Universität zu Köln

Hilfiker-Kleiner, Denise, Haghikia, Arash, Berliner, Dominik, Vogel-Claussen, Jens ORCID: 0000-0001-5595-6948, Schwab, Johannes, Franke, Annegret, Schwarzkopf, Marziel, Ehlermann, Philipp, Pfister, Roman, Michels, Guido, Westenfeld, Ralf, Stangl, Verena, Kindermann, Ingrid, Kuehl, Uwe, Angermann, Christiane E., Schlitt, Axel, Fischer, Dieter, Podewski, Edith, Boehm, Michael, Sliwa, Karen and Bauersachs, Johann (2017). Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur. Heart J., 38 (35). S. 2671 - 2680. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims An anti-angiogenic cleaved prolactin fragment is considered causal for peripartum cardiomyopathy (PPCM). Experimental and first clinical observations suggested beneficial effects of the prolactin release inhibitor bromocriptine in PPCM. Methods and results In this multicentre trial, 63 PPCM patients with left ventricular ejection fraction (LVEF) <= 35% were randomly assigned to short-term (1W: bromocriptine, 2.5 mg, 7 days) or long-term bromocriptine treatment (8W: 5 mg for 2 weeks followed by 2.5mg for 6weeks) in addition to standard heart failure therapy. Primary end point was LVEF change (delta) from baseline to 6 months assessed by magnetic resonance imaging. Bromocriptine was well tolerated. Left ventricular ejection fraction increased from 28 +/- 10% to 49 +/- 12% with a delta-LVEF of +21 +/- 11% in the 1W-group, and from 27 +/- 10% to 51 +/- 10% with a delta-LVEF of +24 +/- 11% in the 8W-group (delta-LVEF: P = 0.381). Full-recovery (LVEF >= 50%) was present in 52% of the 1W- and in 68% of the 8W-group with no differences in secondary end points between both groups (hospitalizations for heart failure: 1W: 9.7% vs. 8W: 6.5%, P = 0.651). The risk within the 8W-group to fail full-recovery after 6 months tended to be lower. No patient in the study needed heart transplantation, LV assist device or died. Conclusion Bromocriptine treatment was associated with high rate of full LV-recovery and low morbidity and mortality in PPCM patients compared with other PPCM cohorts not treated with bromocriptine. No significant differences were observed between 1W and 8W treatment suggesting that 1-week addition of bromocriptine to standard heart failure treatment is already beneficial with a trend for better full-recovery in the 8W group. Clinical trial registration: ClinicalTrials. gov, study number: NCT00998556.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hilfiker-Kleiner, Denise UNSPECIFIED UNSPECIFIED UNSPECIFIED Haghikia, Arash UNSPECIFIED UNSPECIFIED UNSPECIFIED Berliner, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogel-Claussen, Jens UNSPECIFIED orcid.org/0000-0001-5595-6948 UNSPECIFIED Schwab, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, Annegret UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarzkopf, Marziel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ehlermann, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Westenfeld, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Stangl, Verena UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindermann, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuehl, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Angermann, Christiane E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlitt, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Podewski, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Sliwa, Karen UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauersachs, Johann UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-217792
DOI:	10.1093/eurheartj/ehx355
Journal or Publication Title:	Eur. Heart J.
Volume:	38
Number:	35
Page Range:	S. 2671 - 2680
Date:	2017
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1522-9645
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEART-FAILURE ASSOCIATION; EUROPEAN-SOCIETY; POSTPARTUM; MANAGEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21779