Clinical profiles and shortterm outcomes of women with peripartum and dilated cardiomyopathies

Abstract

Background: We aimed to compare the clinical and sociodemographic characteristics, rate of left ventricular reverse remodeling (LVRR), heart failure hospitalization and allcause mortality of women with peripartum and dilated cardiomyopathies (PPCM and DCM respectively) in Nigeria. Methods: This was a prospective longitudinal study and a total of 130 patients (65 for each group) were recruited consecutively and followed up for 6 months. Results: PPCM patients were younger, but the DCM patients had higher frequency of atrial fibrillation and complete left bundle branch block, higher mean left atrial and LV dimensions, higher LV filling pressures, and worse renal dysfunction, respectively, at baseline. At the end of the 6month followup, 15 female DCM vs 21 PPCM patients (p=0.684) had achieved LVRR, 13 DCM vs 11 PPCM patients (p=0.098) were hospitalized for heart failure, and 10 DCM vs 5 PPCM patients (p=0.098) had died. The odds for achieving LVRR was independently increased by systolic blood pressure (SBP) >100 mmHg and tricuspid annular plane systolic excursion >16 mm at baseline in PPCM patients, and by use of angiotensin converting enzyme inhibitors at baseline in female DCM patients. The odds for mortality were increased by tachycardia and pericardial effusion and reduced by the use of loop diuretics at baseline in DCM patients, and SBP <90 mmHg at baseline increased it by 9fold in PPCM patients. Conclusions: Our results suggest that women with DCM and PPCM differ significantly in their demographic and clinical characteristics, and predictors of clinical outcomes.