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Peripartum myocarditis and cardiomyopathy
M G Midei1, S H DeMent, A M Feldman
1Johns Hopkins Medical Institutions, Department of Medicine, Baltimore, Maryland.
Circulation
|March 1, 1990
Summary
Peripartum cardiomyopathy often involves myocarditis. Immunosuppressive therapy may improve outcomes for patients with persistent left ventricular dysfunction, though some cases resolve spontaneously.
Area of Science:
- Cardiology
- Pathology
Background:
- Peripartum cardiomyopathy (PPCM) is a rare form of heart failure.
- The role of myocarditis in PPCM and the efficacy of immunosuppressive therapy remain areas of investigation.
Purpose of the Study:
- To determine the incidence of myocarditis in PPCM.
- To evaluate the response of PPCM patients with myocarditis to immunosuppressive agents.
Main Methods:
- Retrospective analysis of 18 PPCM patients.
- Evaluation included echocardiography, nuclear ventriculography, right heart catheterization, and myocardial biopsy.
- Myocardial biopsy was used to diagnose myocarditis and assess treatment response.
Main Results:
- Myocarditis was present in 78% of PPCM patients.
- Nine of ten patients treated with immunosuppressives showed improvement.
- Follow-up biopsies indicated resolution or improvement of myocarditis.
- Four patients without myocarditis had varied outcomes, including two requiring transplantation.
Conclusions:
- Myocarditis is a frequent finding in PPCM.
- Resolution of myocarditis correlates with improved left ventricular function.
- Immunosuppressive therapy may benefit PPCM patients with persistent left ventricular dysfunction.