Elevated follow-up CRP and BNP levels predicted nonrecovery in peripartum cardiomyopathy, where the overall cohort had 57.7% complete recovery, 23.1% persistent dysfunction, and 19.2% mortality.
Cohort (n=52)
Do serial assessments of clinical, echocardiographic, and biochemical markers predict early or delayed recovery in women with peripartum cardiomyopathy?
Persistent elevation of CRP and BNP at 3 and 6 months predicts slower or non-recovery in peripartum cardiomyopathy, while bromocriptine therapy is associated with early recovery.
Background: Predictors of early or delayed recovery are unclear in peripartum cardiomyopathy (PPCM). Therefore, we aimed to assess the prognostic value of serial assessment of clinical, echocardiographic, and biochemical markers in patients with PPCM.Methods: Fifty-two consecutive women with PPCM were enrolled in this prospective study. Each patient underwent transthoracic echocardiography, B-type natriuretic peptide (BNP) and C-reactive protein (CRP) measurement at admission, and every 3 months. Early recovery was defined as resolution of heart failure at 6 months postdiagnosis, delayed recovery was defined if the length of time required for recovery of left ventricular function was longer than 6 months, and persistent left ventricular dysfunction (PLVD) was defined as an ejection fraction of less than 50% at the end of follow-up.Results: Thirty patients (57.7%) recovered completely, 10 died (19.2%), and 12 (23.1%) had PLVD. There were no significant differences in baseline BNP and CRP values between patients who recovered completely and who did not recover. However, patients with complete recovery were more likely to have a higher left ventricular ejection fraction, smaller left ventricle end-systolic dimensions at baseline, and lower CRP and BNP levels at follow-up. Elevated levels of BNP and CRP on follow up at 3 and 6 months were associated with nonrecovery. Third and sixth month BNP values were significantly lower in patients with rapid recovery, compared to patients with delayed recovery. Bromocriptine therapy was also associated with early recovery.Conclusions: Persistent elevation of plasma CRP and BNP levels at follow-up portend a slower response or nonrecovery in patients with PPCM. Bromocriptine therapy was an independent predictor of early recovery.
Biteker et al. (Wed,) conducted a cohort in Peripartum cardiomyopathy (n=52). Elevated BNP and CRP levels at follow-up vs. Lower BNP and CRP levels was evaluated on Complete recovery, delayed recovery, or persistent left ventricular dysfunction. Elevated follow-up CRP and BNP levels predicted nonrecovery in peripartum cardiomyopathy, where the overall cohort had 57.7% complete recovery, 23.1% persistent dysfunction, and 19.2% mortality.