Universität zu Köln

Haghikia, Arash, Schwab, Johannes, Vogel-Claussen, Jens, Berliner, Dominik, Pfeffer, Tobias, Koenig, Tobias, Zwadlo, Carolin, Moulig, Valeska Abou, Franke, Annegret, Schwarzkopf, Marziel, Ehlermann, Philipp, Pfister, Roman, Michels, Guido, Westenfeld, Ralf, Stangl, Verena, Kuehl, Uwe, Podewski, Edith, Kindermann, Ingrid, Boehm, Michael, Sliwa, Karen, Hilfiker-Kleiner, Denise and Bauersachs, Johann (2019). Bromocriptine treatment in patients with peripartum cardiomyopathy and right ventricular dysfunction. Clin. Res. Cardiol., 108 (3). S. 290 - 298. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

BackgroundRight ventricular (RV) dysfunction predicts adverse outcome in peripartum cardiomyopathy (PPCM). We recently demonstrated beneficial effects associated with the prolactin release inhibitor bromocriptine at different doses when added to standard heart failure therapy in PPCM. Here, we evaluated for the first time the therapeutic potential of bromocriptine particularly in PPCM patients with RV involvement.MethodsIn this study, 40 patients with PPCM were included, of whom 24 patients had reduced RV ejection fraction (RVEF<45%). We examined the effect of short-term (1W: bromocriptine, 2.5mg, 7days, n=10) compared with long-term bromocriptine treatment (8W: 5mg for 2weeks followed by 2.5mg for another 6weeks, n=14) in addition to guideline-based heart failure therapy in patients with an initial RVEF<45% on the following outcomes: (1) change from baseline ( delta) in RVEF, (2) change from baseline in left ventricular EF (LVEF), and (3) rate of patients with full LV recovery (LVEF50%) and (4) rate of patients with full RV recovery (RVEF55%) at 6-month follow-up as assessed by cardiac magnetic resonance imaging.ResultsReduced RVEF at initial presentation was associated with a lower rate of full cardiac recovery at 6-month follow-up (patients with RV dysfunction: 58% vs. patients with normal RV function: 81%; p=0.027). RVEF increased from 387 to 53 +/- 11% with a delta-RVEF of +15 +/- 12% in the 1W group, and from 35 +/- 9 to 58 +/- 7% with a RVEF of +23 +/- 10% in the 8W group ( RVEF 1W vs 8W: p=0.118). LVEF increased from 25 +/- 8 to 46 +/- 12% with a LVEF of +21 +/- 11% in the 1W group, and from 22 +/- 6 to 49 +/- 10% with a LVEF of +27 +/- 9% in the 8W group ( LVEF 1W vs 8W: p=0.211). Full LV recovery was present in 50% of the 1W group and in 64% of the 8W group (p=0.678). Full RV recovery was observed in 40% of the 1W group and in 79% of the 8W group (p=0.092).ConclusionsDespite overall worse outcome in patients with RV dysfunction at baseline, bromocriptine treatment in PPCM patients with RV involvement was associated with a high rate of full RV and LV recovery, although no significant differences were observed between the short-term and long-term bromocriptine treatment regime. These findings suggest that bromocriptine in addition to standard heart failure therapy may be also effective in PPCM patients with biventricular impairment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Haghikia, Arash UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogel-Claussen, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Berliner, Dominik UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeffer, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Koenig, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Zwadlo, Carolin UNSPECIFIED UNSPECIFIED UNSPECIFIED Moulig, Valeska Abou 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 Kuehl, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Podewski, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindermann, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Sliwa, Karen UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilfiker-Kleiner, Denise UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauersachs, Johann UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-155818
DOI:	10.1007/s00392-018-1355-7
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	108
Number:	3
Page Range:	S. 290 - 298
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DIAGNOSIS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15581