[Clinical characteristics associated with unfavorable outcomes in peripartum myocardiopathy]

To assess the clinical characteristics of women with a previous diagnosis of peripartum myocardiopathy and to study the characteristics associated with unfavorable outcomes.

Clinical, obstetric, and echocardiographic variables were studied in 12 patients with peripartum myocardiopathy, assessed at diagnosis and at a current appointment, when they were divided into 2 groups: FG (n = 6, without cardiac alterations) and UG (n = 6, with cardiomegaly and persistent ventricular dysfunction). The comparisons were made using the Student t test and Fisher's exact test (P < 0.05).

At diagnosis, mean age of the patients (8 Caucasian and 4 black/non-Caucasian) was 24+/-7.4 years, all in Functional Class IV (NYHA) and 8 reporting gestational hypertension or preeclampsia. Mean follow-up time was 25 months. Ten patients developed Functional Class I/II. Comparison between the groups demonstrated that UG had lower left ventricular ejection fractions (0.30+/-0.05 vs. 0.58+/-0.09; P < 0.001) and greater LV systolic diameter (58+/-5 mm vs. 46+/-3 mm; P < 0.001) at diagnosis. An unfavorable outcome was more frequent among non-Caucasian women (P = 0.01). In the current evaluation, UG had lower relative wall thickness (0.13+/-0.02 vs. 0.17+/-0.02; P < 0.05) and greater LV mass (283+/-90 g vs. 186+/-41 g; P < 0.05).

Patients with previous peripartum myocardiopathy had unfavorable outcomes associated with black race, and stronger initial cardiac alterations; a favorable outcome was associated with a reduction in myocardial mass and an increase in relative ventricular wall thickness.