Clinical characteristics associated with unfavorable outcomes in peripartum myocardiopathy

• Autor(a) principal: Da Costa Moreira, Caroline [UNESP]
• Data de Publicação: 2005
• Outros Autores: Zanati, Silméia Garcia [UNESP], Medeiros, Vera Therezinha Borges [UNESP], Guimarães, Claudia [UNESP], Simões, Elaine Farah [UNESP], Matsubara, Beatriz Bojikian [UNESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/231754
• topic: Echocardiogram; Gestation; Heart failure

Objective: To assess the clinical characteristics of women with a previous diagnosis of peripartum myocardiopathy and to study the characteristics associated with unfavorable outcomes. Methods: Clinical, obstetric, and echocardiographic variables were studied in 12 patients with peripartum myocardiopathy, assessed at diagnosis and at a current appointment, when they were divided into 2 groups: FG (n = 6, without cardiac alterations) and UG (n = 6, with cardiomegaly and persistent ventricular dysfunction). The comparisons were made using the Student t test and Fisher's exact test (P < 0.05). Results: At diagnosis, mean age of the patients (8 Caucasian and 4 black/non-Caucasian) was 24±7.4 years, all in Functional Class IV (NYHA) and 8 reporting gestational hypertension or preeclampsia. Mean follow-up time was 25 months. Ten patients developed Functional Class I/II. Comparison between the groups demonstrated that UG had lower left ventricular ejection fractions (0.30±0.05 vs. 0.58±0.09; P < 0.001) and greater LV systolic diameter (58±5mm vs. 46±3mm; P < 0.001) at diagnosis. An unfavorable outcome was more frequent among non-Caucasian women (P = 0.01). In the current evaluation, UG had lower relative wall thickness (0.13±0.02 vs. 0.17±0.02; P < 0.05) and greater LV mass (283±90g vs. 186±41g; P < 0.05). Conclusion: Patients with previous peripartum myocardiopathy had unfavorable outcomes associated with black race, and stronger initial cardiac alterations; a favorable outcome was associated with a reduction in myocardial mass and an increase in relative ventricular wall thickness.