Key result
Markedly elevated CRP in peripartum cardiomyopathy correlates with lower LVEF and higher mortality.
Why the study?
Do elevated inflammatory markers (CRP, TNF-α, IL6) predict mortality and worse echocardiographic parameters in patients with peripartum cardiomyopathy?
Case-Control (n=86)
Do elevated inflammatory markers (CRP, TNF-α, IL6) predict mortality and worse echocardiographic parameters in patients with peripartum cardiomyopathy?
Elevated inflammatory markers (CRP, TNF-α, IL6) in peripartum cardiomyopathy correlate with worse left ventricular function and serve as predictors of mortality, suggesting inflammation plays a role in its pathogenesis.
Elevated CRP associated with mortality and lower EF in peripartum cardiomyopathy; hypothesis-generating for inflammation but requires prospective validation.
Peripartum cardiomyopathy (PPCM) is a disorder of unknown aetiology. We correlated plasma levels of C-reactive protein TNF-α and IL6 as prognostic value for major clinical in-hospital events and 6-month follow-up in patients with PPCM. A total of 86 subjects were enrolled [patients (n-46) and controls (n-40)]. Clinical assessment, echocardiography, and blood analysis and inflammatory markers (C-reactive protein, TNF-α and IL6) were measured at baseline and at 6 months. The baseline characteristics of the study population at first presentation are similar (compared with controls) 0.91% were diagnosed as PPCM patients for the first time and 49% patients presented within 1 month after delivery. C-reactive protein (22 mg/dl vs 08 mg/dl), TNF-α (9.6 vs 3.2 pg/dl) and IL6 were (73.19 ± 34.4 vs 31.52 ± 8.83 pg/dl) which were significantly abnormal, and these patients showed a significant higher LV dimensions LV EDD (61.6 ± 7.1 mm vs 46 ± 9 mm), LV ESD (53.1 ± 7 vs 32 ± 8) and significant lower echocardiography LVEF (25.9 ± 8.2 vs 55 ± 12) and well correlate with NYHA FC and death. LVEF improved from 25.9 ± 8.2 to 42.9 + 13.6% at 6 months (P < 0.0001). LVEF (>50%) was only observed in 11 (35%) patients. Seven patients died within 6 months of diagnoses. Inflammatory markers like CRP, IL6 TNF-α were significantly elevated in PPCM patients and correlated with increased LV dimensions and lower EF and higher NYHA FC were the only predictors of mortality at presentation and inflammation may contribute to the pathogenesis of PPCM and its complications.
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Shanker et al. (2012) conducted a case-control in Peripartum cardiomyopathy (n=86). Peripartum cardiomyopathy vs. Controls was evaluated on Baseline C-reactive protein (mg/dl). Patients with peripartum cardiomyopathy had significantly elevated C-reactive protein (22 vs 8 mg/dl) compared to controls, which correlated with lower ejection fraction and mortality.
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