Tukeni Kedir Negesso, Asefa Elsah Tegene, Woyimo Tamirat Godebo, Gudina Esayas Kebede, Estner Heidi, Haas Nikolaus Alexander
Medical Faculty, Ludwig Maximilians University, Munich, Germany.
Department of Internal Medicine, Jimma University, Jimma, Ethiopia.
Front Cardiovasc Med. 2025 Apr 28;12:1568493. doi: 10.3389/fcvm.2025.1568493. eCollection 2025.
Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy that develops in women without a history of heart disease during the last trimester of pregnancy or within 6 months postpartum. It is one of the primary causes of heart failure during pregnancy, which increases peripartum morbidity and mortality. PPCM can cause significant left ventricular dysfunction, progressive heart failure, and refractory cardiogenic shock, resulting in increased maternal morbidity and mortality. Dyspnea, exhaustion, and lower extremity edema are common symptoms and are often misdiagnosed as normal postpartum changes, demanding careful assessment with echocardiography. Furthermore, diagnosis and treatment are often delayed due to insufficient awareness among healthcare providers, with varying definitions of the disease across countries. Its underlying causes remain unclear, although recent studies point to a potential prolactin-oxidative stress mechanism that might lead to potential future treatments. Clinical care follows basic heart failure management guidelines while taking medication teratogenicity into account. The prognosis varies geographically based on the level and pattern of treatment, with a considerable number of patients displaying partial recovery. The prevalence and treatment patterns of these patients in Africa, including the benefits and safety profiles of bromocriptine, are reviewed here, to identify directions in its prospective use in different forms of cardiomyopathies based on the available literature.
围产期心肌病(PPCM)是一种扩张型心肌病,发生于妊娠晚期或产后6个月内无心脏病史的女性。它是妊娠期心力衰竭的主要原因之一,会增加围产期发病率和死亡率。PPCM可导致严重的左心室功能障碍、进行性心力衰竭和难治性心源性休克,从而增加孕产妇的发病率和死亡率。呼吸困难、疲惫和下肢水肿是常见症状,常被误诊为正常的产后变化,需要通过超声心动图进行仔细评估。此外,由于医疗保健人员认识不足,加上各国对该疾病的定义不同,诊断和治疗往往会延迟。其根本原因尚不清楚,不过最近的研究指出了一种潜在的催乳素-氧化应激机制,这可能会带来未来潜在的治疗方法。临床护理遵循基本的心力衰竭管理指南,同时考虑药物致畸性。预后因治疗水平和模式的不同而存在地域差异,相当一部分患者会部分恢复。本文回顾了非洲这些患者的患病率和治疗模式,包括溴隐亭的益处和安全性,以便根据现有文献确定其在不同类型心肌病中的前瞻性应用方向。