Using Echocardiography and Biomarkers to Determine Prognosis in Peripartum Cardiomyopathy: A Systematic Review

Peripartum cardiomyopathy (PPCM) is a rare but debilitating form of heart failure that affects pregnant women. Although PPCM has a high rate of complete resolution, some patients often have a progressive disease and develop significant morbidity and mortality. Making an accurate prediction of outcomes and identifying those patients at the highest risk has proven difficult over the years. This study aimed to establish if we can use echocardiographic parameters and biomarkers as reliable indicators of prognosis. A predetermined systematic search strategy was employed in four databases: PubMed, Google Scholar, Science Direct, and Cochrane Library to include articles from the last 15 years (January 2007 to January 2022). Data from 12 studies were synthesized and included in this study. Although no parameter proved consistent in all the studies, echocardiographic parameters, including strain profiles and biomarkers, proved significant in the prognostication of patients with PPCM in the various studies evaluated. Therefore, a holistic approach is still needed in the risk stratification of patients with PPCM. Future studies should evaluate these parameters as well as clinical characteristics in a larger cohort study with a long follow-up period of more than one year in order to potentially develop prognostic score criteria that can be used to accurately identify those patients at the highest risk of developing severe disease or death to allow for timely and targeted therapies to improve outcomes in these patients.