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Long-term followup and late recovery in peripartum cardiomyopathy (PPCM) has not been well defined.
A 10 year review of PPCM patients and their echoes from the primary obstetric and heart failure hospitals in the state. Independent chart review and echo interpretations were performed. Recovery defined as LVEF ≥ 55%.
30 cases of PPCM were identified, 25 with regular and complete echo followup (5 incomplete but there were no deaths or cardiac transplants). Diagnosis occurred within a month of delivery in 92%. Age 31.9 ± 4.9 years. Race: Caucasian 84%, Hispanic 8%, mixed race 8%. Hypertension or preeclampsia 52%. Baseline LVEF 35 ± 9.8 %. Recovery occurred in 76% and were older (33.7 vs 27.5 years, p=.0023) and had higher BP at presentation (154±23 mmHg vs 124±14 mmHg, p=.0063) and MAP (110±19 mmHg vs 91±16 mmHg p=.0542). There was no difference in LVEF (36 ± 10% vs 30 ± 12%), parity, incidence of hypertension or preeclampsia between the groups. Of those that recovered, only 60% did so by 6 mos, 75% by 1 year and an additional 25% at >2 years (range 2-8 years). All were treated with guideline-directed medical therapy.
In this long-term study, a higher rate of recovery of function was noted related to the longer duration of followup and predominately Caucasian population. In the current era of medical therapy, PPCM patients should be counseled that late recovery of ventricular function is likely to occur.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Dilated Cardiomyopathies: From Peripartum, Cancer Therapy, Familial Cardiomyopathies to Cardiac Amyloidosis
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1134-280
- 2013 American College of Cardiology Foundation