Key result
In a prospective registry of women with peripartum cardiomyopathy in Senegal, 50.6% achieved complete left ventricular recovery at 2 years, though advanced age and severe baseline impairment predicted non-recovery.
Why the study?
Peripartum cardiomyopathy is common in Africa with variable progression, but few prospective cohort studies exist in sub-Saharan Africa.
Observational (n=79)
No
In a sub-Saharan African cohort, peripartum cardiomyopathy showed a 50.6% complete remission rate at 2 years with standard heart failure therapy, though advanced age and severe baseline LV impairment predicted non-recovery.
Variable PPCM recovery (50% at 2 years) with 7% mortality in Senegal; leaves open predictors and management strategies for sub-Saharan cohorts.
Introduction: Peripartum cardiomyopathy (PPCM) is a rare pathology in Western countries but is common in Africa. Its progression is highly variable, left ventricular function improves in almost one-third to one-half of patients. In sub-Saharan Africa, there are few prospective cohort studies. We aimed to describe the long-term evolutionary aspects of this pathology in a sub-Saharan African country, so we developed a PPCM registry; here, we present the first results after 2 years of follow-up. Methodology: This work was performed at the cardiology clinic of the Aristide Le Dantec Teaching Hospital of Dakar from January 01, 2017, to January 01, 2021, for a total duration of 4 years. This was an observational, longitudinal prospective study including patients admitted for peripartum cardiomyopathy. Results: During our study, 5372 patients were admitted to the cardiology clinic. Considering the inclusion criteria, 79 patients were consecutively recruited. The mean age was 30.5 ± 6.7 years, ranging from 18 to 42 years. Half of the patients came from rural areas (56.3%), and 78.2% of patients had a low socioeconomic status. Multiparity and twin pregnancies were noted in 72.8% and 20% of the patients, respectively. A total of 91% of patients had advanced NYHA stage 4 heart failure, and 3 patients had cardiogenic shock. Left ventricular dilatation was found in 52 patients, and severe left ventricular systolic dysfunction was found in 50 patients (90.9%). During hospitalization, 19 patients (34.5%) had complications. The evolution in the hospital was favourable in 45 patients (81.8%). The global mortality rate was 7.3% at 2 years. In multivariate analysis, fewer patients with a dilated left ventricle, a severe alteration of the LVEF and an advanced age progressed towards remission. Conclusion: The long-term evolution of PPCM is very variable. Despite a good rate of remission, progression to end-stage heart failure and death is not negligible in cases of advanced maternal age and severe left ventricular impairment.
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Aw et al. (2023) conducted an observational in Peripartum cardiomyopathy (n=79). Peripartum cardiomyopathy was evaluated on Complete remission (LVEF ≥ 50%) at 2 years. In a prospective registry of women with peripartum cardiomyopathy in Senegal, 50.6% achieved complete left ventricular recovery at 2 years, though advanced age and severe baseline impairment predicted non-recovery.
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