Efficacy of guideline-based management and recurrence risk in peripartum cardiomyopathy: a multicenter cohort analysis
Abstract
Peripartum cardiomyopathy (PPCM) is a rare, life-threatening condition marked by left ventricular systolic dysfunction (LVEF <45%) occurring in late pregnancy or the postpartum period. Despite advances in management, predictors of recovery and recurrence remain poorly characterized.
This multicenter study assessed clinical outcomes, recovery of LVEF, changes in NT-proBNP and NYHA heart failure functional class, and factors linked to non-recovery in patients with PPCM treated according to contemporary heart failure guidelines.
This observational cohort study (2015–2023) included 98 patients from 4 centres with confirmed PPCM. All patients had a pre-pregnancy or first-trimester LVEF greater than 50%, and a PPCM diagnosis was established based on the presence of NYHA class II-III symptoms, echocardiographic evidence of LVEF <45%, and elevated NT-proBNP levels (≥300 pg/mL). The treatment protocol during pregnancy included beta-blockers administered to 100% of patients, diuretics used in 61%, and spironolactone in 50%. After delivery, therapy was expanded to include ACE inhibitors/ARNI in 69% of patients, SGLT2 inhibitors in 10% and digoxin in 10%.
All patients were followed up for 6 months. At baseline, the mean LVEF was 37.5 ± 3.2%. Patients were retrospectively categorized into two groups: a recovered group (Group 1, n = 40, 41%), which included patients with LVEF either increased by 10% or/and reached 50%, and a non-recovered group (Group 2, n = 58, 59%) with patients with…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 98 participants or records.
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