RELATIONSHIP BETWEEN LEFT VENRICULAR EJECTION …
RELATIONSHIP BETWEEN LEFT VENRICULAR EJECTION FRACTION AND RECOVERY OF VENTRICULAR FUNCTION IN WOMEN WITH PERIPARTUM CARDIOMYOPATHY
U. Elkayam
University of Southern California, Los Angeles, USA
Background: PPCM is an idiopathic form of pregnancy associated cardiomyopathy presenting with a marked depression of LV systolic function. Prediction of early recovery of cardiac function or its failure can have important implications on management strategies.
Methods: We analyzed baseline parameters of LV ejection fraction (LVEF) in 187 PPCM patients with ≥ 6 months follow up data in an attempt to detect the value of this parameter as a predictor of early (6 months) recovery of LV systolic function.
Results: At 6 months after diagnoses, 115 patients (61%) demonstrated recovery of LV function (LVEF ≥ 50%) and 39% did not. Multivariate analysis identified baseline LVEF > 30% as a significant predictor for recovery of LV systolic function at 6 months (OR = 5.2, CI: 1.96 – 7.70, p>0.0001), Recovery of LV function was 6.4 fold higher in women with baseline LVEF of ≥ 30% (group III) and 3.9 fold higher in women with EF 20%-29% (group II) compared to those with LVEF of 10%-19% (Group I). Failure to achieve full recovery was seen in 63% of group I and 32% of group II patients (p=0.03) and 21% of group III patients (p=0.02 vs. group I). Failure to achieve LVEF of ≥ 30% was seen in 30% of group I patients and 13% of group II (p=0.09).
Conclusions: Persistent LV dysfunction is significantly more common in patients with more severe myocardial insult at time of diagnosis.
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