Universität zu Köln

Moulig, Valeska, Pfeffer, Tobias Jonathan, Ricke-Hoch, Melanie, Schlothauer, Stella, Koenig, Tobias, Schwab, Johannes, Berliner, Dominik, Pfister, Roman, Michels, Guido, Haghikia, Arash, Falk, Christine S., Duncker, David, Veltmann, Christian, Hilfiker-Kleiner, Denise and Bauersachs, Johann (2019). Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities. Eur. J. Heart Fail., 21 (12). S. 1534 - 1543. HOBOKEN: WILEY. ISSN 1879-0844

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Abstract

Aims Peripartum cardiomyopathy (PPCM) establishes late in pregnancy or in the first postpartum months. Many patients recover well within the first year, but long-term outcome studies on morbidity and mortality are rare. Here, we present 5-year follow-up data of a German PPCM cohort. Methods and results Five-year follow-up data were available for 66 PPCM patients (mean age 34 +/- 5 years) with a mean left ventricular ejection fraction (LVEF) of 26 +/- 9% at diagnosis. Ninety-eight percent initially received standard heart failure therapy (beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and/or mineralocorticoid receptor antagonists), and 86% were additionally treated with dopamine D2 receptor agonists (mainly bromocriptine) and anticoagulation. After 1 year, mean LVEF had improved to 50 +/- 11% (n = 48) and further increased to 54 +/- 7% at 5-year follow-up with 72% of patients having achieved full cardiac recovery (LVEF >50%). At 5-year follow-up, only three patients (5%) displayed no recovery, of whom one had died. However, 20% had arterial hypertension and 17% arrhythmias, including paroxysmal supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation. Moreover, 70% were still on at least one heart failure drug. Subsequent pregnancy occurred in 16 patients with two abortions and 14 uneventful pregnancies. Mean LVEF was 55 +/- 7% at 5-year follow-up in these patients. Conclusion Our PPCM collective treated with standard therapy for heart failure, dopamine D2 receptor agonists, and anticoagulation displays a high and stable long-term recovery rate with low mortality at 5-year follow-up. However, long-term use of cardiovascular medication, persisting or de novo hypertension and arrhythmias were frequent.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moulig, Valeska UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeffer, Tobias Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Ricke-Hoch, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlothauer, Stella UNSPECIFIED UNSPECIFIED UNSPECIFIED Koenig, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Berliner, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Haghikia, Arash UNSPECIFIED UNSPECIFIED UNSPECIFIED Falk, Christine S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duncker, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Veltmann, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilfiker-Kleiner, Denise UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauersachs, Johann UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-127750
DOI:	10.1002/ejhf.1624
Journal or Publication Title:	Eur. J. Heart Fail.
Volume:	21
Number:	12
Page Range:	S. 1534 - 1543
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1879-0844
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLINICAL CHARACTERISTICS; AFRICAN-AMERICAN; OUTCOMES; RISK; BROMOCRIPTINE; PREGNANCY; HISTORY; WOMEN Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12775