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Peripartum Cardiomyopathy and Preeclampsia: Overlapping Diseases of Pregnancy

Pavan Parikh1, Lori Blauwet2

  • 1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mayo Clinic, 200 1st Street South West, Rochester, MN, 55905, USA. parikh.pavan@mayo.edu.

Current Hypertension Reports
|July 5, 2018
PubMed

Insights

Hypertensive disorders of pregnancy (HDP) and peripartum cardiomyopathy (PPCM) share cardiac dysfunction, including right ventricular issues and an anti-angiogenic environment. Further research into their overlapping pathophysiology is warranted.

Area of Science:

  • Cardiology
  • Obstetrics
  • Reproductive Medicine

Background:

  • Hypertensive disorders of pregnancy (HDP) are linked to cardiac dysfunction.
  • HDP is considered a potential risk factor for peripartum cardiomyopathy (PPCM), but their relationship is debated.
  • Understanding this association is crucial for maternal cardiovascular health.

Purpose of the Study:

  • To review the current understanding of the relationship between HDP and PPCM.
  • To explore the overlapping pathophysiology and clinical presentations of HDP and PPCM.
  • To identify areas for future research into the connection between these conditions.

Main Methods:

  • Literature review of studies examining cardiac function in HDP and PPCM.
  • Analysis of clinical data on mortality and morbidity in co-occurring HDP and PPCM.
  • Examination of basic science evidence regarding shared pathophysiological mechanisms.

Main Results:

  • Diastolic dysfunction is more common in HDP, while systolic dysfunction is more typical in PPCM, though findings vary.
  • Mortality and morbidity patterns in HDP-associated PPCM are inconsistent.
  • Right ventricular dysfunction is a common feature in both HDP and PPCM.
  • Both conditions exhibit an anti-angiogenic biological environment.

Conclusions:

  • PPCM and HDP-associated cardiomyopathy show significant overlap.
  • Shared pathophysiological mechanisms, including an anti-angiogenic milieu, warrant further investigation.
  • A unifying theory for the pathophysiology of PPCM and HDP-associated cardiac dysfunction is needed.
Abstract

Keywords:
CardiomyopathyHeart failureHypertensionPeripartumPreeclampsiaPregnancy

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