Sheppard Richard, Rajagopalan Navin, Safirstein Jordan, Briller Joan
Jewish General Hospital, McGill University, Montreal H3T1E2, Canada.
Future Cardiol. 2014 May;10(3):435-47. doi: 10.2217/fca.14.23.
Peripartum cardiomyopathy (PPCM) is a well-established complication of pregnancy. Criteria include heart failure that presents with reduced left ventricular function, signs and symptoms of heart failure either late in pregnancy or early in the postpartum period. The incidence varies widely depending geography and ethnicity. The pathophysiology of PPCM is still an area of active investigation, but includes immune and inflammatory mechanisms, which are the subject of several investigations. Therapies for chronic heart failure from PPCM are similar to those patients with nonischemic cardiomyopathy from different etiologies, however novel therapies may include bromocriptine, pentoxifylline or other potential therapies influencing the immune system. The need for implantable defibrillators, left ventricular assist devices and cardiac transplant in women with PPCM is rare, and prognosis is better than other forms of nonischemic cardiomyopathy. Despite this, further information about the epidemiology, prognosis and potential therapies are required to better manage and diagnose PPCM in women with signs and symptoms of heart failure.
围产期心肌病(PPCM)是一种公认的妊娠并发症。其标准包括出现左心室功能降低的心力衰竭,以及在妊娠晚期或产后早期出现的心力衰竭体征和症状。发病率因地理位置和种族不同而有很大差异。PPCM的病理生理学仍是一个积极研究的领域,但其包括免疫和炎症机制,这也是多项研究的主题。PPCM所致慢性心力衰竭的治疗方法与不同病因的非缺血性心肌病患者相似,然而新型治疗方法可能包括溴隐亭、己酮可可碱或其他影响免疫系统的潜在疗法。PPCM女性患者很少需要植入式除颤器、左心室辅助装置和心脏移植,且预后优于其他形式的非缺血性心肌病。尽管如此,仍需要更多关于流行病学、预后和潜在治疗方法的信息,以便更好地管理和诊断有心力衰竭体征和症状的女性PPCM患者。