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Peripartum Cardiomyopathy

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Maternal and Fetal Cardiovascular Disease

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Abstract

Peripartum cardiomyopathy (PPCM) is a specific cardiomyopathy in which heart failure develops during pregnancy or in the postpartum period in women without a history of heart disease, and reduced myocardial contraction is found on examination. The frequency of this condition is low in routine medical practice, but it should be included in differential diagnosis for pregnant and postpartum women who complain of dyspnea and excessive edema because it may lead to maternal death in severe cases. Advanced age, grand multipara, multiple conception, hypertensive disorders in pregnancy (HDP), and use of tocolytic agents are known risk factors. Especially, HDP is the strongest risk factor and complicates in about 40% of PPCM patients. A Japanese survey found that PPCM patients with HDP tended to have better long-term outcomes than those without. In contrast, PPCM patients with truncating variants associated with dilated cardiomyopathy (DCM) tended to have lower cardiac function in long-term than those without. Basic studies in animals and genetic analyses have recently been reported, and an association between vascular disorder such as HDP cardiomyopathy is currently attracting attention. Since “peripartum cardiomyopathy” is a diagnosis of exclusion, it indicates that PPCM is a group of heterogeneous conditions.

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References

  1. Demakis JG, Rahimtoola SH (1971) Peripartum cardiomyopathy. Circulation 44:964–968

    Article  CAS  Google Scholar 

  2. Sliwa K, Hilfiker-Kleiner D, Petrie MC et al (2010) 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 12:767–778

    Article  Google Scholar 

  3. Tomoike H, Izumi T, Imaizumi T et al (2016) Guidelines for management of dilated cardiomyopathy and secondary cardiomyopathy (JCS 2011). Circ J 80:753–774. http://www.j-circ.or.jp/form/kankoubutsu/guuideline_index.htm

  4. Elkayam U, Akhter MW, Singh H et al (2005) Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation 111(16):2050–2055

    Article  Google Scholar 

  5. Halkein J, Tabruyn SP, Ricke-Hoch M et al (2013) MicroRNA-146a is a therapeutic target and biomarker for peripartum cardiomyopathy. J Clin Invest 123:2143–2154

    Article  CAS  Google Scholar 

  6. Kamiya CA, Kitakaze M, Ishibashi-Ueda H et al (2011) Different characteristics of peripartum cardiomyopathy between patients complicated with and without hypertensive disorders. Results from the Japanese Nationwide survey of peripartum cardiomyopathy. Circ J 75:1975–1981

    Article  Google Scholar 

  7. Haghikia A, Podewski E, Libhaber E et al (2013) Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy. Basic Res Cardiol 108:366

    Article  CAS  Google Scholar 

  8. McNamara DM, Elkayam U, Alharethi R, Damp J, Hsich E, Ewald G et al (2015) Clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy). J Am Coll Cardiol 66:905–914

    Article  Google Scholar 

  9. Sliwa K, Fett J, Elkayam U (2006) Peripartum cardiomyopathy. Lancet 368:687–693

    Article  Google Scholar 

  10. Sliwa K, Forster O, Libhaber E, Fett JD, Sundstrom JB, Hilfiker-Kleiner D, Ansari AA (2006) Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J 27:441–446

    Article  CAS  Google Scholar 

  11. Kamiya CA, Yoshimatsu J, Ikeda T (2016) Peripartum cardiomyopathy from a genetic perspective. Circ J 80:1684–1688

    Article  Google Scholar 

  12. Pearson GD, Veille JC, Rahimtoola S et al (2000) Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA 283:1183–1188

    Article  CAS  Google Scholar 

  13. Hilfiker-Kleiner D, Kaminski K, Podewski E et al (2007) A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy. Cell 128:589–600

    Article  CAS  Google Scholar 

  14. Patten IS, Rana S, Shahul S et al (2012) Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature 485:333–338

    Article  CAS  Google Scholar 

  15. Morales A et al (2010) Rare variant mutations in pregnancy-associated or peripartum cardiomyopathy. Criculation 121:2176–2182

    Article  CAS  Google Scholar 

  16. van Spaendonck-Zwarts KY, van Tintelen JP, van Veldhuisen DJ et al (2010) Peripartum cardiomyopathy as a part of familial dilated cardiomyopathy. Circulation 121:2169–2175

    Article  Google Scholar 

  17. Ware JS, Li J, Mazaika E et al (2016) Shared genetic predisposition in peripartum and dilated cardiomyopathies. N Engl J Med 374:233–241

    Article  CAS  Google Scholar 

  18. Sliwa K, Blauwet L, Tibazarwa K et al (2010) Evaluation of bromocriptine in the treatment of acute severe peripartum cardiomyopathy: a proof-of-concept pilot study. Circulation 121:1465–1473

    Article  CAS  Google Scholar 

  19. Arrigo M, Blet A, Mebazaa A (2017) Bromocriptine for the treatment of peripartum cardiomyopathy: welcome on BOARD. Eur Heart J 38(35):2680–2682

    Article  Google Scholar 

  20. Demakis JG, Rahimtoola SH, Sutton GC et al (1971) Natural course of peripartum cardiomyopathy. Circulation 44:1053–1061

    Article  CAS  Google Scholar 

  21. van Spaendonck-Zwarts KY, Posafalvi A, van den Berg MP et al (2014) Titin gene mutations are common in families with both peripartum cardiomyopathy and dilated cardiomyopathy. Eur Heart J 35:2165–2173

    Article  Google Scholar 

  22. Elkayam U (2014) Risk of subsequent pregnancy in women with a history of peripartum cardiomyopathy. J Am Coll Cardiol 64:1629–1636

    Article  Google Scholar 

  23. Regitz-Zagrosek V, Lundqvist CB, Borghi C et al (2011) ESC guidelines on the management of cardiovascular diseases during pregnancy. Eur Heart J 32:3147–3197

    Article  Google Scholar 

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Authors and Affiliations

  1. The Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Chizuko Aoki-Kamiya

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  1. Chizuko Aoki-Kamiya
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Correspondence to Chizuko Aoki-Kamiya .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie, Japan

    Tomoaki Ikeda

  2. Department of Perinatology and Gynecology, National Cerebral and Cardiovascul Center, Suita, Osaka, Japan

    Chizuko Aoki-Kamiya

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Aoki-Kamiya, C. (2019). Peripartum Cardiomyopathy. In: Ikeda, T., Aoki-Kamiya, C. (eds) Maternal and Fetal Cardiovascular Disease. Springer, Singapore. https://doi.org/10.1007/978-981-10-1993-7_11

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  • DOI: https://doi.org/10.1007/978-981-10-1993-7_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-1991-3

  • Online ISBN: 978-981-10-1993-7

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