印度围产期心肌病女性的临床特征、预测因素及妊娠结局
Clinical characteristics, predictors and pregnancy outcomes in Indian women with peripartum cardiomyopathy.
作者信息
Rajan Saroj, Jha Nivedita, Jha Ajay Kumar
机构信息
Department of Obstetrics and Gynaecology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Cardiothoracic Division, Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
出版信息
Obstet Med. 2023 Mar;16(1):23-28. doi: 10.1177/1753495X211051253. Epub 2021 Dec 16.
BACKGROUND
Predictors, pregnancy and subsequent pregnancy outcomes in women with peripartum cardiomyopathy (PPCM) are poorly understood in our geographical region.
METHODS
We retrospectively analysed 58 women with PPCM diagnosed using criteria by the European Society of Cardiology during 2015 to 2019. The main outcome measures were predictors of left ventricular (LV) recovery. LV recovery was defined as return of LV ejection fraction to over 50%.
RESULTS
Nearly 80% of women had LV recovery during 6 months follow up. Univariate logistic regression revealed LV end diastolic diameter (adjusted odds ratio (OR); 0.87; 95% CI, 0.78-0.98; = 0.02), LV end systolic diameter (OR; 0.89; 95% CI, 0.8-0.98; = 0.02) and inotrope use (OR; 0.2, 95% CI, 0.05-0.7; = 0.01) as predictors of LV recovery. Relapse was not seen in any of the nine women who had a subsequent pregnancy.
CONCLUSION
LV recovery was higher than those reported in contemporary PPCM cohorts from other parts of the world.
背景
在我们所在的地理区域，围产期心肌病（PPCM）女性患者的预测因素、妊娠情况及后续妊娠结局尚未得到充分了解。
方法
我们回顾性分析了2015年至2019年间根据欧洲心脏病学会标准诊断为PPCM的58名女性患者。主要结局指标为左心室（LV）恢复的预测因素。LV恢复定义为LV射血分数恢复至50%以上。
结果
近80%的女性在6个月随访期间LV恢复。单因素逻辑回归显示，LV舒张末期直径（调整比值比（OR）；0.87；95%可信区间，0.78 - 0.98；P = 0.02）、LV收缩末期直径（OR；0.89；95%可信区间，0.8 - 0.98；P = 0.02）和使用血管活性药物（OR；0.2，95%可信区间，0.05 - 0.7；P = 0.01）是LV恢复的预测因素。9名后续妊娠的女性均未出现复发。
结论
LV恢复率高于世界其他地区当代PPCM队列报告的恢复率。
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