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J Hoevelmann, C A Viljoen, K Manning, J Baard, L Hahnle, M Ntsekhe, J Bauersachs, K Sliwa
BACKGROUND: Peripartum cardiomyopathy (PPCM) is an important cause of pregnancy-associated heart failure, which appears in previously healthy women towards the end of pregnancy or within five months following delivery. Although the ECG is widely used in clinical practice, its prognostic value has not been established in PPCM. METHODS: We analysed 12-lead ECGs of patients with PPCM, taken at index presentation and follow-up visits at 6 and 12 months. Poor outcome was determined by the composite endpoint of death, readmission, NYHA functional class III/IV or left ventricular ejection fraction (LVEF) of ≤35% at follow-up...
November 7, 2018: International Journal of Cardiology
Rebecca Simon, Sophia Yang, Afshan B Hameed
Objective  This study is to review published cases of peripartum cardiomyopathy (PPCM) treated with bromocriptine and outline pros and cons of the treatment strategy. Data Sources  Data were collected from PubMed/MedLine,; the years 2007 to 2018 were searched for English-language articles. Search terms: "bromocriptine and peripartum cardiomyopathy", "bromocriptine and cardiomyopathy." Methods of Study Selection  This search strategy yielded 171 articles. After excluding duplicates, 86 studies were reviewed...
October 2018: American Journal of Perinatology Reports
Kathryn J Lindley, Amanda K Verma, Lori A Blauwet
Occurring in approximately 1 in 1000 live births in the United States, peripartum cardiomyopathy (PPCM) is characterized by left ventricular ejection fraction reduced to less than 45% near the end of pregnancy or within the first 5 months after delivery. Although the cause of PPCM remains unclear, increasing evidence supports a complex interaction of genetic and environmental factors contributing to angiogenic imbalance, which may lead to myocardial dysfunction in a susceptible woman. This article reviews the progress that has been made regarding understanding of the cause, management, and natural history of PPCM...
January 2019: Heart Failure Clinics
Jasmine Peterson, April Hinds, Aida Garza, Jamie Barner, Lucas Hill, Michelle Nguyen, Phillip Lai, Tyler Gums
PURPOSE: A popular method for enhancing medication management within a patient-centered medical home (PCMH) is the physician-pharmacist collaborative management (PPCM) model. To improve efficiency of health-care delivery within 4 federally qualified health centers (FQHCs), the PPCM model was implemented through coordinated physician-pharmacist covisits. OBJECTIVE: To evaluate the impact of physician-pharmacist covisits on clinical outcomes among patients with uncontrolled diabetes...
November 14, 2018: Journal of Pharmacy Practice
Anne S Ersbøll, Annemie S Bojer, Maria G Hauge, Marianne Johansen, Peter Damm, Finn Gustafsson, Niels G Vejlstrup
Background Long-term clinical studies of peripartum cardiomyopathy ( PPCM ) are few. We aimed to measure the long-term effect of PPCM on cardiac function in comparison with the long-term effects of severe preeclampsia and uncomplicated pregnancy. Methods and Results A nationwide Danish cohort of women diagnosed with PPCM from 2005 to 2014 ( PPCM group) were invited to participate in a clinical follow-up study including maximal cardiopulmonary exercise testing and cardiac magnetic resonance imaging. Matched women with previous severe preeclampsia (preeclampsia group) and previous uncomplicated pregnancies (uncomplicated pregnancies group) served as comparison groups...
October 16, 2018: Journal of the American Heart Association
Giuseppe Limongelli, Marta Rubino, Augusto Esposito, Mariagiovanna Russo, Giuseppe Pacileo
PURPOSE OF REVIEW: To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. RECENT FINDINGS: Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus...
December 2018: Current Opinion in Obstetrics & Gynecology
Takeshi Mikami, Hitoshi Kamiunten
Peripartum cardiomyopathy (PPCM) is an idiopathic left ventricular dysfunction in women who are in late pregnancy or the postpartum period. PPCM is a rare but sometimes fatal disease, and mechanical circulatory support is required if heart failure is refractory to conventional therapy. A 28-year-old woman in late pregnancy was admitted to our hospital due to congestive heart failure with cardiogenic shock. Her heart rate was 200 beats per minute (sinus tachycardia), and left ventricular ejection fraction (LVEF) was 10%...
June 2018: Journal of Cardiology Cases
Lindsey Rosman, Elena Salmoirago-Blotcher, John Cahill, Samuel F Sears
BACKGROUND: Psychological distress can adversely affect heart failure prognosis, yet the immediate and ongoing challenges faced by women diagnosed with peripartum cardiomyopathy (PPCM) are not well studied. OBJECTIVE: We examined psychological distress and quality of life in a large, national sample of patients with PPCM and evaluated whether these characteristics differ among newly diagnosed (0-1 year), short-term (2-4 years), and long-term (5-10 years) survivors...
September 28, 2018: Journal of Cardiovascular Nursing
Abigail Khan, Emmanuelle Paré, Shimoli Shah
PURPOSE OF REVIEW: This review summarizes the pathophysiology, diagnosis, and treatment of peripartum cardiomyopathy (PPCM), with a focus on recent discoveries of clinical relevance. RECENT FINDINGS: An increase in oxidative stress and anti-angiogenic activity play key roles in the pathophysiology of peripartum cardiomyopathy. Therapies that target this dysregulation may have a future role in treatment. Suppression of prolactin release using bromocriptine, a dopamine-receptor antagonist, has been associated with more favorable outcomes in small studies but more research is needed...
September 29, 2018: Current Treatment Options in Cardiovascular Medicine
Elias J Dayoub, Hema Datwani, Jennifer Lewey, Peter W Groeneveld
BACKGROUND: Peripartum cardiomyopathy (PPCM) is an important cause of obstetrical morbidity. Few large national studies have investigated the cardiovascular outcomes of women with PPCM, particularly beyond the immediate postpartum period. We examined the cardiovascular outcomes of 1-year survivors of PPCM in a large commercially insured population. METHODS AND RESULTS: A retrospective cohort study was conducted with the use of administrative claims from patients aged 15-54 years insured by a national commercial payer during 2005-2012...
October 2018: Journal of Cardiac Failure
Esa M Davis, Gregory Ewald, Michael M Givertz, Navin Rajagopalan, Leslie T Cooper, Joan Briller, G Michael Felker, Biykem Bozkurt, Mark H Drazner, Karen Hanley-Yanez, Indrani Halder, Charles F McTiernan, Dennis M McNamara
OBJECTIVE:  To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). STUDY DESIGN:  This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity...
September 5, 2018: American Journal of Perinatology
Reza Masoomi, Zubair Shah, Zoltan Arany, Kamal Gupta
OBJECTIVE: Peripartum cardiomyopathy (PPCM) can present during pregnancy and up to months post-delivery. Most large-scale epidemiologic studies have reported on cases occurring during pregnancy or the first few days postpartum (termPPCM). Limited information is available on PPCM in the later postpartum period (latePPCM). We studied the incidence, predictors, and hospital outcome of peripartum cardiomyopathy (PPCM) in the prepartum and immediate post delivery period versus up to 3 months post-delivery...
July 2018: Pregnancy Hypertension
Julie A Damp, Zolt Arany, James D Fett, Lori Blauwet, Uri Elkayam
No abstract text is available yet for this article.
September 25, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Arash Haghikia, Johannes Schwab, Jens Vogel-Claussen, Dominik Berliner, Tobias Pfeffer, Tobias König, Carolin Zwadlo, Valeska Abou Moulig, Annegret Franke, Marziel Schwarzkopf, Philipp Ehlermann, Roman Pfister, Guido Michels, Ralf Westenfeld, Verena Stangl, Uwe Kühl, Edith Podewski, Ingrid Kindermann, Michael Böhm, Karen Sliwa, Denise Hilfiker-Kleiner, Johann Bauersachs
BACKGROUND: Right ventricular (RV) dysfunction predicts adverse outcome in peripartum cardiomyopathy (PPCM). We recently demonstrated beneficial effects associated with the prolactin release inhibitor bromocriptine at different doses when added to standard heart failure therapy in PPCM. Here, we evaluated for the first time the therapeutic potential of bromocriptine particularly in PPCM patients with RV involvement. METHODS: In this study, 40 patients with PPCM were included, of whom 24 patients had reduced RV ejection fraction (RVEF < 45%)...
August 18, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Kathleen Stergiopoulos, Fabio V Lima
Peripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period. While the disease is relatively uncommon, its incidence is rising. It is a form of idiopathic dilated cardiomyopathy, defined as pregnancy-related left ventricular dysfunction, diagnosed either towards the end of pregnancy or in the months following delivery, in women without any other identifiable cause. The clinical presentation, diagnostic assessment and treatment usually mirror that of other forms of cardiomyopathy...
August 1, 2018: Trends in Cardiovascular Medicine
Harshida Patel, Marie Berg, Cecily Begley, Maria Schaufelberger
BACKGROUND: Peripartum cardiomyopathy (PPCM), a potentially life-threatening condition in women, can have a profound impact on the family. Although structured support systems are developed, these systems tend to be based on the healthcare providers' perceptions and focus mainly on mothers' care. Fathers' vital role in supporting their partners has been advocated in previous research. However, the impact of PPCM on the male partners of women is less understood. The aim of this study was to explore the experiences of healthcare in fathers whose partner was suffering from peripartum cardiomyopathy...
August 13, 2018: BMC Pregnancy and Childbirth
Wei-Wei Wang, Yu Wang
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...
August 2018: Medicine (Baltimore)
Feriel Azibani, Karen Sliwa
PURPOSE OF REVIEW: Peripartum cardiomyopathy (PPCM) is an idiopathic disorder defined as heart failure occurring in women during the last month of pregnancy and up to 5 months postpartum. In this review, we outline recent reports about the disease pathogenesis and management and highlight the use of diagnosis and prognosis biomarkers. RECENT FINDINGS: Novel data strengthen the implication of endothelial function in PPCM pathogenesis. The first international registry showed that patient presentations were similar globally, with heterogeneity in patient management and outcome...
October 2018: Current Heart Failure Reports
Karolina E Kryczka, Zofia Dzielińska, Maria Franaszczyk, Izabela Wojtkowska, Jan Henzel, Mateusz Śpiewak, Janina Stępińska, Zofia T Bilińska, Rafał Płoski, Marcin Demkow
BACKGROUND Peripartum cardiomyopathy (PPCM) is a potentially life-threatening, pregnancy-associated cause of heart failure affecting previously healthy women. Recent research suggests a possible role of 16-kDa prolactin in promoting cardiomyocyte damage. However, the genetic predisposition is not well recognized. CASE REPORT We report the case of a 25-year-old woman with a severe course of PPCM with left ventricle ejection fraction of 25-30%, complicated by ventricular arrhythmia and postpartum thyroiditis...
July 12, 2018: American Journal of Case Reports
Pavan Parikh, Lori Blauwet
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy (HDP) often result in cardiac dysfunction and have been variably included as a risk factor for peripartum cardiomyopathy (PPCM). However, there is debate regarding the relationship between the two entities. RECENT FINDINGS: Diastolic dysfunction appears to be more predominant among gravidas with HDP, while systolic dysfunction predominates in PPCM. However, this finding is not consistent in all studies. Recent examinations of mortality and morbidity associated with PPCM in the setting of HDP do not demonstrate a predominant pattern with a mixture of results...
July 3, 2018: Current Hypertension Reports
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