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- Title
Risk of heart failure relapse in subsequent pregnancy among peripartum cardiomyopathy mothers
- Authors
Fett, James D.; Fristoe, Karie L.; Welsh, Serena N.
- Abstract
<bold>Objective: </bold>To quantify the level of risk for heart failure relapse in a subsequent pregnancy in women who have had peripartum cardiomyopathy (PPCM), and to test the hypothesis that meeting additional criteria may help lower the risk.<bold>Methods: </bold>Prospectively-identified PPCM patients volunteering between 2003 and 2009 were identified from the PPCM Registry of Hôpital Albert Schweitzer, Deschapelles, Haiti, and an internet support group. Data were assessed for full adherence to monitoring and diagnostic criteria, clinical data, statistical analysis, and reporting.<bold>Results: </bold>Of 61 post-PPCM pregnancies identified, there were 18 relapses (29.5%) of heart failure. Of 26 pregnancies with a left ventricular ejection fraction (LVEF) of less than 0.55 prior to the pregnancy, relapse occurred in 12 (46.2%) pregnancies. Of 35 pregnancies with an LVEF of 0.55 or greater prior to the pregnancy, relapse occurred in 6 (17.1%) (P<0.01). No relapses occurred in 9 women who also demonstrated adequate contractile reserve.<bold>Conclusion: </bold>The most important criterion associated with reduced risk for heart failure relapse in a post-PPCM pregnancy is recovery defined by an LVEF 0.55 or greater before the subsequent pregnancy. Exercise stress echocardiography showing adequate contractile reserve may help to identify women at an even lower risk of relapse.
- Subjects
HEART failure; SUBSEQUENT pregnancy; CARDIOMYOPATHIES; HOPITAL Albert Schweitzer; HEART diseases in pregnancy; STRESS echocardiography; HEALTH risk assessment
- Publication
International Journal of Gynecology & Obstetrics, 2010, Vol 109, Issue 1, p34
- ISSN
0020-7292
- Publication type
journal article
- DOI
10.1016/j.ijgo.2009.10.011