PPCM, we still do not know why some apparently recovered PPCM mothers have a relapse of heart failure in a subsequent pregnancy. Knowing that some risk for relapse is always present, careful monitoring of the post-PPCM pregnancy is currently the best way to enable earlier diagnosis with institution of effective evidence-based treatment. In that situation it is reassuring to observe that when a subsequent pregnancy begins with recovered left ventricular systolic function to echocardiographic ejection fraction ≥0.

Peripartum cardiomyopathy: A puzzle closer to solution.

Peripartum cardiomyopathy (PPCM) represents new heart failure in a previously heart-healthy peripartum patient. It is necessary to rule out all other known causes of heart failure before accepting a diagnosis of PPCM. The modern era for PPCM in the United States and beyond began with the report of the National Institutes of Health PPCM Workshop in 2000, clarifying all then-currently known aspects of the disease.

Earlier detection can help avoid many serious complications of peripartum cardiomyopathy.

Peripartum cardiomyopathy (PPCM) has a remarkable potential for recovery. It may be within our capability to help almost all women with PPCM not only to survive, but also to completely recover heart function. Time-of-diagnosis left ventricular ejection fraction (LVEF) ≥0.