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围产期心肌病综述:当前的知识状况

Reviewing peripartum cardiomyopathy: current state of knowledge.

作者信息

Selle Tina, Renger Isabelle, Labidi Saida, Bultmann Insa, Hilfiker-Kleiner Denise

机构信息

Hannover Medical School, Department of Cardiology & Agiology, Carl-Neuberg-Str. 1, Hannover 30625, Germany.

出版信息

Future Cardiol. 2009 Mar;5(2):175-89. doi: 10.2217/14796678.5.2.175.

Abstract

Peripartum cardiomyopathy (PPCM) is a serious, potentially life-threatening heart disease of unknown etiology in previously healthy women that develops between the last month of pregnancy and 5-6 months after delivery. PPCM is a distinct clinical entity in which echocardiography demonstrates the features of an idiopathic dilated cardiomyopathy with a high morbidity and mortality, but in addition, patients suffering with PPCM have a chance of reaching full recovery. A variety of potential risk factors related to PPCM have been suggested over the last decades, which may help to identify women at risk in the future. Recent advances in understanding the pathophysiology of PPCM assign a key role to unbalanced oxidative stress and the generation of a cardiotoxic prolactin subfragment. In this regard, pharmacological blockade of prolactin holds the promise of novel, more disease-specific therapy options. The present article provides an overview on the clinical appearance and management, risk factors and potential pathophysiological mechanisms of PPCM.

摘要

围产期心肌病(PPCM)是一种严重的、可能危及生命的心脏病,病因不明,发生在既往健康的女性身上,在妊娠最后一个月至产后5至6个月之间发病。PPCM是一种独特的临床实体,超声心动图显示其具有特发性扩张型心肌病的特征,发病率和死亡率较高,但此外,患有PPCM的患者有完全康复的机会。在过去几十年中,人们提出了多种与PPCM相关的潜在风险因素,这可能有助于在未来识别有风险的女性。在理解PPCM病理生理学方面的最新进展表明,氧化应激失衡和心脏毒性催乳素亚片段的产生起着关键作用。在这方面,催乳素的药物阻断有望带来新的、更具疾病特异性的治疗选择。本文概述了PPCM的临床表现与管理、风险因素以及潜在的病理生理机制。

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