Abstract:
BACKGROUND:There is limited data on electrocardiographic (ECG) abnormalities and their prognostic significance in women with peripartum cardiomyopathy (PPCM). We sought to characterize ECG findings in PPCM and explore the association of ECG findings with myocardial recovery and clinical outcomes. HYPOTHESIS:We hypothesized that ECG indicators of myocardial remodeling would portend worse systolic function and outcomes. METHODS:Standard 12-lead ECGs were obtained at enrollment in the Investigations of Pregnancy-Associated Cardiomyopathy study and analyzed for 88 women. Left ventricular ejection fraction (LVEF) was measured by echocardiography at baseline, 6 months, and 12 months. Women were followed for clinical events (death, mechanical circulatory support, and/or cardiac transplantation) until 1 year. RESULTS:Half of women had an "abnormal" ECG, defined as atrial abnormality, ventricular hypertrophy, ST-segment deviation, and/or bundle branch block. Women with left atrial abnormality (LAA) had lower LVEF at 6 months (44% vs 52%, P = 0.02) and 12 months (46% vs 54%, P = 0.03). LAA also predicted decreased event-free survival at 1 year (76% vs 97%, P = 0.008). Neither left ventricular hypertrophy by ECG nor T-wave abnormalities predicted outcomes. A normal ECG was associated with recovery in LVEF to ≥50% (84% vs 49%, P = 0.001) and event-free survival at 1 year (100% vs 85%, P = 0.01). CONCLUSIONS:ECG abnormalities are common in women with PPCM, but a normal ECG does not rule out the presence of PPCM. LAA predicted lower likelihood of myocardial recovery and event-free survival, and a normal ECG predicted favorable event-free survival.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Honigberg MC,Elkayam U,Rajagopalan N,Modi K,Briller JE,Drazner MH,Wells GL,McNamara DM,Givertz MM,IPAC Investigators.doi
10.1002/clc.23171subject
Has Abstractpub_date
2019-05-01 00:00:00pages
524-529issue
5eissn
0160-9289issn
1932-8737journal_volume
42pub_type
杂志文章,多中心研究abstract::The designation of atherosclerosis as a chronic inflammatory process represents an exciting and logical paradigm shift for cardiologists. Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the recruitment and activation of monocytes and thus in the development of atherosclerosis. Enhanced MCP-1 expr...
journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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