Mishra T K, Swain S, Routray S N
Department of Cardiology, SCB Medical College, Cuttack, Orissa, India.
Int J Gynaecol Obstet. 2006 Nov;95(2):104-9. doi: 10.1016/j.ijgo.2006.06.013. Epub 2006 Aug 28.
To determine the clinical and echocardiographic profiles of women with peripartum cardiomyopathy and ascertain the natural course of the disease.
Fifty-six women with peripartum cardiomyopathy were followed up for a mean period of 6.1 years and their clinical and echocardiographic profiles were studied as well as their outcomes.
The mean+/-SD age at presentation was 31+/-5 years and mean parity was 2.6+/-1. Of the 56 patients, 18 (32.1%) had NYHA Class II, 24 (42.9%) had NYHA Class III, and 14 (25%) had NYHA Class IV symptoms, and 21 (37.5%) and 35 (62.5%), respectively, presented with features of heart failure during pregnancy and the postpartum. During follow-up, the left ventricular ejection fraction improved from 31%+/-7.2% to 43%+/-8% (P</=0.05). Nine patients (16.1%) became pregnant, with a mortality of 55.5% during pregnancy and 23.2% during follow-up.
Women with peripartum cardiomyopathy present with severe left ventricular dysfunction late in the pregnancy or early in the puerperium. A considerable number of women still die from this condition despite the use of angiotensin-converting enzyme inhibitors and beta-blockers. A subsequent pregnancy carries a very high risk of mortality.
确定围产期心肌病女性的临床和超声心动图特征，并明确该疾病的自然病程。
对56例围产期心肌病女性进行了平均6.1年的随访，研究了她们的临床和超声心动图特征以及结局。
发病时的平均年龄±标准差为31±5岁，平均产次为2.6±1。56例患者中，18例（32.1%）为纽约心脏协会（NYHA）心功能Ⅱ级，24例（42.9%）为NYHA心功能Ⅲ级，14例（25%）为NYHA心功能Ⅳ级症状，分别有21例（37.5%）和35例（62.5%）在孕期和产后出现心力衰竭特征。随访期间，左心室射血分数从31%±7.2%提高到43%±8%（P≤0.05）。9例患者（16.1%）再次怀孕，孕期死亡率为55.5%，随访期间死亡率为23.2%。
围产期心肌病女性在妊娠晚期或产褥早期出现严重左心室功能障碍。尽管使用了血管紧张素转换酶抑制剂和β受体阻滞剂，仍有相当数量的女性死于这种疾病。再次怀孕的死亡率非常高。
