TY - JOUR
T1 - Myocardial recovery in peripartum cardiomyopathy
T2 - Prospective comparison with recent onset cardiomyopathy in men and nonperipartum women
AU - Cooper, Leslie T.
AU - Mather, Paul J.
AU - Alexis, Jeffrey D.
AU - Pauly, Daniel F.
AU - Torre-Amione, Guillermo
AU - Wittstein, Ilan S.
AU - Dec, G. William
AU - Zucker, Mark
AU - Narula, Jagat
AU - Kip, Kevin
AU - McNamara, Dennis M.
N1 - Funding Information:
Supported by NIH contracts HL75038 , HL086918 , HL102429 , HL69912 .
PY - 2012/1
Y1 - 2012/1
N2 - Background: Whether myocardial recovery occurs more frequently in peripartum cardiomyopathy (PPCM) than in recent onset cardiomyopathies in men and nonperipartum women has not been prospectively evaluated. This was examined through an analysis of outcomes in the Intervention in Myocarditis and Acute Cardiomyopathy 2 (IMAC2) registry. Methods and Results: IMAC2 enrolled 373 subjects with recent onset nonischemic dilated cardiomyopathy. Left ventricular ejection fraction (LVEF) was assessed at entry and 6 months, and subjects followed for up to 4 years. Myocardial recovery was compared between men (group 1), nonperipartum women (group 2) and subjects with PPCM (group 3). The cohort included 230 subjects in group 1, 104 in group 2, and 39 in group 3. The mean LVEF at baseline in groups 1, 2, and 3 was 0.23 ± 0.08, 0.24 ± 0.08, and 0.27 ± 0.07 (P =.04), and at 6 months was 0.39 ± 0.12, 0.42 ± 0.11, and 0.45 ± 0.14 (P =.007). Subjects in group 3 had a much greater likelihood of achieving an LVEF >0.50 at 6 months than groups 1 or 2 (19 %, 34%, and 48% respectively, P =.002). Conclusions: Prospective evaluation confirms myocardial recovery is greatest in women with PPCM, poorest in men, and intermediate in nonperipartum women. On contemporary therapy, nearly half of women with PPCM normalize cardiac function by 6 months.
AB - Background: Whether myocardial recovery occurs more frequently in peripartum cardiomyopathy (PPCM) than in recent onset cardiomyopathies in men and nonperipartum women has not been prospectively evaluated. This was examined through an analysis of outcomes in the Intervention in Myocarditis and Acute Cardiomyopathy 2 (IMAC2) registry. Methods and Results: IMAC2 enrolled 373 subjects with recent onset nonischemic dilated cardiomyopathy. Left ventricular ejection fraction (LVEF) was assessed at entry and 6 months, and subjects followed for up to 4 years. Myocardial recovery was compared between men (group 1), nonperipartum women (group 2) and subjects with PPCM (group 3). The cohort included 230 subjects in group 1, 104 in group 2, and 39 in group 3. The mean LVEF at baseline in groups 1, 2, and 3 was 0.23 ± 0.08, 0.24 ± 0.08, and 0.27 ± 0.07 (P =.04), and at 6 months was 0.39 ± 0.12, 0.42 ± 0.11, and 0.45 ± 0.14 (P =.007). Subjects in group 3 had a much greater likelihood of achieving an LVEF >0.50 at 6 months than groups 1 or 2 (19 %, 34%, and 48% respectively, P =.002). Conclusions: Prospective evaluation confirms myocardial recovery is greatest in women with PPCM, poorest in men, and intermediate in nonperipartum women. On contemporary therapy, nearly half of women with PPCM normalize cardiac function by 6 months.
KW - Heart failure
KW - dilated cardiomyopathy
KW - myocardial recovery
KW - outcomes
KW - pregnancy
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U2 - 10.1016/j.cardfail.2011.09.009
DO - 10.1016/j.cardfail.2011.09.009
M3 - Article
C2 - 22196838
AN - SCOPUS:84855655578
SN - 1071-9164
VL - 18
SP - 28
EP - 33
JO - Journal of cardiac failure
JF - Journal of cardiac failure
IS - 1
ER -