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Clinical characteristics and risk factors for peripartum cardiomyopathy.

BACKGROUND
Peripartum cardiomyopathy (PPCM) is a potentially fatal form of heart failure and the recognition of its risk factors is important for prevention and treatment.


OBJECTIVE
To explore the clinical characteristics and the risk factors for PPCM.


METHODS
Echocardiographic was used to examine the left ventricular ejection fraction (LVEF). Blood level of troponin I (cTNI), high sensitive C-reaction protein (hs-CRP), NT-proBNP was measured. All PPCM occurred within weeks following delivery.


RESULTS
Fifty-two PPCM patients and 52 normal delivery subjects (control group) were included in this study. Compared with the control group, PPCM patients were older, with a higher level of blood pressure, and a higher rate of suspected respiratory infection. The level of leucocytes, hs-CRP, cTNI and NT-proBNP in PPCM patients were higher than in the control. Multivariate logistic regression analysis showed that elevated plasma hs-CRP (OR =1.86, p<0.05), respiratory infection (OR = 2.87, p<0.01), and hypertension (OR =1.68, p < 0.05) were independent risk factors for PPCM. During the follow up of 21.6±5.4 d, one patient (1.9%) died probably of heart failure but other patients remained well.


CONCLUSION
Hypertension, respiratory infection, and elevated plasma hs-CRP seem to be associated with the pathogenesis of peripartum cardiomyopathy in this patient population.