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. 2006 Feb;27(4):441-6.
doi: 10.1093/eurheartj/ehi481. Epub 2005 Sep 5.

Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients

Karen Sliwa  1 , Olaf Förster, Elena Libhaber, James D Fett, Jay Bruce Sundstrom, Denise Hilfiker-Kleiner, Aftab A Ansari
Affiliations

Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients

Karen Sliwa et al. Eur Heart J. 2006 Feb.

Abstract

Aims: Peripartum cardiomyopathy (PPCM) is a disorder of unknown aetiology with a course and outcome that is largely unpredictable. We evaluated the prognostic role of multiple inflammatory markers in the plasma of a large cohort of African patients with PPCM.

Methods and results: The study of 100 patients with newly diagnosed PPCM was single-centred, prospective, and longitudinal. Clinical assessment, echocardiography, and blood analysis were done at baseline and after 6 months of standard therapy. Inflammatory markers were measured at baseline only. Fifteen patients died. Left ventricular ejection fraction (LVEF) improved from 26.2+/-8.2 to 42.9+/-13.6% at 6 months (P<0.0001). However, normalization of LVEF (>50%) was only observed in 23%. Baseline levels of C-reactive protein correlated positively with baseline LV end-diastolic (rs=0.33, P=0.0026) and end-systolic (rs=0.35, P=0.0012) diameters and inversely with LVEF (rs=-0.27, P=0.015). Patients who died presented with significantly lower mean EF and higher Fas/Apo-1 plasma values (P<0.05). Fas/Apo-1 and New York Heart Association functional class (NYHA FC) predicted mortality at baseline.

Conclusion: Plasma markers of inflammation were significantly elevated and correlated with increased LV dimensions and lower LVEF at presentation. Baseline Fas/Apo-1 and higher NYHA FC were the only predictors of mortality. Normalization of LVEF was only observed in 23% of this African cohort.

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