Congestive Heart FailureMyocarditis and long-term survival in peripartum cardiomyopathy☆
Section snippets
Patients
All patients undergoing endomyocardial biopsy at The Johns Hopkins Hospital between 1983 and 1998 with a diagnosis of possible PPCM were retrospectively reviewed. Patients were included if they met the following criteria: (1) onset of left ventricular dysfunction in the last month of pregnancy or the first 5 months after delivery, (2) no evidence of preexisting left ventricular dysfunction, (3) no other explanation for left ventricular dysfunction, and (4) initial evaluation within 2 years of
Patient characteristics
Clinical and obstetric characteristics are shown in Table I.Age (y) 29 ± 6 Race White 52% Black 46% Hispanic 2% Parity 1 47% 2 24% 3 13% >3 16% Multiple gestations Single 88% Twin 12% Type of delivery Vaginal 62% Cesarean 38% Hypertension* Chronic 17% Gestational 26% Eclampsia/preeclampsia 0% None 57% Diabetes mellitus Gestational 2% None 98% Alcohol use During pregnancy 7% Before pregnancy 2% None 91% Tobacco use During pregnancy 40% None 60% *Chronic, Blood pressure >140/90 before 20 weeks of
Discussion
The current study is the largest reported series of patients with PPCM that used strict diagnostic criteria. This series attempts to determine the long-term survival, assess the prevalence of myocarditis, and identify factors associated with prognosis in a relatively large series of patients who have undergone a standardized clinical evaluation at a single institution. The natural history of PPCM is variable, with some patients demonstrating recovery of left ventricular function and others
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Reprint requests: Kenneth L. Baughman, MD, Division of Cardiology, Blalock 568, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. E-mail: [email protected]