Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
Abstract Aims To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). Methods Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women)...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14141 |
| _version_ | 1828089170017386496 |
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| author | Sorel Goland Jacob George Uri Elkayam Sara Shimoni Irena Fugenfirov Edi Vaisbuch Michael Arad Dov Freimark Michal Simchen Rafael Kuperstein |
| author_facet | Sorel Goland Jacob George Uri Elkayam Sara Shimoni Irena Fugenfirov Edi Vaisbuch Michael Arad Dov Freimark Michal Simchen Rafael Kuperstein |
| author_sort | Sorel Goland |
| collection | DOAJ |
| description | Abstract Aims To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). Methods Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women) were identified: 8 miscarriages, 8 terminations, and 59 life birth. Results Forty‐five patients with 59 full‐term SSPs [mean age was 32.9 ± 4.1 years, LV ejection fraction (LVEF) 57.7 ± 5.1%] were analysed. Data on LVEF at 1‐month post‐delivery were available in 46 and at 6 months in 36 SSPs. There was a small decrease in the mean LVEF, mostly at third trimester (57.2 ± 5.6 vs. 54.4. ± 7.3, P < 0.001); and at 1‐mont (57.9 ± 5.7% vs. 55.4 ± 6.1%, P = 0.001) and at 6‐month post‐delivery (57.4 ± 6.1 vs. 55.3 ± 7.9%, P = 0.03). In patients with pre‐SSP LV LVEF ≥55%, a mild reduction in the mean group LVEF was seen at 1‐month post‐delivery (P = 0.009). One patient with pre‐SSP LVEF ≥55% developed severe relapse. In patients with pre‐SSP LVEF <55%, a mild reduction in LVEF was obtained mostly at third trimester (51.1 ± 5.6 vs 47.0 ± 7.4%, P < 0.001), which persisted at 6 months (P = 0.03). A relapse was observed in three (25%) women with LVEF <55%. There was no maternal mortality, 32 patients delivered by caesarean section, and there were no foetal complications. Conclusions Our study indicates a favourable outcome and low likelihood of maternal mortality associated with SSP in women with a history of PPCM and recovered LV systolic function. SSP was associated with a slight reduction in LVEF mostly during the third trimester, which persisted up to 6 months after delivery. |
| first_indexed | 2024-04-11T05:36:02Z |
| format | Article |
| id | doaj.art-97090967533a49f9834f843d49fd7a5e |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-11T05:36:02Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-97090967533a49f9834f843d49fd7a5e2022-12-22T12:55:34ZengWileyESC Heart Failure2055-58222022-12-01964262427010.1002/ehf2.14141Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathySorel Goland0Jacob George1Uri Elkayam2Sara Shimoni3Irena Fugenfirov4Edi Vaisbuch5Michael Arad6Dov Freimark7Michal Simchen8Rafael Kuperstein9The Heart Institute Kaplan Medical Center Rehovot IsraelThe Heart Institute Kaplan Medical Center Rehovot IsraelDepartment of Medicine, Division of Cardiovascular Medicine and Department of Obstetrics and Gynecology, Keck School of Medicine University of Southern California Los Angeles CA USAThe Heart Institute Kaplan Medical Center Rehovot IsraelThe Heart Institute Kaplan Medical Center Rehovot IsraelHadassah Medical School Hebrew University Jerusalem IsraelLeviev Heart Center Sheba Medical Center Ramat Gan IsraelLeviev Heart Center Sheba Medical Center Ramat Gan IsraelSackler School of Medicine Tel Aviv University Tel Aviv IsraelLeviev Heart Center Sheba Medical Center Ramat Gan IsraelAbstract Aims To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). Methods Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women) were identified: 8 miscarriages, 8 terminations, and 59 life birth. Results Forty‐five patients with 59 full‐term SSPs [mean age was 32.9 ± 4.1 years, LV ejection fraction (LVEF) 57.7 ± 5.1%] were analysed. Data on LVEF at 1‐month post‐delivery were available in 46 and at 6 months in 36 SSPs. There was a small decrease in the mean LVEF, mostly at third trimester (57.2 ± 5.6 vs. 54.4. ± 7.3, P < 0.001); and at 1‐mont (57.9 ± 5.7% vs. 55.4 ± 6.1%, P = 0.001) and at 6‐month post‐delivery (57.4 ± 6.1 vs. 55.3 ± 7.9%, P = 0.03). In patients with pre‐SSP LV LVEF ≥55%, a mild reduction in the mean group LVEF was seen at 1‐month post‐delivery (P = 0.009). One patient with pre‐SSP LVEF ≥55% developed severe relapse. In patients with pre‐SSP LVEF <55%, a mild reduction in LVEF was obtained mostly at third trimester (51.1 ± 5.6 vs 47.0 ± 7.4%, P < 0.001), which persisted at 6 months (P = 0.03). A relapse was observed in three (25%) women with LVEF <55%. There was no maternal mortality, 32 patients delivered by caesarean section, and there were no foetal complications. Conclusions Our study indicates a favourable outcome and low likelihood of maternal mortality associated with SSP in women with a history of PPCM and recovered LV systolic function. SSP was associated with a slight reduction in LVEF mostly during the third trimester, which persisted up to 6 months after delivery.https://doi.org/10.1002/ehf2.14141SubsequentPregnanciesPeripartumCardiomyopathyOutcome |
| spellingShingle | Sorel Goland Jacob George Uri Elkayam Sara Shimoni Irena Fugenfirov Edi Vaisbuch Michael Arad Dov Freimark Michal Simchen Rafael Kuperstein Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy ESC Heart Failure Subsequent Pregnancies Peripartum Cardiomyopathy Outcome |
| title | Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| title_full | Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| title_fullStr | Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| title_full_unstemmed | Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| title_short | Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| title_sort | contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy |
| topic | Subsequent Pregnancies Peripartum Cardiomyopathy Outcome |
| url | https://doi.org/10.1002/ehf2.14141 |
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