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中国人群围产期心肌病的危险因素及临床特征

Risk Factors and Clinical Features of Peripartum Cardiomyopathy in a Chinese Population.

作者信息

Huang Hui, Ye Qing, Xu Yulan, Tao Baoming, Liu Junlan, Xie Tian, Zha Lingfeng

机构信息

Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

Hubei Key Laboratory of Biological Targeted Therapy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.

出版信息

J Multidiscip Healthc. 2024 Aug 5;17:3763-3772. doi: 10.2147/JMDH.S468377. eCollection 2024.

Abstract

PURPOSE

We investigated the risk factors and characteristic clinical features of peripartum cardiomyopathy (PPCM) to lay the groundwork for early identification, screening, diagnosis, and intervention in high-risk pregnant women.

PATIENTS AND METHODS

A retrospective case-control study was conducted to analyze data from 44 patients with PPCM and 226 normal pregnant women from a Chinese population.

RESULTS

Significant differences were found between the groups in terms of various factors such as age, body mass index (BMI), heart rate, and medical history. Logistic regression models identified abnormal electrocardiography (OR=18.852), upper respiratory tract infection (OR=41.822), gestational hypertension (OR=18.188), and cesarean section (OR=8.394) as risk factors for PPCM. Common clinical features observed in patients with PPCM included cough, wheezing, and chest tightness (68.18%), left heart enlargement (56.82%) and valvular insufficiency (81.82%). Additionally, cardiotropic virus was detected in a subset of patients (43.18%) and NT-proBNP was elevated ≥ 400 pg/mL (81.82%).

CONCLUSION

In the Chinese population, the presence of abnormal electrocardiograms during pregnancy, history of upper respiratory tract infection, gestational hypertension, and maternal choice of cesarean section suggest the possibility of PPCM development. Factors such as advanced age, family history of cardiovascular disease, gestational diabetes mellitus, eclampsia, anemia, and hypoproteinemia should be considered. Clinically, patients present with cough, wheezing, chest tightness, enlarged left heart, valvular insufficiency and NT-proBNP elevated ≥ 400 pg/mL. This study could serve as a valuable reference for medical practitioners for the early identification and screening of patients with PPCM.

摘要

目的

我们研究了围产期心肌病(PPCM)的危险因素和特征性临床特征,为高危孕妇的早期识别、筛查、诊断和干预奠定基础。

患者与方法

进行了一项回顾性病例对照研究,分析了来自中国人群的44例PPCM患者和226例正常孕妇的数据。

结果

两组在年龄、体重指数(BMI)、心率和病史等各种因素方面存在显著差异。Logistic回归模型确定心电图异常(OR=18.852)、上呼吸道感染(OR=41.822)、妊娠期高血压(OR=18.188)和剖宫产(OR=8.394)为PPCM的危险因素。PPCM患者常见的临床特征包括咳嗽、喘息和胸闷(68.18%)、左心扩大(56.82%)和瓣膜关闭不全(81.82%)。此外,部分患者检测到嗜心肌病毒(43.18%),NT-proBNP升高≥400 pg/mL(81.82%)。

结论

在中国人群中,孕期心电图异常、上呼吸道感染史、妊娠期高血压以及产妇选择剖宫产提示有发生PPCM的可能性。应考虑高龄、心血管疾病家族史、妊娠期糖尿病、子痫、贫血和低蛋白血症等因素。临床上,患者表现为咳嗽、喘息、胸闷、左心扩大、瓣膜关闭不全以及NT-proBNP升高≥400 pg/mL。本研究可为医生早期识别和筛查PPCM患者提供有价值的参考。

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