Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage
This study aimed to evaluate the diagnostic and prognostic value of cardiac magnetic resonance in acute peripartum cardiomyopathy (PPCM). A total of 17 patients with PPCM in the acute stage and 15 healthy controls were retrospectively analyzed regarding myocardial function, edema, late gadolinium en...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/2/378 |
| _version_ | 1797481203722354688 |
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| author | Alexander Isaak Tiyasha H. Ayub Waltraut M. Merz Anton Faron Christoph Endler Alois M. Sprinkart Claus C. Pieper Daniel Kuetting Darius Dabir Ulrike Attenberger Sebastian Zimmer Ulrich M. Becher Julian A. Luetkens |
| author_facet | Alexander Isaak Tiyasha H. Ayub Waltraut M. Merz Anton Faron Christoph Endler Alois M. Sprinkart Claus C. Pieper Daniel Kuetting Darius Dabir Ulrike Attenberger Sebastian Zimmer Ulrich M. Becher Julian A. Luetkens |
| author_sort | Alexander Isaak |
| collection | DOAJ |
| description | This study aimed to evaluate the diagnostic and prognostic value of cardiac magnetic resonance in acute peripartum cardiomyopathy (PPCM). A total of 17 patients with PPCM in the acute stage and 15 healthy controls were retrospectively analyzed regarding myocardial function, edema, late gadolinium enhancement (LGE), and T1 and T2 mappings (T1, T2). Echocardiographic follow-ups were performed. Functional recovery was defined as a left ventricular ejection fraction (LVEF) of ≥50%. Patients with PPCM displayed biventricular dysfunction with reduced myocardial strain parameters and left ventricular and atrial dilatation, as well as diffuse myocardial edema (T2 signal intensity ratio: 2.10 ± 0.34 vs. 1.58 ± 0.21, <i>p</i> < 0.001; T1: 1070 ± 51 ms vs. 980 ± 28 ms, <i>p</i> = 0.001; T2: 63 ± 5 ms vs. 53 ± 2 ms, <i>p</i> < 0.001). Visual myocardial edema was present in 10 patients (59%). LGE was positive in 2 patients (12%). A total of 13 patients (76%) showed full LVEF recovery. The absence of visual myocardial edema and impairment of strain parameters were associated with delayed LVEF recovery. Multivariable Cox regression analysis revealed global longitudinal strain as an independent prognostic factor for LVEF recovery. In conclusion, biventricular systolic dysfunction with diffuse myocardial edema seems to be present in acute PPCM. Myocardial edema and strain may have prognostic value for LVEF recovery. |
| first_indexed | 2024-03-09T22:11:09Z |
| format | Article |
| id | doaj.art-34bdf698ff5d40e0807c1a7615a8c28d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T22:11:09Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-34bdf698ff5d40e0807c1a7615a8c28d2023-11-23T19:31:03ZengMDPI AGDiagnostics2075-44182022-02-0112237810.3390/diagnostics12020378Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute StageAlexander Isaak0Tiyasha H. Ayub1Waltraut M. Merz2Anton Faron3Christoph Endler4Alois M. Sprinkart5Claus C. Pieper6Daniel Kuetting7Darius Dabir8Ulrike Attenberger9Sebastian Zimmer10Ulrich M. Becher11Julian A. Luetkens12Department of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Obstetrics and Prenatal Medicine, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Internal Medicine II-Cardiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Internal Medicine II-Cardiology, University Hospital Bonn, 53127 Bonn, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, GermanyThis study aimed to evaluate the diagnostic and prognostic value of cardiac magnetic resonance in acute peripartum cardiomyopathy (PPCM). A total of 17 patients with PPCM in the acute stage and 15 healthy controls were retrospectively analyzed regarding myocardial function, edema, late gadolinium enhancement (LGE), and T1 and T2 mappings (T1, T2). Echocardiographic follow-ups were performed. Functional recovery was defined as a left ventricular ejection fraction (LVEF) of ≥50%. Patients with PPCM displayed biventricular dysfunction with reduced myocardial strain parameters and left ventricular and atrial dilatation, as well as diffuse myocardial edema (T2 signal intensity ratio: 2.10 ± 0.34 vs. 1.58 ± 0.21, <i>p</i> < 0.001; T1: 1070 ± 51 ms vs. 980 ± 28 ms, <i>p</i> = 0.001; T2: 63 ± 5 ms vs. 53 ± 2 ms, <i>p</i> < 0.001). Visual myocardial edema was present in 10 patients (59%). LGE was positive in 2 patients (12%). A total of 13 patients (76%) showed full LVEF recovery. The absence of visual myocardial edema and impairment of strain parameters were associated with delayed LVEF recovery. Multivariable Cox regression analysis revealed global longitudinal strain as an independent prognostic factor for LVEF recovery. In conclusion, biventricular systolic dysfunction with diffuse myocardial edema seems to be present in acute PPCM. Myocardial edema and strain may have prognostic value for LVEF recovery.https://www.mdpi.com/2075-4418/12/2/378peripartum cardiomyopathypregnancyheart failurecardiac magnetic resonance imagingmyocardial edemamapping |
| spellingShingle | Alexander Isaak Tiyasha H. Ayub Waltraut M. Merz Anton Faron Christoph Endler Alois M. Sprinkart Claus C. Pieper Daniel Kuetting Darius Dabir Ulrike Attenberger Sebastian Zimmer Ulrich M. Becher Julian A. Luetkens Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage Diagnostics peripartum cardiomyopathy pregnancy heart failure cardiac magnetic resonance imaging myocardial edema mapping |
| title | Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage |
| title_full | Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage |
| title_fullStr | Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage |
| title_full_unstemmed | Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage |
| title_short | Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage |
| title_sort | peripartum cardiomyopathy diagnostic and prognostic value of cardiac magnetic resonance in the acute stage |
| topic | peripartum cardiomyopathy pregnancy heart failure cardiac magnetic resonance imaging myocardial edema mapping |
| url | https://www.mdpi.com/2075-4418/12/2/378 |
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