Badianyama Marheb, Das Prasanta K, Gaddameedi Sai Rakshith, Saukhla Sonia, Nagammagari Tejaswini, Bandari Vandana, Mohammed Lubna
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Sep 24;13(9):e18248. doi: 10.7759/cureus.18248. eCollection 2021 Sep.
In formerly healthy females, acute heart failure (HF) of an unknown cause that develops during the last weeks of gestation or in the first months after childbirth is known as peripartum cardiomyopathy (PPCM). This study aimed to establish the therapeutic value of combining bromocriptine with conventional HF treatment on left ventricular ejection fraction (LVEF), death, thromboembolic events, left ventricular (LV) dysfunction recurrence in subsequent pregnancies in PPCM women, and newborn children's outcomes. We conducted a systematic review to find clinical studies that described the utility of bromocriptine in addition to conventional HF treatment compared to conventional HF treatment only in the management of acute PPCM. Four databases comprising records from July 10, 2001, to July 10, 2021, were analyzed, including PubMed (MEDLINE), Google Scholar, Scopus, and the Cochrane Library. We discovered 4,717 potentially eligible records across all the databases. According to our eligibility criteria, we included six studies consisting of 263 patients in this review. Bromocriptine combined with conventional HF therapy led to an 11.37% increase in LVEF (mean difference: 11.37; 95% confidence interval [CI]: 9.55-13.19; p-value = 0.001) after six months compared to conventional HF treatment only. Notably, bromocriptine combined with conventional HF treatment reduced mortality associated with PPCM, and no thromboembolism events were recorded in the 263 patients. PPCM is a severe condition affecting women globally. In this study, the combination of bromocriptine with conventional HF treatment enhanced the LVEF of women with acute PPCM and their clinical outcomes.
在既往健康的女性中,在妊娠最后几周或产后头几个月发生的病因不明的急性心力衰竭(HF)被称为围产期心肌病(PPCM)。本研究旨在确定溴隐亭与传统HF治疗相结合对PPCM女性左心室射血分数(LVEF)、死亡、血栓栓塞事件、后续妊娠中左心室(LV)功能障碍复发以及新生儿结局的治疗价值。我们进行了一项系统评价,以寻找描述溴隐亭在传统HF治疗基础上与仅采用传统HF治疗相比在急性PPCM管理中的效用的临床研究。分析了四个包含2001年7月10日至2021年7月10日记录的数据库,包括PubMed(MEDLINE)、谷歌学术、Scopus和Cochrane图书馆。我们在所有数据库中发现了4717条潜在符合条件的记录。根据我们的纳入标准,本评价纳入了六项研究,共263例患者。与仅采用传统HF治疗相比,溴隐亭联合传统HF治疗在六个月后使LVEF提高了11.37%(平均差值:11.37;95%置信区间[CI]:9.55 - 13.19;p值 = 0.001)。值得注意的是,溴隐亭联合传统HF治疗降低了与PPCM相关的死亡率,并且在这263例患者中未记录到血栓栓塞事件。PPCM是一种影响全球女性的严重疾病。在本研究中,溴隐亭与传统HF治疗相结合提高了急性PPCM女性的LVEF及其临床结局。