ABSTRACT:
Objective: Peripartum cardiomyopathy (PPCM) diagnosis made by
excluding identifiable causes of heart failure (HF) and occurs end of
the pregnancy or during the postpartum period of five months. It
presents a clinical HF spectrum with left ventricular systolic
dysfunction.
Background: The purpose of this study is to retrospectively
evaluate the clinical characteristics, cardiac magnetic resonance (CMR)
imaging features, and end-points consisting of left ventricle recovery,
left ventricular assist device implantation, heart transplantation, and
all-cause mortality.
Method: Outpatient HF records between 2008 to 2021 were
screened. Thirty-seven patients were defined as PPCM. Twenty-five
patients had CMR evaluation at the time of diagnosis, and six patients
were re-evaluated with CMR.
Results: The mean age was 30.5±5.6 years, and the mean LVEF was
28.2±6.7%. In thirteen(35.7%) patients, LVEF recovered during the
follow-up course. The median recovery time was 281(IQR [78-358])
days. LVEF on CMR was 35.3±10.5, and three patients exhibited late
gadolinium enhancement(LGE) patterns. Sub-endocardial and mid-wall
uptake pattern types were detected. 18(75%) patients met the Petersen
left ventricle non-compaction cardiomyopathy(LVNC) criteria. Patients
with NC/C ratio lower than 2.3 had lower LVEDVi and LVESVi
(124.9±35.4,86.4±7.5, p=0.003;86.8±34.6,52.6±7.6, p=0.006),
respectively. The median follow-up time was 2129 (IQR [911-2634])
days. The primary endpoint-free one-year survival was 88.9%(event rate
11.1%), and five-year survival was 75.7%(event rate 24.3%).
Conclusion: In a retrospective cohort of PPCM patients, 35.7%
of patients’ LVEF recovered, and the primary end-point of free-five-year
survival was 75%. Twenty-five patients were assessed with CMR; three of
four met the Petersen CMR-derived LVNC at initial evaluation.