Abstract 17528: Delayed Rocovery in Peripartum Cardiomyopathy: An Indication for Long-Term Follow-Up and Sustained Therapy
Background: Persistence of left ventricle systolic dysfunction after 6 months of diagnosis is believed to be a marker of an irreversible cardiomyopathy and worse survival in peripartum cardiomyopathy (PPCM). We sought to determine the length of time required for recovery of left ventricle systolic function (LVSF) in patients with PPCM.
Methods: Forty-two consecutive women with PPCM treated at two tertiary hospitals in Turkey were enrolled in this prospective study over a 5-year period. The minimum required time of follow-up for inclusion was 30 months (range 30-65 months). Clinical evaluation, B-type natriuretic peptide (BNP) and C-reactive protein (CRP) concentrations, and transthoracic echocardiography were evaluated at baseline, every 3 months during the first year, and every 6 months thereafter. Rapid recovery is defined as resolution of heart failure symptoms or signs and normalization of LVSF at 6 months post-diagnosis. Delayed recovery is defined if the length of time required for recovery of LVSF was longer than 6 months. Persistent left ventricular dysfunction (PLVD) is defined as an ejection fraction of less than 50 % at the end of follow-up.
Results: Twenty patients (47.6%) recovered completely, 10 died (23.8%), and 12 (28.6%) were left with PLVD. Average time to complete recovery was 19.3 months after initial diagnosis (3-42 months). Rapid recovery is observed only in 6 patients (30%) whereas delayed recovery is observed in 14 out of 20 patients (%70) (Figure). Persistent elevation of plasma BNP and CRP above the cut-off values at 3th month is predictive of delayed recovery.
Conclusions: Full recovery of LVSF in PPCM patients often requires longer than 6 months. Persistent elevation of plasma CRP and BNP above the cut-off values portends a slower response.
- © 2011 by American Heart Association, Inc.