Electrocardiographic findings in peripartum cardiomyopathy.

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 Cardiol

journal_title

Clinical cardiology

authors

Honigberg MC,Elkayam U,Rajagopalan N,Modi K,Briller JE,Drazner MH,Wells GL,McNamara DM,Givertz MM,IPAC Investigators.

doi

10.1002/clc.23171

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

524-529

issue

5

eissn

0160-9289

issn

1932-8737

journal_volume

42

pub_type

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