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Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy

BACKGROUND: Delays in diagnosis of peripartum cardiomyopathy (PPCM) are common and are associated with worse outcomes; however, few studies have addressed methods for improving early detection. HYPOTHESIS: We hypothesized that easily accessible data (heart rate [HR] and electrocardiograms [ECGs]) co...

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Autores principales: Cooney, Ryan, Scott, John R., Mahowald, Madeline, Langen, Elizabeth, Sharma, Garima, Kao, David P., Davis, Melinda B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860487/
https://www.ncbi.nlm.nih.gov/pubmed/35129215
http://dx.doi.org/10.1002/clc.23782
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author Cooney, Ryan
Scott, John R.
Mahowald, Madeline
Langen, Elizabeth
Sharma, Garima
Kao, David P.
Davis, Melinda B.
author_facet Cooney, Ryan
Scott, John R.
Mahowald, Madeline
Langen, Elizabeth
Sharma, Garima
Kao, David P.
Davis, Melinda B.
author_sort Cooney, Ryan
collection PubMed
description BACKGROUND: Delays in diagnosis of peripartum cardiomyopathy (PPCM) are common and are associated with worse outcomes; however, few studies have addressed methods for improving early detection. HYPOTHESIS: We hypothesized that easily accessible data (heart rate [HR] and electrocardiograms [ECGs]) could identify women with more severe PPCM and at increased risk of adverse outcomes. METHODS: Clinical data, including HR and ECG, from patients diagnosed with PPCM between January 1998 and July 2016 at our institution were collected and analyzed. Linear and logistic regression were used to analyze the relationship between HR at diagnosis and the left ventricular ejection fraction (LVEF) at diagnosis. Outcomes included overall mortality, recovery status, and major adverse cardiac events. RESULTS: Among 82 patients meeting inclusion criteria, the overall mean LVEF at diagnosis was 26 ± 11.1%. Sinus tachycardia (HR > 100) was present in a total of 50 patients (60.9%) at the time of diagnosis. In linear regression, HR significantly predicted lower LVEF (F = 30.00, p < .0001). With age‐adjusted logistic regression, elevated HR at diagnosis was associated with a fivefold higher risk of overall mortality when initial HR was >110 beats per minute (adjusted odds ratio 5.35, confidence interval 1.23–23.28), p = .025). CONCLUSION: In this study, sinus tachycardia in women with PPCM was associated with lower LVEF at the time of diagnosis. Tachycardia in the peripartum period should raise concern for cardiomyopathy and may be an early indicator of adverse prognosis.
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spelling pubmed-88604872022-02-27 Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy Cooney, Ryan Scott, John R. Mahowald, Madeline Langen, Elizabeth Sharma, Garima Kao, David P. Davis, Melinda B. Clin Cardiol Clinical Investigations BACKGROUND: Delays in diagnosis of peripartum cardiomyopathy (PPCM) are common and are associated with worse outcomes; however, few studies have addressed methods for improving early detection. HYPOTHESIS: We hypothesized that easily accessible data (heart rate [HR] and electrocardiograms [ECGs]) could identify women with more severe PPCM and at increased risk of adverse outcomes. METHODS: Clinical data, including HR and ECG, from patients diagnosed with PPCM between January 1998 and July 2016 at our institution were collected and analyzed. Linear and logistic regression were used to analyze the relationship between HR at diagnosis and the left ventricular ejection fraction (LVEF) at diagnosis. Outcomes included overall mortality, recovery status, and major adverse cardiac events. RESULTS: Among 82 patients meeting inclusion criteria, the overall mean LVEF at diagnosis was 26 ± 11.1%. Sinus tachycardia (HR > 100) was present in a total of 50 patients (60.9%) at the time of diagnosis. In linear regression, HR significantly predicted lower LVEF (F = 30.00, p < .0001). With age‐adjusted logistic regression, elevated HR at diagnosis was associated with a fivefold higher risk of overall mortality when initial HR was >110 beats per minute (adjusted odds ratio 5.35, confidence interval 1.23–23.28), p = .025). CONCLUSION: In this study, sinus tachycardia in women with PPCM was associated with lower LVEF at the time of diagnosis. Tachycardia in the peripartum period should raise concern for cardiomyopathy and may be an early indicator of adverse prognosis. John Wiley and Sons Inc. 2022-02-07 /pmc/articles/PMC8860487/ /pubmed/35129215 http://dx.doi.org/10.1002/clc.23782 Text en © 2022 The Authors. Clinical Cardiology published by Wiley Periodicals, LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigations
Cooney, Ryan
Scott, John R.
Mahowald, Madeline
Langen, Elizabeth
Sharma, Garima
Kao, David P.
Davis, Melinda B.
Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title_full Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title_fullStr Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title_full_unstemmed Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title_short Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
title_sort heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy
topic Clinical Investigations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860487/
https://www.ncbi.nlm.nih.gov/pubmed/35129215
http://dx.doi.org/10.1002/clc.23782
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