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Biomarkers and Their Relation to Cardiac Function Late After Peripartum Cardiomyopathy

Anne S Ersbøll1, Jens P Goetze2, Marianne Johansen1

  • 1Department of Obstetrics.

Journal of Cardiac Failure
|January 10, 2021
PubMed

Insights

Women with peripartum cardiomyopathy (PPCM) show lasting angiogenic imbalance and elevated cathepsin D (CD) activity. These factors correlate with reduced exercise capacity and cardiac dysfunction years after diagnosis.

Area of Science:

  • Cardiology
  • Reproductive Medicine
  • Biochemistry

Background:

  • Peripartum cardiomyopathy (PPCM) involves angiogenic imbalance and cathepsin D (CD) activity.
  • Soluble Fms-like tyrosine kinase-1 (sFlt-1) and CD are implicated in PPCM pathogenesis.
  • This study investigates the long-term impact of these factors in PPCM survivors.

Purpose of the Study:

  • To assess long-term angiogenic imbalance and CD activity in women with PPCM.
  • To correlate these biomarkers with cardiac function and exercise capacity.
  • To understand the lasting effects of PPCM on cardiovascular health.

Main Methods:

  • Follow-up study of a nationwide Danish cohort of women with PPCM (n=28).
  • Comparison with age-matched controls with previous preeclampsia (n=28) and uncomplicated pregnancies (n=28).
  • Biomarker analysis (sFlt-1, placental growth factor, NT-proBNP, copeptin), exercise testing, and cardiac MRI.

Main Results:

  • PPCM group showed significantly higher levels of sFlt-1, placental growth factor, NT-proBNP, and copeptin.
  • Detectable CD activity was more prevalent in the PPCM group (68%) versus controls (29-36%).
  • Higher biomarker levels correlated inversely with maximal exercise capacity and cardiac function parameters.

Conclusions:

  • Women with PPCM exhibit persistent angiogenic imbalance and elevated CD activity up to 7 years post-diagnosis.
  • These persistent abnormalities are linked to residual cardiac dysfunction and reduced exercise capacity.
  • Findings suggest a long-lasting impact of angiogenic imbalance and CD activity in PPCM recovery.
Abstract

Keywords:
Peripartum cardiomyopathyheart failurepregnancy

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