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Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy

AIMS: To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). METHODS: Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women) were id...

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Autores principales: Goland, Sorel, George, Jacob, Elkayam, Uri, Shimoni, Sara, Fugenfirov, Irena, Vaisbuch, Edi, Arad, Michael, Freimark, Dov, Simchen, Michal, Kuperstein, Rafael
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/PMC9773727/
https://www.ncbi.nlm.nih.gov/pubmed/36128657
http://dx.doi.org/10.1002/ehf2.14141
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author Goland, Sorel
George, Jacob
Elkayam, Uri
Shimoni, Sara
Fugenfirov, Irena
Vaisbuch, Edi
Arad, Michael
Freimark, Dov
Simchen, Michal
Kuperstein, Rafael
author_facet Goland, Sorel
George, Jacob
Elkayam, Uri
Shimoni, Sara
Fugenfirov, Irena
Vaisbuch, Edi
Arad, Michael
Freimark, Dov
Simchen, Michal
Kuperstein, Rafael
author_sort Goland, Sorel
collection PubMed
description AIMS: To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). METHODS: Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women) were identified: 8 miscarriages, 8 terminations, and 59 life birth. RESULTS: Forty‐five patients with 59 full‐term SSPs [mean age was 32.9 ± 4.1 years, LV ejection fraction (LVEF) 57.7 ± 5.1%] were analysed. Data on LVEF at 1‐month post‐delivery were available in 46 and at 6 months in 36 SSPs. There was a small decrease in the mean LVEF, mostly at third trimester (57.2 ± 5.6 vs. 54.4. ± 7.3, P < 0.001); and at 1‐mont (57.9 ± 5.7% vs. 55.4 ± 6.1%, P = 0.001) and at 6‐month post‐delivery (57.4 ± 6.1 vs. 55.3 ± 7.9%, P = 0.03). In patients with pre‐SSP LV LVEF ≥55%, a mild reduction in the mean group LVEF was seen at 1‐month post‐delivery (P = 0.009). One patient with pre‐SSP LVEF ≥55% developed severe relapse. In patients with pre‐SSP LVEF <55%, a mild reduction in LVEF was obtained mostly at third trimester (51.1 ± 5.6 vs 47.0 ± 7.4%, P < 0.001), which persisted at 6 months (P = 0.03). A relapse was observed in three (25%) women with LVEF <55%. There was no maternal mortality, 32 patients delivered by caesarean section, and there were no foetal complications. CONCLUSIONS: Our study indicates a favourable outcome and low likelihood of maternal mortality associated with SSP in women with a history of PPCM and recovered LV systolic function. SSP was associated with a slight reduction in LVEF mostly during the third trimester, which persisted up to 6 months after delivery.
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spelling pubmed-97737272022-12-23 Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy Goland, Sorel George, Jacob Elkayam, Uri Shimoni, Sara Fugenfirov, Irena Vaisbuch, Edi Arad, Michael Freimark, Dov Simchen, Michal Kuperstein, Rafael ESC Heart Fail Original Articles AIMS: To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM). METHODS: Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007–2019), 75 SSPs (in 50 women) were identified: 8 miscarriages, 8 terminations, and 59 life birth. RESULTS: Forty‐five patients with 59 full‐term SSPs [mean age was 32.9 ± 4.1 years, LV ejection fraction (LVEF) 57.7 ± 5.1%] were analysed. Data on LVEF at 1‐month post‐delivery were available in 46 and at 6 months in 36 SSPs. There was a small decrease in the mean LVEF, mostly at third trimester (57.2 ± 5.6 vs. 54.4. ± 7.3, P < 0.001); and at 1‐mont (57.9 ± 5.7% vs. 55.4 ± 6.1%, P = 0.001) and at 6‐month post‐delivery (57.4 ± 6.1 vs. 55.3 ± 7.9%, P = 0.03). In patients with pre‐SSP LV LVEF ≥55%, a mild reduction in the mean group LVEF was seen at 1‐month post‐delivery (P = 0.009). One patient with pre‐SSP LVEF ≥55% developed severe relapse. In patients with pre‐SSP LVEF <55%, a mild reduction in LVEF was obtained mostly at third trimester (51.1 ± 5.6 vs 47.0 ± 7.4%, P < 0.001), which persisted at 6 months (P = 0.03). A relapse was observed in three (25%) women with LVEF <55%. There was no maternal mortality, 32 patients delivered by caesarean section, and there were no foetal complications. CONCLUSIONS: Our study indicates a favourable outcome and low likelihood of maternal mortality associated with SSP in women with a history of PPCM and recovered LV systolic function. SSP was associated with a slight reduction in LVEF mostly during the third trimester, which persisted up to 6 months after delivery. John Wiley and Sons Inc. 2022-09-20 /pmc/articles/PMC9773727/ /pubmed/36128657 http://dx.doi.org/10.1002/ehf2.14141 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Goland, Sorel
George, Jacob
Elkayam, Uri
Shimoni, Sara
Fugenfirov, Irena
Vaisbuch, Edi
Arad, Michael
Freimark, Dov
Simchen, Michal
Kuperstein, Rafael
Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title_full Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title_fullStr Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title_full_unstemmed Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title_short Contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
title_sort contemporary outcome of subsequent pregnancies in patients with previous peripartum cardiomyopathy
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773727/
https://www.ncbi.nlm.nih.gov/pubmed/36128657
http://dx.doi.org/10.1002/ehf2.14141
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