Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy

Eur J Heart Fail. 2010 Aug;12(8):767-78. doi: 10.1093/eurjhf/hfq120.

Abstract

Peripartum cardiomyopathy (PPCM) is a cause of pregnancy-associated heart failure. It typically develops during the last month of, and up to 6 months after, pregnancy in women without known cardiovascular disease. The present position statement offers a state-of-the-art summary of what is known about risk factors for potential pathophysiological mechanisms, clinical presentation of, and diagnosis and management of PPCM. A high index of suspicion is required for the diagnosis, as shortness of breath and ankle swelling are common in the peripartum period. Peripartum cardiomyopathy is a distinct form of cardiomyopathy, associated with a high morbidity and mortality, but also with the possibility of full recovery. Oxidative stress and the generation of a cardiotoxic subfragment of prolactin may play key roles in the pathophysiology of PPCM. In this regard, pharmacological blockade of prolactin offers the possibility of a disease-specific therapy.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Cardiology / trends*
  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / etiology
  • Cathepsin D
  • Europe
  • Female
  • Humans
  • Incidence
  • Inflammation
  • Natriuretic Peptide, Brain
  • Oxidative Stress
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / drug therapy
  • Pregnancy Complications / etiology
  • Prognosis
  • Prolactin / antagonists & inhibitors
  • Prolactin / drug effects
  • Risk Factors
  • Societies, Medical / trends

Substances

  • Antihypertensive Agents
  • Natriuretic Peptide, Brain
  • Prolactin
  • Cathepsin D