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cardiomyopathy post pregnancy

Guan-Sheng Liu, George Gardner, George Adly, Min Jiang, Wen-Feng Cai, Chi Keung Lam, Fawzi Alogaili, Nathan Robbins, Jack Rubinstein, Evangelia G Kranias
Heat shock protein 20 (Hsp20) has been shown to be a critical regulator of cardiomyocyte survival upon cardiac stress. In this study, we investigated the functional significance of a novel human Hsp20 mutation (S10F) in peripartum cardiomyopathy. Previous findings showed that cardiac-specific overexpression of this mutant were associated with reduced autophagy, left ventricular dysfunction and early death in male mice. However, this study indicates that females have normal function with no alterations in autophagy but died within a week after 1-4 pregnancies...
May 15, 2018: Journal of Cellular and Molecular Medicine
E Gandjbakhch, E Varlet, G Duthoit, V Fressart, P Charron, C Himbert, C Maupain, C Bordet, F Hidden-Lucet, J Nizard
INTRODUCTION: The prognosis of pregnancy in patients with Arrhythmogenic Right Ventricular Cardiomyopathy/dysplasia (ARVC/D) is poorly documented. The aim of this study is to assess the cardiac risks during pregnancy and the impact of ARVC/D on fetuses/neonates/children. METHODS: We included all ARVC/D women with a history of pregnancy from the ARVC/D Pitié-Salpêtrière registry. Cardiac and obstetrical events having occurred during pregnancy/delivery/post-partum periods and neonatal data/follow-up were collected...
May 1, 2018: International Journal of Cardiology
Nadia Bouabdallaoui, Pierre Demondion, Sylvestre Maréchaux, Shaida Varnous, Guillaume Lebreton, Frédéric Mouquet, Pascal Leprince
BACKGROUND: Peripartum cardiomyopathy is an idiopathic disorder defined by the occurrence of acute heart failure during late pregnancy or post-partum period in the absence of any other definable cause. Its clinical course is variable and severe cases might require heart transplantation. OBJECTIVE: To investigate long-term outcomes after heart transplantation (HT) for peripartum cardiomyopathy (PPCM). METHODS: Out of a single-center series of 1938 HT, 14 HT were performed for PPCM...
February 2018: Arquivos Brasileiros de Cardiologia
I Naciri, M Meziane, L Benzekri, M Ghaouti, K Senouci, B Hassam
BACKGROUND: We report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM). PATIENTS AND METHODS: A 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy...
December 6, 2017: Annales de Dermatologie et de Vénéréologie
Victor Chien-Chia Wu, Tien-Hsing Chen, Jih-Kai Yeh, Michael Wu, Cheng-Hui Lu, Shao-Wei Chen, Katie Pei-Hsuan Wu, Chun-Wen Cheng, Chih-Hsiang Chang, Kuo-Chun Hung, Ming-Shyan Chern, Fen-Chiung Lin, Ming-Shien Wen
Peripartum cardiomyopathy (PPCM) is the development of heart failure during late pregnancy to months postpartum with potential fatal outcome. However, the disease is not well-studied in Asia.We aimed to investigate the epidemiology and clinical outcomes of PPCM in Taiwan.Electronic medical records were retrieved from Taiwan National Health Insurance Research Database from 1997 to 2011. Patients with PPCM were separated into 3 groups based on the timing of diagnosis. Early: PPCM diagnosed first to ninth month of pregnancy...
October 2017: Medicine (Baltimore)
Vincent Bonnet, Thérèse Simonet, Fabien Labombarda, Patricia Dolley, Paul Milliez, Michel Dreyfus, Jean-Luc Hanouz
Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0% (95% CI [28.3-41.7]) and 37.0% (95% CI [30.3-43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications...
February 2018: Anaesthesia, Critical Care & Pain Medicine
Sorel Goland, Jean Marc Weinstein, Adi Zalik, Rafael Kuperstein, Liaz Zilberman, Sara Shimoni, Michael Arad, Tuvia Ben Gal, Jacob George
BACKGROUND: Recent studies suggest that angiogenic imbalance during pregnancy may lead to acute peripartum cardiomyopathy (PPCM). We propose that angiogenic imbalance and residual cardiac dysfunction may exist even after recovery from PPCM. METHODS AND RESULTS: Twenty-nine women at least 12 months after presentation with PPCM, who exhibited recovery of left ventricular (LV) ejection fraction (≥50%), were included in the study (mean age 35±6 years, LV ejection fraction 61...
November 2016: Circulation. Heart Failure
Sara Ruiz, Miguel Martinez-Marin, Pilar Luque, Nadia Nassar, Daniel Oros
Takotsubo cardiomyopathy (TCM) is clinically identical to acute myocardial infarction. We report an unusual case of TCM and review similar cases in pregnant women. A young woman with no pre-existing cardiovascular risk factors suffered sudden dyspnea during a cesarean section. Electrocardiography (ECG) showed T-wave inversion. We observed acute lung edema and left ventricular systolic dysfunction on echocardiography. A cardiac catheterization diagnosed TCM. We reviewed 20 cases of TCM; 17 cases occurred during the post-partum period and three during pregnancy...
February 2017: Journal of Obstetrics and Gynaecology Research
Joyee Basu, Christopher Redman, Oliver Ormerod
Peripartum cardiomyopathy is a heart failure syndrome occurring late in pregnancy or during the early post-natal period. The pathophysiology of peripartum cardiomyopathy is not fully understood and various mechanisms have been postulated including an underlying inflammatory process. We here report four cases presenting with acute left ventricular systolic dysfunction. Three out of four of the patients presented with a left ventricular ejection fraction <30% and one with a left ventricular ejection fraction of 35%...
December 2016: Obstetric Medicine
H Jaïdane, A Halouani, H Jmii, F Elmastour, S Abdelkefi, G Bodart, H Michaux, T Chakroun, F Sane, M Mokni, V Geenen, D Hober, M Aouni
Type B coxsackievirus (CV-B) infections are involved frequently in the triggering of several autoimmune diseases such as myocarditis, dilated cardiomyopathy, pericarditis, pancreatitis, type 1 diabetes, encephalitis, thyroiditis or Sjögren's syndrome. Serological and virological evidence suggests that maternal infections during pregnancy can play a role in the appearance of these diseases in offspring. The current study aims to explore the effect of an in-utero CV-B infection on the fetal thymus, the central site for programming immunological self-tolerance...
March 2017: Clinical and Experimental Immunology
Elena Salmoirago-Blotcher, Shira Dunsiger, Heather H Swales, Gerard P Aurigemma, Ira Ockene, Lindsey Rosman, Ilan S Wittstein
Takotsubo cardiomyopathy (TC) occurs predominantly in postmenopausal women, suggesting a possible role of reproductive and hormonal factors in the pathophysiology of this condition. Yet reproductive characteristics of women with TC have received limited attention. This prospective case-control study sought to explore reproductive characteristics associated with TC. Incident TC cases and myocardial infarction (MI) controls were recruited among consecutive women presenting at the emergency departments of 2 large medical centers in Massachusetts and Connecticut...
December 15, 2016: American Journal of Cardiology
Rebecca L Dekker, Christine H Morton, Paula Singleton, Audrey Lyndon
INTRODUCTION: Cardiovascular disease has been identified as the leading cause of maternal mortality in the United States, with cardiomyopathy, including peripartum cardiomyopathy (PPCM), accounting for 12% to 16% of all pregnancy-related deaths. The purpose of this study was to describe women's experiences being diagnosed with PPCM. METHODS: This investigation was conducted using a qualitative design. We collected publicly available narratives posted by 92 women with PPCM (mean [SD] age 29 [6] years, mean [SD] ejection fraction 25...
July 2016: Journal of Midwifery & Women's Health
Julie Damp, Michael M Givertz, Marc Semigran, Rami Alharethi, Gregory Ewald, G Michael Felker, Biykem Bozkurt, John Boehmer, Jennifer Haythe, Hal Skopicki, Karen Hanley-Yanez, Jessica Pisarcik, Indrani Halder, John Gorcsan, Sarosh Rana, Zoltan Arany, James D Fett, Dennis M McNamara
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. METHODS: In 98 women with newly diagnosed PPCM enrolled in the Investigation in Pregnancy Associated Cardiomyopathy study, serum was obtained at baseline for analysis of relaxin-2, prolactin, soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF)...
May 2016: JACC. Heart Failure
Xiaoxiao Guo, Yongtai Liu, Ligang Fang, Quan Fang
OBJECTIVE: To explore the clinical characteristics and risk factors in patients with peripartum cardiomyopathy (PPCM). METHODS: A total of 35 patients admitted in Peking Union Medical College Hospital and diagnosed with PPCM between January 1995 and December 2014 was included and analyzed in this study. The subjects were divided into two groups: the early recovery and delayed recovery. Early recovery was defined as normalization of left ventricle ejection fraction (LVEF) ≥50% before 6 months post-diagnosis...
February 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Harshida Patel, Marie Berg, Anders Barasa, Cecily Begley, Maria Schaufelberger
OBJECTIVE: Peripartum Cardiomyopathy is a form of cardiac disease often associated with cardiac failure, occurring in late pregnancy or after childbirth. The anatomical and physiological changes in the mother associated with normal pregnancy are profound, and this may result in symptoms and signs that overlap with Peripartum Cardiomyopathy, leading to missed or delayed diagnosis. Women's experiences of Peripartum Cardiomyopathy symptoms remain poorly studied. The aim of this study was to explore and describe women's experiences of symptoms in Peripartum Cardiomyopathy...
January 2016: Midwifery
Nadia Bouabdallaoui, Frederic Mouquet, Guillaume Lebreton, Pierre Demondion, Thierry H Le Jemtel, Pierre V Ennezat
Heart failure with left ventricular dysfunction occurring during pregnancy or during the post-partum period in patients without history of cardiovascular disease defines peripartum cardiomyopathy (PPCM). PPCM carries a high morbidity and mortality rate as well as the possibility of recovery ad integrum. Its incidence shows ethnic variations, with a greater prevalence of the disease among women with African descent. Pathogenesis of PPCM remains poorly understood. Both "oxidative stress-prolactin axis" and "anti-angiogenic-signaling excess" hypotheses are currently being investigated...
June 2017: European Heart Journal. Acute Cardiovascular Care
Dennis M McNamara, Uri Elkayam, Rami Alharethi, Julie Damp, Eileen Hsich, Gregory Ewald, Kalgi Modi, Jeffrey D Alexis, Gautam V Ramani, Marc J Semigran, Jennifer Haythe, David W Markham, Josef Marek, John Gorcsan, Wen-Chi Wu, Yan Lin, Indrani Halder, Jessica Pisarcik, Leslie T Cooper, James D Fett
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. The LVEF was assessed by echocardiography at baseline and at 2, 6, and 12 months post-partum...
August 25, 2015: Journal of the American College of Cardiology
T Haddad, D Hakem, A Berrah
INTRODUCTION: The pregnancies in systemic erythematous lupus (SLE) disease is a situation of high risk and involve both the mother and the fetus. The prematurity and the miscarriage are there more frequent, with increase risks of eclampsia, acute hypertension, HELP syndrome and of worsening renal disease. So the morbimortality is multiplied particularly when a anti-phospholipid syndrome 'APLS' is associated. The pregnancy remains however authorized when the SLE is in remission for more than 6 months with a validated treatment and successful means of monitoring...
July 2012: Pregnancy Hypertension
Akanksha Dutt, Akshi Agarwal, Rama Chatterji, Farid Ahmed
Peripartum cardiomyopathy (PPCM) is a disease of unknown etiology which affects pregnant females during late pregnancy or during the first 5 months post-partum. The clinical presentation of these patients is similar to that of patients with dilated cardiomyopathy. Anesthetic management of such cases poses a challenge; due to the increased risk of various perioperative complications. We report the successful anesthetic management of lower segment caesarean section in a patient with PPCM.
May 2013: Anesthesia, Essays and Researches
Tasneem Z Naqvi
Research in pregnancy is challenging as it involves a special 'vulnerable' group due to the involvement of the mother and the fetus. These challenges, which are inherent in studying pregnancy in physiologic and pathologic states, have contributed to the scant research in pregnancy. Until recently, most studies in pregnancy were nonrandomized and retrospective in nature, representing prevailing clinical standards of practice and clinicians' biases. Prospective studies were generally limited to single centers, comprising of small sample sizes and were observational in nature, rather than randomized studies involving therapy...
November 2014: Future Cardiology
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