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通过互联网招募的围产期心肌病患者队列中左心室恢复的预测因素。

Predictors of left ventricular recovery in a cohort of peripartum cardiomyopathy patients recruited via the internet.

机构信息

Department of Cardiology, The Gagnon Cardiovascular Institute at Morristown Memorial Hospital, Morristown, NJ 07960, United States.

出版信息

Int J Cardiol. 2012 Jan 12;154(1):27-31. doi: 10.1016/j.ijcard.2010.08.065. Epub 2010 Sep 21.

Abstract

BACKGROUND

Peripartum cardiomyopathy (PPCM) is the onset of acute heart failure without demonstrable cause during the last month of pregnancy or within five months after delivery. The purpose of this study was to create a prospective registry of PPCM patients with the assistance of the internet and identify clinical factors predictive of ejection fraction (EF) recovery.

METHODS

Patients with PPCM were identified by novel web-based methods. Subjects were categorized as recovered (EF>50) or nonrecovered (EF<50) and compared on the basis of demographic and clinical variables.

RESULTS

Fifty-five subjects met criteria for inclusion. There was a statistically significant association between diagnosis during third trimester and persistent systolic dysfunction (25% vs. 4.7%, p=0.03). Gestational hypertension and breastfeeding were significantly associated with EF recovery (48.8% vs. 16.7%, p=0.046, and 39.5% vs. 8.3%, p=0.04, respectively). EF normalization occurred in all patients with EF(1) ≥ 35%.

CONCLUSIONS

Presence of gHTN, EF ≥ 35% at diagnosis, breastfeeding, and postpartum diagnosis were all significantly associated with recovery of systolic function. Internet recruitment may be a valuable tool for studying PPCM.

摘要

背景

围产期心肌病(PPCM)是指在妊娠最后一个月或分娩后 5 个月内发生的急性心力衰竭,且无明显病因。本研究的目的是在互联网的协助下建立一个 PPCM 患者前瞻性登记处,并确定预测射血分数(EF)恢复的临床因素。

方法

通过新的基于网络的方法来确定 PPCM 患者。根据 EF 恢复情况(EF>50)和未恢复情况(EF<50)将受试者进行分类,并对其进行基于人口统计学和临床变量的比较。

结果

55 名患者符合纳入标准。在第三孕期诊断与持续收缩功能障碍之间存在统计学显著关联(25%与 4.7%,p=0.03)。妊娠高血压和母乳喂养与 EF 恢复显著相关(48.8%与 16.7%,p=0.046,和 39.5%与 8.3%,p=0.04)。EF≥35%的所有患者 EF 均正常化。

结论

存在妊娠高血压、诊断时 EF≥35%、母乳喂养和产后诊断均与收缩功能恢复显著相关。互联网招募可能是研究 PPCM 的一种有价值的工具。

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