Clinical and echocardiographic predictors of outcomes in patients with peripartum cardiomyopathy : A single centre, six month follow-up study
Copyright © 2021 Cardiological Society of India. Published by Elsevier B.V. All rights reserved..
INTRODUCTION: Peripartum cardiomyopathy (PPCM) is an important cause of maternal mortality and morbidity. But, there is a paucity of prospective data on outcomes and prognostic markers in patients receiving contemporary evidence-based therapy, particularly in developing countries.
METHODS: This was a single centre, prospective, cohort study on 43 PPCM patients who were followed for 6 months. The primary endpoint was a composite incidence of decompensation related re-hospitalization, all-cause death, and poor recovery (defined as left ventricular ejection fraction, LVEF: <45% at 6 months). Multivariate logistic regression analysis was performed to identify the independent predictors and Kaplan-Meier plots for event (re-hospitalization or death) free survival were computed at their optimal cut-offs.
RESULTS: Mean LVEF at presentation was 34.7%. Two patients died during index hospitalization but there were no deaths during follow-up and 63.4% of patients had full LV recovery after discharge. 32.5% of the study population experienced the composite endpoint with high left atrial volume index (LAVi), and low right ventricular fractional area change (RVFAC) at presentation as independent predictors. Use of Inotropic therapy during index hospitalization (with dobutamine or levosimendan) and bromocriptine therapy were not associated with better outcome.
CONCLUSIONS: At the end of 6 months after PPCM diagnosis, about 61% of patients had full LV functional recovery with a mortality rate of 4.7%. RVFAC (<31.4% with 86% accuracy) and LAVi (>29.6 ml/m2 with 72% accuracy) at presentation but not LVEF, predicts poor outcomes. Presence of both these risk factors at index hospitalization was associated with a significantly lower event free survival compared to patients without these predictors.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
|---|---|
| Enthalten in: |
Indian heart journal - 73(2021), 3 vom: 22. Mai, Seite 319-324 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ravi Kiran, G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Bromocriptine |
|---|
| Anmerkungen: |
Date Completed 19.10.2021 Date Revised 19.10.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.ihj.2021.01.009 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM327021616 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM327021616 | ||
| 003 | DE-627 | ||
| 005 | 20231225195846.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ihj.2021.01.009 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1090.xml |
| 035 | |a (DE-627)NLM327021616 | ||
| 035 | |a (NLM)34154749 | ||
| 035 | |a (PII)S0019-4832(21)00009-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ravi Kiran, G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical and echocardiographic predictors of outcomes in patients with peripartum cardiomyopathy |b A single centre, six month follow-up study |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 19.10.2021 | ||
| 500 | |a Date Revised 19.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Cardiological Society of India. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a INTRODUCTION: Peripartum cardiomyopathy (PPCM) is an important cause of maternal mortality and morbidity. But, there is a paucity of prospective data on outcomes and prognostic markers in patients receiving contemporary evidence-based therapy, particularly in developing countries | ||
| 520 | |a METHODS: This was a single centre, prospective, cohort study on 43 PPCM patients who were followed for 6 months. The primary endpoint was a composite incidence of decompensation related re-hospitalization, all-cause death, and poor recovery (defined as left ventricular ejection fraction, LVEF: <45% at 6 months). Multivariate logistic regression analysis was performed to identify the independent predictors and Kaplan-Meier plots for event (re-hospitalization or death) free survival were computed at their optimal cut-offs | ||
| 520 | |a RESULTS: Mean LVEF at presentation was 34.7%. Two patients died during index hospitalization but there were no deaths during follow-up and 63.4% of patients had full LV recovery after discharge. 32.5% of the study population experienced the composite endpoint with high left atrial volume index (LAVi), and low right ventricular fractional area change (RVFAC) at presentation as independent predictors. Use of Inotropic therapy during index hospitalization (with dobutamine or levosimendan) and bromocriptine therapy were not associated with better outcome | ||
| 520 | |a CONCLUSIONS: At the end of 6 months after PPCM diagnosis, about 61% of patients had full LV functional recovery with a mortality rate of 4.7%. RVFAC (<31.4% with 86% accuracy) and LAVi (>29.6 ml/m2 with 72% accuracy) at presentation but not LVEF, predicts poor outcomes. Presence of both these risk factors at index hospitalization was associated with a significantly lower event free survival compared to patients without these predictors | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Bromocriptine | |
| 650 | 4 | |a Ejection fraction | |
| 650 | 4 | |a Fractional area change | |
| 650 | 4 | |a Inotropes | |
| 650 | 4 | |a Left atrial volume index | |
| 650 | 4 | |a Peripartum cardiomyopathy | |
| 700 | 1 | |a RajKumar, C |e verfasserin |4 aut | |
| 700 | 1 | |a Chandrasekhar, P |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Indian heart journal |d 1961 |g 73(2021), 3 vom: 22. Mai, Seite 319-324 |w (DE-627)NLM000004162 |x 2213-3763 |7 nnns |
| 773 | 1 | 8 | |g volume:73 |g year:2021 |g number:3 |g day:22 |g month:05 |g pages:319-324 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ihj.2021.01.009 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 73 |j 2021 |e 3 |b 22 |c 05 |h 319-324 | ||