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围产期心肌病管理的当前知识与最新进展

Current knowledge and recent development on management of peripartum cardiomyopathy.

作者信息

Bouabdallaoui Nadia, Mouquet Frederic, Lebreton Guillaume, Demondion Pierre, Le Jemtel Thierry H, Ennezat Pierre V

机构信息

1 Cardio-Thoracic Surgery Department, Pitié-Salpétrière Hospital, France.

2 Polyclinique du Bois, France.

出版信息

Eur Heart J Acute Cardiovasc Care. 2017 Jun;6(4):359-366. doi: 10.1177/2048872615612465. Epub 2015 Oct 16.

Abstract

Heart failure with left ventricular dysfunction occurring during pregnancy or during the post-partum period in patients without history of cardiovascular disease defines peripartum cardiomyopathy (PPCM). PPCM carries a high morbidity and mortality rate as well as the possibility of recovery ad integrum. Its incidence shows ethnic variations, with a greater prevalence of the disease among women with African descent. Pathogenesis of PPCM remains poorly understood. Both "oxidative stress-prolactin axis" and "anti-angiogenic-signaling excess" hypotheses are currently being investigated. Novel diagnostic strategies and biomarkers are currently being evaluated. Besides conventional treatment of heart failure, targeted therapies such as pharmacological prolactin blockade are under evaluation. The aim of this short review is to highlight current management as targeted therapy has far been disappointing.

摘要

围产期心肌病(PPCM)是指在无心血管疾病史的患者中,妊娠期间或产后发生的左心室功能障碍引起的心力衰竭。PPCM具有高发病率和死亡率,以及完全康复的可能性。其发病率存在种族差异,在非洲裔女性中该病的患病率更高。PPCM的发病机制仍知之甚少。目前正在研究“氧化应激-催乳素轴”和“抗血管生成信号过度”这两种假说。目前正在评估新的诊断策略和生物标志物。除了心力衰竭的传统治疗外,诸如药物性催乳素阻断等靶向治疗也在评估中。这篇简短综述的目的是强调当前的治疗情况,因为迄今为止靶向治疗令人失望。

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