Skip to main content

Advertisement

SpringerLink
Log in

Peripartum Cardiomyopathy and Preeclampsia: Overlapping Diseases of Pregnancy

  • Preeclampsia (VD Garovic, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Hypertensive disorders of pregnancy (HDP) often result in cardiac dysfunction and have been variably included as a risk factor for peripartum cardiomyopathy (PPCM). However, there is debate regarding the relationship between the two entities.

Recent Findings

Diastolic dysfunction appears to be more predominant among gravidas with HDP, while systolic dysfunction predominates in PPCM. However, this finding is not consistent in all studies. Recent examinations of mortality and morbidity associated with PPCM in the setting of HDP do not demonstrate a predominant pattern with a mixture of results. Further, right ventricular dysfunction is identified to be a common theme in both populations. From a basic science perspective, there is evidence to demonstrate a predominantly anti-angiogenic milieu in both PPCM and HDP.

Summary

PPCM and HDP associated cardiomyopathy overlap significantly. As such, unifying theories for their pathophysiology should be investigated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance

  1. Desai DK, Moodley J, Naidoo DP, Bhorat I. Cardiac abnormalities in pulmonary oedema associated with hypertensive crises in pregnancy. Br J Obstet Gynaecol. 1996;103(6):523–8.

    Article  PubMed  CAS  Google Scholar 

  2. Bello N, Rendon ISH, Arany Z. The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis. J Am Coll Cardiol. 2013;62(18):1715–23. https://doi.org/10.1016/j.jacc.2013.08.717 [published Online First: Epub Date]|.

  3. • Ntusi NB, Badri M, Gumedze F, Sliwa K, Mayosi BM. Pregnancy-associated heart failure: a comparison of clinical presentation and outcome between hypertensive heart failure of pregnancy and idiopathic peripartum cardiomyopathy. PLoS One 2015;10(8):e0133466 doi: https://doi.org/10.1371/journal.pone.0133466[published Online First: Epub Date]|. Retrospective cohort study reported that there may be a difference between hypertensive heart failure of pregnancy compared to idiopathic peripartum cardiomyopathy. Of note, not all patients had EF <50%.

  4. Kamiya CA, Kitakaze M, Ishibashi-Ueda H, Nakatani S, Murohara T, Tomoike H, et al. Different characteristics of peripartum cardiomyopathy between patients complicated with and without hypertensive disorders. Results from the Japanese Nationwide survey of peripartum cardiomyopathy. Circ J. 2011;75(8):1975–81.

    Article  PubMed  Google Scholar 

  5. • Barasa A, Goloskokova V, Ladfors L, Patel H, Schaufelberger M. Symptomatic recovery and pharmacological management in a clinical cohort with peripartum cardiomyopathy. J Matern Fetal Neonatal Med 2018;31(10):1342–49 doi: https://doi.org/10.1080/14767058.2017.1317341 [published Online First: Epub Date]|. Retrospective cohort study reported that the presence of preeclampsia resulted in better outcome in a cohort of Swedish patients with PPCM.

  6. •• McNamara DM, Elkayam U, Alharethi R, Damp J, Hsich E, Ewald G, et al. Clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC study (investigations of pregnancy-associated cardiomyopathy). J Am Coll Cardiol. 2015;66(8):905–14. https://doi.org/10.1016/j.jacc.2015.06.1309 [published Online First: Epnub Date]|. This prospective cohort study of PPCM did not identify any differences in outcomes in the presence of hypertensive disorders of pregnancy among American population

  7. Haghikia A, Podewski E, Libhaber E, Labidi S, Fischer D, Roentgen P, et al. Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy. Basic Res Cardiol. 2013;108(4):366. https://doi.org/10.1007/s00395-013-0366-9 [published Online First: Epub Date]|.

  8. Idiopathic myocardial degeneration associated with pregnancy and especially the puerperium. Am Heart J 1937;14(4):509 doi: https://doi.org/10.1016/S0002-8703(37)90538-6

  9. Walsh JJ, Burch GE, Black WC, Ferrans VJ, Hibbs RG. Idiopathic myocardiopathy of the puerperium (postpartal heart disease). Circulation. 1965;32:19–31.

    Article  PubMed  CAS  Google Scholar 

  10. Demakis JG, Rahimtoola SH. Peripartum cardiomyopathy. Circulation. 1971;44(5):964–8.

    Article  PubMed  CAS  Google Scholar 

  11. Elkayam U, Akhter MW, Singh H, Khan S, Bitar F, Hameed A, et al. Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation. 2005;111(16):2050–5. https://doi.org/10.1161/01.CIR.0000162478.36652.7E [published Online First: Epub Date]|.

  12. Pearson GD, Veille JC, Rahimtoola S, Hsia J, Oakley CM, Hosenpud JD, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000;283(9):1183–8.

    Article  PubMed  CAS  Google Scholar 

  13. Maron BJ, Towbin JA, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association scientific statement from the council on clinical cardiology, heart failure and transplantation committee; quality of care and outcomes research and functional genomics and translational biology interdisciplinary working groups; and council on epidemiology and prevention. Circulation 2006;113(14):1807–16 doi: https://doi.org/10.1161/CIRCULATIONAHA.106.174287 .

  14. Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the task force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur J Heart Fail. 2008;10(10):933–89. https://doi.org/10.1016/j.ejheart.2008.08.005. [published Online First: Epub Date]|

  15. • Sliwa K, Hilfiker-Kleiner D, Petrie MC, Mebazaa A, Pieske B, Buchmann E, Regitz-Zagrosek V, Schaufelberger M, Tavazzi L, van Veldhuisen D, Watkins H, Shah AJ, Seferovic PM, Elkayam U, Pankuweit S, Papp Z, Mouquet F, McMurray J, Heart Failure Association of the European Society of Cardiology Working Group on Peripartum Cardiomyopathy Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the heart failure Association of the European Society of cardiology working group on peripartum cardiomyopathy. Eur J Heart Fail 2010;12(8):767–778 doi: https://doi.org/10.1093/eurjhf/hfq120 [published Online First: Epub Date]|. The most recent definition from the European Society of Cardiology Challenges the notion that PPCM is inherently a dilated cardiomyopathy.

  16. Blauwet LA, Libhaber E, Forster O, Tibazarwa K, Mebazaa A, Hilfiker-Kleiner D, et al. Predictors of outcome in 176 South African patients with peripartum cardiomyopathy. Heart. 2013;99(5):308–13. https://doi.org/10.1136/heartjnl-2012-302760 [published Online First: Epub Date]|.

  17. Sliwa K, Forster O, Libhaber E, et al. Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J. 2006;27(4):441–6. https://doi.org/10.1093/eurheartj/ehi481 [published Online First: Epub Date]|.

  18. Forster O, Hilfiker-Kleiner D, Ansari AA, Sundstrom JB, Libhaber E, Tshani W, et al. Reversal of IFN-gamma, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy. Eur J Heart Fail. 2008;10(9):861–8. https://doi.org/10.1016/j.ejheart.2008.07.005 [published Online First: Epub Date]|.

  19. Fett JD, Christie LG, Carraway RD, Murphy JG. Five-year prospective study of the incidence and prognosis of peripartum cardiomyopathy at a single institution. Mayo Clin Proc. 2005;80(12):1602–6. https://doi.org/10.4065/80.12.1602 [published Online First: Epub Date]|.

  20. Koyama Y, Nishihama M, Inagawa G, Kamiya Y, Miki T, Kurihara R, et al. Comparison of haemodynamic responses to tracheal intubation using the airway scope ((R)) and Macintosh laryngoscope in normotensive and hypertensive patients. Anaesthesia. 2011;66(10):895–900. https://doi.org/10.1111/j.1365-2044.2011.06802.x [published Online First: Epub Date]|.

  21. •• Lindley KJ, Conner SN, Cahill AG, Novak E, Mann DL. Impact of preeclampsia on clinical and functional outcomes in women with peripartum cardiomyopathy. Circ Heart Fail. 2017;10(6):e003797. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003797. This cohort study demonstrated the clinical outcomes of worsened morbidity and mortality in women with peripartum cardiomyopathy with and without concurrent PPCM and HDP.

    Article  PubMed  PubMed Central  Google Scholar 

  22. American College of O, Gynecologists, Task Force on Hypertension in P. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122–31. https://doi.org/10.1097/01.AOG.0000437382.03963.88.

    Article  Google Scholar 

  23. Fett JD, Carraway RD, Dowell DL, King ME, Pierre R. Peripartum cardiomyopathy in the hospital Albert Schweitzer District of Haiti. Am J Obstet Gynecol. 2002;186(5):1005–10. https://doi.org/10.1067/mob.2002.122423 [published Online First: Epub Date]|.

  24. Brar SS, Khan SS, Sandhu GK, Jorgensen MB, Parikh N, Hsu JWY, et al. Incidence, mortality, and racial differences in peripartum cardiomyopathy. Am J Cardiol. 2007;100(2):302–4. https://doi.org/10.1016/j.amjcard.2007.02.092 [published Online First: Epub Date]|.

  25. Wu VC, Chen TH, Yeh JK, et al. Clinical outcomes of peripartum cardiomyopathy: a 15-year nationwide population-based study in Asia. Medicine (Baltimore). 2017;96(43):e8374. https://doi.org/10.1097/MD.0000000000008374 [published Online First: Epub Date]|.

  26. Barasa A, Rosengren A, Sandstrom TZ, Ladfors L, Schaufelberger M. Heart failure in late pregnancy and postpartum: incidence and long-term mortality in Sweden from 1997 to 2010. J Card Fail. 2017;23(5):370–8. https://doi.org/10.1016/j.cardfail.2016.12.011 [published Online First: Epub Date]|.

  27. Lee S, Cho GJ, Park GU, et al. Incidence, risk factors, and clinical characteristics of peripartum cardiomyopathy in South Korea. Circ. Heart Fail. 2018;11(4):e004134 doi: https://doi.org/10.1161/CIRCHEARTFAILURE.117.004134 [published Online First: Epub Date]|.

  28. • Krishnamoorthy P, Garg J, Palaniswamy C, Pandey A, Ahmad H, Frishman WH, Lanier G Epidemiology and outcomes of peripartum cardiomyopathy in the United States: findings from the Nationwide inpatient sample. J Cardiovasc Med (Hagerstown) 2016;17(10):756–761 doi: https://doi.org/10.2459/JCM.0000000000000222 [published Online First: Epub Date]|. Mortality seems to be related to race and ethnicity, with an analysis of the Nationwide Inpatient Sample demonstrating mortality rates of 8.3%, 2.8%, and 0.3% for patients of Asian, African American and Caucasian ancestry respectively. Approximately 50% of patients had concurrent HDP.

  29. Visser W, Wallenburg HC. Central hemodynamic observations in untreated preeclamptic patients. Hypertension. 1991;17(6 Pt 2):1072–7.

    Article  PubMed  CAS  Google Scholar 

  30. Sibai BM, Mabie BC, Harvey CJ, Gonzalez AR. Pulmonary edema in severe preeclampsia-eclampsia: analysis of thirty-seven consecutive cases. Am J Obstet Gynecol. 1987;156(5):1174–9.

    Article  PubMed  CAS  Google Scholar 

  31. Bosio PM, McKenna PJ, Conroy R, O’Herlihy C. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol. 1999;94(6):978–84.

    PubMed  CAS  Google Scholar 

  32. Sibai BM, Mabie WC. Hemodynamics of preeclampsia. Clin Perinatol. 1991;18(4):727–47.

    Article  PubMed  CAS  Google Scholar 

  33. Dennis AT, Castro J, Carr C, Simmons S, Permezel M, Royse C. Haemodynamics in women with untreated pre-eclampsia. Anaesthesia. 2012;67(10):1105–18. https://doi.org/10.1111/j.1365-2044.2012.07193.x [published Online First: Epub Date]|.

  34. •• Kyung Choi S, Chul Shin J, Gyu Park Y, Yang Park I, Young Kwon J, Sun Ko H, et al. The efficacy of peripartum transthoracic echocardiography in women with preeclampsia. Pregnancy Hypertens. 2017;10:187–91. https://doi.org/10.1016/j.preghy.2017.05.002. This retrospective cohort study demonstrated increased diastolic dysfunction, left ventricular hypertrophy, and occasionally systolic dysfunction in women with preeclampsia

    Article  PubMed  Google Scholar 

  35. • Vaddamani S, Keepanasseril A, Pillai AA, Kumar B. Maternal cardiovascular dysfunction in women with early onset preeclampsia and late onset preeclampsia: a cross-sectional study. Pregnancy Hypertens. 2017;10:247–50. https://doi.org/10.1016/j.preghy.2017.10.010 [published Online First: Epub Date]|. Patients with early onset preeclampsia have more altered LV geometry, diastolic dysfunction and impaired myocardial contractility compared to those with late onset preeclampsia.

  36. • Soma-Pillay P, Louw MC, Adeyemo AO, Makin J, Pattinson RC. Cardiac diastolic function after recovery from pre-eclampsia. Cardiovasc J Afr. 2017;28:1–6. https://doi.org/10.5830/CVJA-2017-031 [published Online First: Epub Date]|. Patients with early onset preeclampsia have an increased risk of diastolic dysfunction regardless of the presence of chronic hypertension.

  37. Borges VTM, Zanati SG, PeraColi MTS, et al. Maternal hypertrophy and diastolic disfunction and brain natriuretic peptide concentration in early and late pre-eclampsia. Ultrasound Obstet Gynecol. 2017; https://doi.org/10.1002/uog.17495 [published Online First: Epub Date]|.

  38. Muthyala T, Mehrotra S, Sikka P, Suri V. Maternal cardiac diastolic dysfunction by Doppler echocardiography in women with preeclampsia. J Clin Diagn Res 2016;10(8):QC01–3 doi: https://doi.org/10.7860/JCDR/2016/17840.8220 [published Online First: Epub Date]|.

  39. • Orabona R, Vizzardi E, Sciatti E, Prefumo F, Bonadei I, Valcamonico A, et al. Maternal cardiac function after HELLP syndrome: an echocardiography study. Ultrasound Obstet Gynecol. 2017;50(4):507–13. https://doi.org/10.1002/uog.17358 [published Online First: Epub Date]|. Patients with HELLP syndrome also demonstrate increased risk of diastolic dysfunction, reduced LV ejection fraction and LV remodeling.

  40. • Ambia AM, Morgan JL, Wilson KL, et al. Frequency and consequences of ventricular hypertrophy in pregnant women with treated chronic hypertension. Am J Obstet Gynecol 2017;217(4):467 e1–67 e6 doi: https://doi.org/10.1016/j.ajog.2017.05.061 [published Online First: Epub Date]|. 1 in 5 women treated for chronic hypertension in the antepartum period will have left ventricular hypertrophy leading to an increased incidence of superimposed preeclampsia and preterm delivery.

  41. • Timpka S, Macdonald-Wallis C, Hughes AD, Chaturvedi N, Franks PW, Lawlor DA, et al. Hypertensive disorders of pregnancy and offspring cardiac structure and function in adolescence. J Am Heart Assoc. 2016;5(11):e003906. https://doi.org/10.1161/JAHA.116.003906 [published Online First: Epub Date]|. Offspring of patients with preeclampsia or gestational hypertension had greater relative wall thickness and small LV end diastolic volume on echocardiography at ~17 years of age.

  42. • Mutlu K, Karadas U, Yozgat Y, et al. Echocardiographic evaluation of cardiac functions in newborns of mildly preeclamptic pregnant women within postnatal 24–48 hours. J Obstet Gynaecol 2018;38(1):16–21 doi: https://doi.org/10.1080/01443615.2017.1322564 [published Online First: Epub Date]|. Early echocardiography at 24-48 hours of postnatal life in neonates whose mothers had preeclampsia demonstrated elongation in right and left ventricle myocardial performance index, but no changes in systolic or diastolic function.

  43. • Caglar FN, Ozde C, Bostanci E, et al. Assessment of right heart function in preeclampsia by echocardiography. Pregnancy Hypertens. 2016;6(2):89–94. https://doi.org/10.1016/j.preghy.2015.12.004 [published Online First: Epub Date]|. Right heart function is altered in patients with preeclampsia

  44. • Orabona R, Vizzardi E, Sciatti E, Bonadei I, Valcamonico A, Metra M, et al. Insights into cardiac alterations after pre-eclampsia: an echocardiographic study. Ultrasound Obstet Gynecol. 2017;49(1):124–33. https://doi.org/10.1002/uog.15983 [published Online First: Epub Date]|. Patients with early onset preeclampsia are more likely to have subclinical impairment of systolic biventricular function than those with late onset preeclampsia or controls.

  45. • Li W, Li H, Long Y. Clinical characteristics and long-term predictors of persistent left ventricular systolic dysfunction in peripartum cardiomyopathy. Can J Cardiol 2016;32(3):362–368 doi: https://doi.org/10.1016/j.cjca.2015.07.733 [published Online First: Epub Date]|. Large retrospective cohort study demonstrating that preeclampsia was not a predictor of LVEF recovery in patients with peripartum cardiomyopathy.

  46. • Blauwet LA, Delgado-Montero A, Ryo K, Marek JJ, Alharethi R, Mather PJ, et al. Right ventricular function in peripartum cardiomyopathy at presentation is associated with subsequent left ventricular recovery and clinical outcomes. Circ Heart Fail. 2016;9(5):e002756. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002756 [published Online First: Epub Date]|. Right ventricular function predicts left ventricular recovery in patients with PPCM

  47. Karaye KM. Right ventricular systolic function in peripartum and dilated cardiomyopathies. Eur J Echocardiogr. 2011;12(5):372–4. https://doi.org/10.1093/ejechocard/jer024 [published Online First: Epub Date]|.

  48. • Haghikia A, Rontgen P, Vogel-Claussen J, et al. Prognostic implication of right ventricular involvement in peripartum cardiomyopathy: a cardiovascular magnetic resonance study. ESC Heart Fail. 2015;2(4):139–49. https://doi.org/10.1002/ehf2.12059 [published Online First: Epub Date]|. German cohort demonstrated improved outcomes of PPCM in the setting of HDP

  49. Blauwet LA, Cooper LT. Diagnosis and management of peripartum cardiomyopathy. Heart 2011;97(23):1970–81 doi: https://doi.org/10.1136/heartjnl-2011-300349 1981.

  50. • Shahul S, Medvedofsky D, Wenger JB, Nizamuddin J, Brown SM, Bajracharya S, et al. Circulating antiangiogenic factors and myocardial dysfunction in hypertensive disorders of pregnancy. Hypertension. 2016;67(6):1273–80. https://doi.org/10.1161/HYPERTENSIONAHA.116.07252 [published Online First: Epub Date]|. sFlt-1 levels were associated with increased cardiac dysfunction in patients with HDP

  51. . Agrawal S, Cerdeira AS, Redman C, Vatish M. Meta-analysis and systematic review to assess the role of soluble FMS-like tyrosine kinase-1 and placenta growth factor ratio in prediction of preeclampsia: the SaPPPhirE study. Hypertension. 2018;71(2):306–16. https://doi.org/10.1161/HYPERTENSIONAHA.117.10182.

    Article  PubMed  CAS  Google Scholar 

  52. Patten IS, Rana S, Shahul S, Rowe GC, Jang C, Liu L, et al. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature. 2012;485(7398):333–8. https://doi.org/10.1038/nature11040 [published Online First: Epub Date]|.

  53. Mebazaa A, Seronde MF, Gayat E, Tibazarwa K, Anumba DOC, Akrout N, et al. Imbalanced angiogenesis in peripartum cardiomyopathy—diagnostic value of placenta growth factor. Circ J. 2017;81(11):1654–61. https://doi.org/10.1253/circj.CJ-16-1193 [published Online First: Epub Date]|.

  54. •• Damp J, Givertz MM, Semigran M, Alharethi R, Ewald G, Felker GM, et al. Relaxin-2 and soluble Flt1 levels in peripartum cardiomyopathy: results of the multicenter IPAC study. JACC Heart Fail. 2016;4(5):380–8. https://doi.org/10.1016/j.jchf.2016.01.004. Prospective cohort study demonstrated worse PPCM outcomes in the setting of elevated sFlt-1 levels

    Article  PubMed  PubMed Central  Google Scholar 

  55. Hilfiker-Kleiner D, Kaminski K, Podewski E, Bonda T, Schaefer A, Sliwa K, et al. A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy. Cell. 2007;128(3):589–600. https://doi.org/10.1016/j.cell.2006.12.036 [published Online First: Epub Date]|.

  56. • Leanos-Miranda A, Campos-Galicia I, Ramirez-Valenzuela KL, Chinolla-Arellano ZL, Isordia-Salas I. Circulating angiogenic factors and urinary prolactin as predictors of adverse outcomes in women with preeclampsia. Hypertension. 2013;61(5):1118–25. https://doi.org/10.1161/HYPERTENSIONAHA.111.00754 [published Online First: Epub Date]|. sFlt-1/PIGF and sEng, along with urinary prolactin may be predictive of adverse maternal outcomes in preeclampsia

  57. Hilfiker-Kleiner D, Haghikia A, Berliner D, Vogel-Claussen J, Schwab J, Franke A, et al. Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur Heart J. 2017;38(35):2671–9. https://doi.org/10.1093/eurheartj/ehx355 [published Online First: Epub Date]|. RCT demonstrating that bromocriptine (to reduce prolactin anti-angiogenic effect) did not improve outcomes in PPCM

  58. Taylor BD, Ness RB, Klebanoff MA, Zoh R, Bass D, Hougaard DM, et al. First and second trimester immune biomarkers in preeclamptic and normotensive women. Pregnancy Hypertens. 2016;6(4):388–93. https://doi.org/10.1016/j.preghy.2016.09.002 [published Online First: Epub Date]|.

  59. Charkiewicz K, Jasinska E, Goscik J, et al. Angiogenic factor screening in women with mild preeclampsia—new and significant proteins in plasma. Cytokine. 2017; https://doi.org/10.1016/j.cyto.2017.10.020 [published Online First: Epub Date]|.

  60. Kaitu’u-Lino TJ, Brownfoot FC, Hastie R, et al. Activating transcription factor 3 is reduced in preeclamptic placentas and negatively regulates sFlt-1 (soluble fms-like tyrosine kinase 1), soluble endoglin, and proinflammatory cytokines in placenta. Hypertension. 2017;70(5):1014–24. https://doi.org/10.1161/HYPERTENSIONAHA.117.09548.

    Article  PubMed  CAS  Google Scholar 

  61. Yang Y, Su X, Xu W, Zhou R. Interleukin-18 and interferon gamma levels in preeclampsia: a systematic review and meta-analysis. Am J Reprod Immunol. 2014;72(5):504–14. https://doi.org/10.1111/aji.12298 [published Online First: Epub Date]|.

  62. Agachan B, Attar R, Isbilen E, et al. Association of monocyte chemotactic protein-1 and CC chemokine receptor 2 gene variants with preeclampsia. J Interf Cytokine Res. 2010;30(9):673–6. https://doi.org/10.1089/jir.2010.0008.

    Article  CAS  Google Scholar 

  63. Ricke-Hoch M, Bultmann I, Stapel B, et al. Opposing roles of Akt and STAT3 in the protection of the maternal heart from peripartum stress. Cardiovasc Res. 2014;101(4):587–96. https://doi.org/10.1093/cvr/cvu010.

    Article  PubMed  CAS  Google Scholar 

  64. • Luo ZC, Julien P, Wei SQ, et al. Association of pre-eclampsia with SOD2 Ala16Val polymorphism among mother-father-infant triads. Int J Gynecol Obstet. 2018; https://doi.org/10.1002/ijgo.12528. SOD2 polymorphism is associated with preeclampsia lending credence to a role for dysfunctional free radical production

  65. Aouache R, Biquard L, Vaiman D, Miralles F. Oxidative stress in preeclampsia and placental diseases. Int J Mol Sci. 2018;19(5) https://doi.org/10.3390/ijms19051496.

  66. Akil MA, Bilik MZ, Yildiz A, Acet H, Ertas F, Simsek H, et al. Peripartum cardiomyopathy in Turkey: experience of three tertiary centres. J Obstet Gynaecol. 2016;36(5):574–80. https://doi.org/10.3109/01443615.2015.1107531 [published Online First: Epub Date]|.

  67. Goland S, Modi K, Bitar F, Janmohamed M, Mirocha JM, Czer LSC, et al. Clinical profile and predictors of complications in peripartum cardiomyopathy. J Card Fail. 2009;15(8):645–50. https://doi.org/10.1016/j.cardfail.2009.03.008 [published Online First: Epub Date]|.

  68. Lu CH, Lee WC, Wu M, Chen SW, Yeh JK, Cheng CW, et al. Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy: a 15-year nationwide population-based study in Asia. Medicine. 2017;96(19):e6898. https://doi.org/10.1097/MD.0000000000006898 [published Online First: Epub Date]|.

  69. • van Oostwaard MF, Langenveld J, Schuit E, et al. Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis. Am J Obstet Gynecol 2015;212(5):624 e1–17 doi: https://doi.org/10.1016/j.ajog.2015.01.009. The recurrence risk of HDP in future pregnancies is approximately 20%.

  70. Seeho SK, Algert CS, Roberts CL, Ford JB. Early-onset preeclampsia appears to discourage subsequent pregnancy but the risks may be overestimated. Am J Obstet Gynecol. 2016;215(6):785 e1–85 e8. https://doi.org/10.1016/j.ajog.2016.07.038.

    Article  PubMed  Google Scholar 

  71. Fett JD, Fristoe KL, Welsh SN. Risk of heart failure relapse in subsequent pregnancy among peripartum cardiomyopathy mothers. Int J Gynaecol Obstet. 2010;109(1):34–6. https://doi.org/10.1016/j.ijgo.2009.10.011 [published Online First: Epub Date]|.

  72. de Souza JL Jr, de Carvalho Frimm C, Nastari L, Mady C. Left ventricular function after a new pregnancy in patients with peripartum cardiomyopathy. J Card Fail. 2001;7(1):30–5. https://doi.org/10.1054/jcaf.2001.22424 [published Online First: Epub Date]|.

  73. Mandal D, Mandal S, Mukherjee D, Biswas SC, Maiti TK, Chattopadhaya N, et al. Pregnancy and subsequent pregnancy outcomes in peripartum cardiomyopathy. J Obstet Gynaecol Res. 2011;37(3):222–7. https://doi.org/10.1111/j.1447-0756.2010.01378.x [published Online First: Epub Date]|.

  74. • Codsi E, Rose CH, Blauwet LA. Subsequent pregnancy outcomes in patients with peripartum cardiomyopathy. Obstet Gynecol 2018;131(2):322–27 doi: https://doi.org/10.1097/AOG.0000000000002439. There is an approximately 20% recurrence risk of PPCM in subsquent pregnancies.

  75. Guldbrandt Hauge M, Johansen M, Vejlstrup N, Gustafsson F, Damm P, Ersboll AS. Subsequent reproductive outcome among women with peripartum cardiomyopathy: a nationwide study. BJOG. 2017; https://doi.org/10.1111/1471-0528.15046 [published Online First: Epub Date]|.

  76. • Hilfiker-Kleiner D, Haghikia A, Masuko D, Nonhoff J, Held D, Libhaber E, et al. Outcome of subsequent pregnancies in patients with a history of peripartum cardiomyopathy. Eur J Heart Fail. 2017;19(12):1723–8. https://doi.org/10.1002/ejhf.808 [published Online First: Epub Date]|. Prolactin and free radical damage play a key role in development of PPCM

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mayo Clinic, 200 1st Street South West, Rochester, MN, 55905, USA

    Pavan Parikh

  2. Department of Cardiovascular Medicine, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA

    Lori Blauwet

Authors
  1. Pavan Parikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lori Blauwet
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pavan Parikh.

Ethics declarations

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Preeclampsia

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parikh, P., Blauwet, L. Peripartum Cardiomyopathy and Preeclampsia: Overlapping Diseases of Pregnancy. Curr Hypertens Rep 20, 69 (2018). https://doi.org/10.1007/s11906-018-0868-9

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11906-018-0868-9

Keywords

Search

Navigation