Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, No. 2 Anzhen Road, Beijing, 100029, China.
BMC Cardiovasc Disord. 2021 Apr 22;21(1):205. doi: 10.1186/s12872-021-02021-6.
The aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients.
Sixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. We further determined the risk factors associated with nonrecovery and the influence posed by AKI on the LV function of the patients.
Compared with the patients in the recovery group, those in the nonrecovery group had higher proportions of multiparity [78.6% (22/28) vs. 43.8% (14/32)], function class III- IV heart failure [92.9% (26/28) vs. 71.9% (23/32)], and a higher incidence of AKI [35.7% (10/28) vs. 3.1% (1/32)]. Logistic regression analysis showed that having AKI [odds ratio (OR): 10.556; 95% confidence interval (CI) 1.177-94.654; P = 0.035] and left ventricular ejection fraction (LVEF) < 40% [OR: 4.533; 95% CI 1.118-18.382; P = 0.034] were independently associated with nonrecovery of PPCM.
The prognosis of patients with PPCM and AKI during hospitalization was poor compared to those without AKI; therefore, clinicians should pay more attention to this phenomenon.
本研究旨在探讨围生期心肌病（PPCM）患者左心室（LV）功能不良的相关危险因素，并确定急性肾损伤（AKI）对患者 LV 功能的影响。
2007 年 1 月至 2018 年 6 月期间共纳入 60 例 PPCM 患者，其中 11 例合并 AKI。将患者分为恢复组（32 例）和未恢复组（28 例），比较两组患者的临床特征、超声心动图和心电图检查结果、实验室结果和治疗措施。进一步确定与未恢复相关的危险因素以及 AKI 对患者 LV 功能的影响。
与恢复组患者相比，未恢复组患者多胎妊娠比例更高[78.6%（22/28）比 43.8%（14/32）]，心功能Ⅲ-Ⅳ级心力衰竭比例更高[92.9%（26/28）比 71.9%（23/32）]，AKI 发生率更高[35.7%（10/28）比 3.1%（1/32）]。Logistic 回归分析显示，合并 AKI[比值比（OR）：10.556；95%置信区间（CI）1.177-94.654；P=0.035]和左心室射血分数（LVEF）＜40%[OR：4.533；95% CI 1.118-18.382；P=0.034]是 PPCM 未恢复的独立相关因素。
与无 AKI 的患者相比，合并 AKI 的 PPCM 患者住院期间的预后较差，临床医生应更加关注这一现象。
