Peripartum cardiomyopathy: A 2022 update
Miocardiopatía periparto: una actualización de 2022
Debabrata Dash, Rohit Mody, Sugandhna Reno Malan, Naveed Ahmed, Bhavya Mody
Abstract
Peripartum cardiomyopathy (PPCM) is a rare but life-threatening condition defined by left ventricular dysfunction and heart failure (HF), occurring in late pregnancy or, more commonly, the early postpartum period. In African American women, women with pre-eclampsia, advanced maternal age, and numerous gestation pregnancies, there is a greater incidence. Although the pathophysiology of PPCM is still undetermined, the importance of vasculo-hormonal pathways has been suggested in research over the past decades. Sarcomere genetic polymorphisms are found in at least some women with the disorder. More than 50% of the patients recover systolic function, albeit some are left with chronic cardiomyopathy, and a small minority of patients requires mechanical support or cardiac transplantation, or both. For the diagnosis of PPCM, electrocardiographic findings of decreased myocardial function are essential. Currently, the management of PPCM is limited to standard treatments for HF with reduced ejection fraction, with attention to minimizing the potential adverse effects on the fetus in women who are still pregnant. As a result, the outcome might range from full recovery to persistent HF, arrhythmia, thromboembolic events, or death. Research on PPCM is examined in this review, as are potential future paths for further study.
Keywords
Resumen
La miocardiopatía periparto (PPCM) es una afección rara pero potencialmente mortal que se define por disfunción ventricular izquierda e insuficiencia cardíaca (IC), que ocurre al final del embarazo o, más comúnmente, al comienzo del período posparto. En mujeres afroamericanas, mujeres con preeclampsia, edad materna avanzada y gestaciones numerosas, existe una mayor incidencia. Aunque la fisiopatología de la PPCM aún no se ha determinado, la importancia de las vías vasculohormonales se ha sugerido en la investigación durante las últimas décadas. Los polimorfismos genéticos del sarcómero se encuentran en algunas mujeres afectas con el trastorno. Más del 50% de los pacientes recuperan la función sistólica, aunque algunos quedan con miocardiopatía crónica y, una pequeña minoría de pacientes, requiere soporte mecánico, trasplante cardíaco, o ambos. Para el diagnóstico de PPCM, los hallazgos electrocardiográficos de función miocárdica disminuida son esenciales. Actualmente, el manejo de la PPCM se limita a los tratamientos estándar para la IC con fracción de eyección reducida, con atención a minimizar los posibles efectos adversos sobre el feto en mujeres que aún están embarazadas. Como resultado, el resultado puede variar desde una recuperación total hasta insuficiencia cardíaca persistente, arritmia, eventos tromboembólicos o muerte. En esta revisión se examina la investigación sobre la PPCM, así como las posibles vías futuras para estudios adicionales.
Palabras clave
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Submitted date:
01/30/2022
Reviewed date:
02/26/2022
Accepted date:
03/27/2022
Publication date:
03/28/2022
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