Clinical characteristics and risk factors for peripartum cardiomyopathy

Afr Health Sci. 2012 Mar;12(1):26-31.

Abstract

Background: Peripartum cardiomyopathy (PPCM) is a potentially fatal form of heart failure and the recognition of its risk factors is important for prevention and treatment.

Objective: To explore the clinical characteristics and the risk factors for PPCM.

Methods: Echocardiographic was used to examine the left ventricular ejection fraction (LVEF). Blood level of troponin I (cTNI), high sensitive C-reaction protein (hs-CRP), NT-proBNP was measured. All PPCM occurred within weeks following delivery.

Results: Fifty-two PPCM patients and 52 normal delivery subjects (control group) were included in this study. Compared with the control group, PPCM patients were older, with a higher level of blood pressure, and a higher rate of suspected respiratory infection. The level of leucocytes, hs-CRP, cTNI and NT-proBNP in PPCM patients were higher than in the control. Multivariate logistic regression analysis showed that elevated plasma hs-CRP (OR =1.86, p<0.05), respiratory infection (OR = 2.87, p<0.01), and hypertension (OR =1.68, p < 0.05) were independent risk factors for PPCM. During the follow up of 21.6±5.4 d, one patient (1.9%) died probably of heart failure but other patients remained well.

Conclusion: Hypertension, respiratory infection, and elevated plasma hs-CRP seem to be associated with the pathogenesis of peripartum cardiomyopathy in this patient population.

Keywords: C-reaction protein; hypertension; inflammation; mortality; peripartum cardiomyopathy.

MeSH terms

  • Adult
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Blood Pressure
  • Cardiomyopathy, Dilated / diagnostic imaging*
  • Cardiomyopathy, Dilated / drug therapy
  • Case-Control Studies
  • China
  • Diuretics / therapeutic use
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnostic imaging*
  • Heart Failure / drug therapy
  • Hospitalization
  • Hospitals, Teaching
  • Humans
  • Logistic Models
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Peripartum Period
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnostic imaging*
  • Pregnancy Complications, Cardiovascular / drug therapy
  • Prospective Studies
  • Puerperal Disorders / diagnostic imaging*
  • Puerperal Disorders / drug therapy
  • Risk Factors
  • Socioeconomic Factors
  • Ventricular Function, Left

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Diuretics
  • Peptide Fragments
  • Natriuretic Peptide, Brain