Karner Eva, Keller Hans, Schäffl-Doweik Lilian, Laccone Franco, Stöllberger Claudia
Department of Obstetrics and Gynecology, Medical University of Vienna, Austria.
Department for Cardiology and Intensive Care, Klinik Landstraße, Vienna, Austria.
Obstet Med. 2025 Jun;18(2):130-132. doi: 10.1177/1753495X231214379. Epub 2023 Nov 13.
Peripartum cardiomyopathy is defined as heart failure secondary to left ventricular (LV) dysfunction with a left ventricular ejection fraction <45% occurring towards the end of pregnancy or in the months following delivery without other identifiable cause. Pathogenesis of peripartum cardiomyopathy and the role of genetic variants are unknown. We present a previously healthy 33-year-old woman in her first pregnancy with acute onset of heart failure postpartum. She developed cardiogenic shock four days after caesarean section and was treated with levosimendan, cabergoline, ramipril and bisoprolol. She used a wearable cardioverter/defibrillator for 3 months. After 8 months, she was free of symptoms with normal left ventricular function and brain-natriuretic-peptide-levels. Genetic analysis was carried out due to a positive family history and disclosed a heterozygous variant c7627dupA in the gene. Genetic analysis in patients with a positive family history should be carried out since that may provide insights in the pathogenesis of heart failure due to systolic dysfunction including peripartum cardiomyopathy.
在妊娠晚期或产后数月内，继发于左心室（LV）功能障碍且左心室射血分数<45%的心力衰竭，且无其他可识别病因。围产期心肌病的发病机制以及基因变异的作用尚不清楚。我们报告一名既往健康的33岁初产妇，产后急性发生心力衰竭。她在剖宫产术后4天出现心源性休克，接受了左西孟旦、卡麦角林、雷米普利和比索洛尔治疗。她使用可穿戴式心脏复律除颤器3个月。8个月后，她无症状，左心室功能和脑钠肽水平正常。由于家族史阳性进行了基因分析，结果显示该基因存在杂合变异c7627dupA。对于家族史阳性的患者应进行基因分析，因为这可能为包括围产期心肌病在内的收缩功能障碍所致心力衰竭的发病机制提供见解。
