Author + information
- Masataka Sugahara,
- Dennis McNamara,
- Lori Blauwet,
- Rami Alharethi,
- Paul Mather,
- Kalgi Modi,
- Richard Sheppard,
- Vinay Thohan,
- Gretchen Wells and
- John Gorcsan
Background: Peripartum cardiomyopathy (PPCM) has variable degrees of myocardial recovery over time. The aim was to assess left ventricular (LV) diastolic wall distensibility (DWD) as a measure of diastolic stiffness in PPCM patients.
Methods: We studied 100 PPCM patients in the Multicenter Pregnancy Associated Cardiomyopathy study [LV ejection fraction (EF) <45% within 2 months of delivery]. Echo was done at entry, 6-month and 1-year; 21 women were normal controls. DWD was defined as [(end-systolic posterior wall thickness (LVPWT) – end-diastolic LVPWT) / end-systolic LVPWT] by digital M-mode. Poor outcomes were predefined as EF < 50% at 1 year, death, transplant or LV assist device (LVAD).
Results: DWD in PPCM at entry was significantly low: 0.14 ± 0.01%* vs. 0.44±0.01 in controls. EF was 35±1%* vs. 61±2% in controls (*p<0.001). At 1 year, 51 (75%) had LV recovery (EF ≥ 50%) and 17 (25%) did not recover (11 with EF<50%, 4 LVADs and 2 deaths). DWD recovery was greater in patients with EF recovery vs. those with poor outcome (p<0.001). Recovery of DWD was attenuated in those who did not recover EF. Whereas the greatest degree of recovery in EF occurred over 6 months, DWD continued to improve over 1 year. (p=0.01).
Conclusions: DWD as marker of LV diastolic stiffness in PPCM patients was associated with subsequent LV recovery and clinical outcomes. Although DWD improved in PPCM patients, it remained significantly lower than controls. Attenuated recovery of DWD implies a prolonged time course of reverse remodeling in PPCM.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-281
- 2017 American College of Cardiology Foundation