Key result
Recovered peripartum cardiomyopathy linked to ~16 mmHg higher central aortic systolic blood pressure vs controls.
Why the study?
The status of arterial stiffness and left ventricular function in women recovered from peripartum cardiomyopathy compared with controls was unclear.
Case-Control (n=37)
Single-blind
Yes
Absolute Event Rate: 120% vs 104%
p-value: p=0.001
Vascular monitoring may merit consideration in recovered peripartum cardiomyopathy but should not yet change practice; leaves open long-term prognostic role of arterial stiffness.
BACKGROUND: Peripartum cardiomyopathy (PPCM) is idiopathic pregnancy-associated heart failure (HF) with reduced left ventricular ejection fraction (LVEF). We aimed to assess arterial stiffness and left ventricular (LV) function in women recovered from PPCM compared with controls. METHODS: Twenty-two PPCM patients were compared with 15 age-matched controls with previous uncomplicated pregnancies. Eleven of the patients were at inclusion in the study recovered and off medication since at least 6 months and still free from cardiovascular symptoms with normal LVEF and normal NT-proBNP. All underwent echocardiography, including LV strain, left atrial (LA) reservoir strain and tissue Doppler early diastolic velocity (e´) and non-invasive assessment for arterial stiffness and central aortic systolic blood pressure (AoBP) at rest and immediately postexercise. RESULTS: The patients off medication showed alterations compared with controls. AoBP was higher (120 ± 9 mm Hg vs. 104 ± 13 mm Hg; p = .001), a difference which persisted postexercise. The arterial elastance was higher (1.9 ± 0.4 mm Hg/ml vs. 1.3 ± 0.2 mm Hg/ml; p < .001), while there were lower e´ septal (8.9 ± 1.7 cm/s vs. 11.0 ± 1.1 cm/s; p = 0. 002), LV global strain (18.7 ± 3.9% vs. 23.1 ± 1.6%; p = .004) and LA reservoir strain (24.8 ± 9.1% vs. 37.7 ± 6.3%; p = .002). CONCLUSIONS: Compared with healthy controls, PPCM patients considered recovered and off medication had increased arterial stiffness, decreased LV longitudinal function and reduced LA function.
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Johansson et al. (2020) conducted a case-control in Peripartum cardiomyopathy (n=37). History of peripartum cardiomyopathy vs. Healthy controls with uncomplicated pregnancies was evaluated on Central aortic systolic blood pressure (AoBP) at rest (p=0.001). Women considered recovered from peripartum cardiomyopathy and weaned off medication exhibited significantly higher central aortic systolic blood pressure (120 vs 104 mm Hg) and increased arterial elastance compared to healthy controls.
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