Incidence, clinical characteristics and one-year outcomes of peripartum cardiomyopathy in Reunion Island

Abstract

Peripartum cardiomyopathy (PPCM) is a form a dilated cardiomyopathy affecting young women, inducing a high morbidity and mortality rate. Little is known about the incidence and outcomes in France. We sought to describe the incidence, clinical characteristics, and one-year outcomes in women with PPCM. We included all women from 18 to 44-year-old hospitalized in Reunion Island University Hospital Center from 2014 to 2019 with a new diagnosis of PPCM. The incidence was 1/2300 births. In our cohort of forty patients, median age was 34 ± 6 years and mean left ventricular ejection fraction (LVEF) was 27 ± 9%. Most patients (42%) were diagnosed during the first month after delivery. 74% presented with severe dyspnea (class III or IV NYHA). Known risk factors for PPCM were: age > 30-year-old (75%), multiparity (65%), gestational hypertension or preexisting chronic hypertension (60%), obesity (40%) and diabetes (28%). Complete recovery (defined by LVEF≥ 50%) was obtained in 71% of women after one-year follow-up and 6% of patients still had a severe left ventricular impairment (LVEF < 35%). One-year mortality rate was 3%. Prognostic factors were: initial and one-month LVEF, left ventricular end-diastolic diameter, and diabetes. Peripartum cardiomyopathy has a particularly high incidence in Reunion Island. Complete recovery is frequent. Targeted screening should be proposed to high-risk patients.