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Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study
BACKGROUND: Peripartum cardiomyopathy (PPCM) is associated with severe morbidity and mortality, and the significance of right ventricular (RV) involvement is unclear. We sought to determine whether RV systolic dysfunction or dilatation is associated with adverse clinical outcomes in women with PPCM....
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700221/ https://www.ncbi.nlm.nih.gov/pubmed/36444364 http://dx.doi.org/10.1016/j.cjco.2022.05.004 |
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author | Pacheco, Christine Tremblay-Gravel, Maxime Marquis-Gravel, Guillaume Couture, Etienne Avram, Robert Desplantie, Olivier Bibas, Lior Simard, François Malhamé, Isabelle Poulin, Anthony Tran, Dan Senechal, Mario Afilalo, Jonathan Farand, Paul Bérubé, Lyne Jolicoeur, E. Marc Ducharme, Anique Tournoux, François |
author_facet | Pacheco, Christine Tremblay-Gravel, Maxime Marquis-Gravel, Guillaume Couture, Etienne Avram, Robert Desplantie, Olivier Bibas, Lior Simard, François Malhamé, Isabelle Poulin, Anthony Tran, Dan Senechal, Mario Afilalo, Jonathan Farand, Paul Bérubé, Lyne Jolicoeur, E. Marc Ducharme, Anique Tournoux, François |
author_sort | Pacheco, Christine |
collection | PubMed |
description | BACKGROUND: Peripartum cardiomyopathy (PPCM) is associated with severe morbidity and mortality, and the significance of right ventricular (RV) involvement is unclear. We sought to determine whether RV systolic dysfunction or dilatation is associated with adverse clinical outcomes in women with PPCM. METHODS: We conducted a multicentre retrospective cohort study examining the association between echocardiographic RV systolic dysfunction or dilatation at the time of PPCM diagnosis and clinical outcomes. Clinical endpoints of interest were the need for mechanical support, recovery of left ventricular ejection fraction at follow-up, and a combined endpoint of hospitalization for heart failure, cardiac transplant, or death. RESULTS: A total of 67 women, median age 30 years (interquartile range: 7), were diagnosed with PPCM between 1994 and 2015 in 17 participating centres. Twin pregnancies occurred in 11%; 62% of women were multiparous; and 24% had preeclampsia. RV systolic function was impaired in 18 (27%) and dilated in 8 (12%). Seven women required ventricular assistance, and 8 experienced the composite outcome during follow-up (25 [interquartile range 61] months). RV dysfunction was associated with the need for mechanical support (odds ratio 10.10 (95% confidence interval: 1.86-54.81), P = 0.007), but neither RV dysfunction nor dilatation was associated with left ventricular ejection fraction recovery, the need for cardiac transplant, heart failure hospitalization, or death. CONCLUSIONS: RV dysfunction is associated with the need for mechanical support in women with PPCM. These findings may improve risk stratification of complications and clinical management. |
format | Online Article Text |
id | pubmed-9700221 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-97002212022-11-27 Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study Pacheco, Christine Tremblay-Gravel, Maxime Marquis-Gravel, Guillaume Couture, Etienne Avram, Robert Desplantie, Olivier Bibas, Lior Simard, François Malhamé, Isabelle Poulin, Anthony Tran, Dan Senechal, Mario Afilalo, Jonathan Farand, Paul Bérubé, Lyne Jolicoeur, E. Marc Ducharme, Anique Tournoux, François CJC Open Original Article BACKGROUND: Peripartum cardiomyopathy (PPCM) is associated with severe morbidity and mortality, and the significance of right ventricular (RV) involvement is unclear. We sought to determine whether RV systolic dysfunction or dilatation is associated with adverse clinical outcomes in women with PPCM. METHODS: We conducted a multicentre retrospective cohort study examining the association between echocardiographic RV systolic dysfunction or dilatation at the time of PPCM diagnosis and clinical outcomes. Clinical endpoints of interest were the need for mechanical support, recovery of left ventricular ejection fraction at follow-up, and a combined endpoint of hospitalization for heart failure, cardiac transplant, or death. RESULTS: A total of 67 women, median age 30 years (interquartile range: 7), were diagnosed with PPCM between 1994 and 2015 in 17 participating centres. Twin pregnancies occurred in 11%; 62% of women were multiparous; and 24% had preeclampsia. RV systolic function was impaired in 18 (27%) and dilated in 8 (12%). Seven women required ventricular assistance, and 8 experienced the composite outcome during follow-up (25 [interquartile range 61] months). RV dysfunction was associated with the need for mechanical support (odds ratio 10.10 (95% confidence interval: 1.86-54.81), P = 0.007), but neither RV dysfunction nor dilatation was associated with left ventricular ejection fraction recovery, the need for cardiac transplant, heart failure hospitalization, or death. CONCLUSIONS: RV dysfunction is associated with the need for mechanical support in women with PPCM. These findings may improve risk stratification of complications and clinical management. Elsevier 2022-05-25 /pmc/articles/PMC9700221/ /pubmed/36444364 http://dx.doi.org/10.1016/j.cjco.2022.05.004 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Pacheco, Christine Tremblay-Gravel, Maxime Marquis-Gravel, Guillaume Couture, Etienne Avram, Robert Desplantie, Olivier Bibas, Lior Simard, François Malhamé, Isabelle Poulin, Anthony Tran, Dan Senechal, Mario Afilalo, Jonathan Farand, Paul Bérubé, Lyne Jolicoeur, E. Marc Ducharme, Anique Tournoux, François Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title | Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title_full | Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title_fullStr | Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title_full_unstemmed | Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title_short | Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study |
title_sort | association between right ventricular dysfunction and adverse outcomes in peripartum cardiomyopathy: insights from the bro-hf quebec cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9700221/ https://www.ncbi.nlm.nih.gov/pubmed/36444364 http://dx.doi.org/10.1016/j.cjco.2022.05.004 |
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