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Acute kidney injury predicts poor left ventricular function for patients with peripartum cardiomyopathy
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, No. 2 Anzhen Road, Beijing, 100029, China.
Insights
Acute kidney injury (AKI) significantly worsens the prognosis for patients with peripartum cardiomyopathy (PPCM), independently predicting poor left ventricular (LV) function recovery. Clinicians must monitor AKI closely in PPCM patients for improved outcomes.
Area of Science:
- Cardiology
- Nephrology
- Maternal Health
Background:
- Peripartum cardiomyopathy (PPCM) affects cardiac function during pregnancy or postpartum.
- Left ventricular (LV) dysfunction is a key concern in PPCM.
- The impact of acute kidney injury (AKI) on PPCM prognosis requires further investigation.
Purpose of the Study:
- To identify risk factors for poor left ventricular (LV) function in peripartum cardiomyopathy (PPCM) patients.
- To assess the influence of acute kidney injury (AKI) on LV function recovery in PPCM.
Main Methods:
- A cohort of 60 PPCM patients (2007-2018) was analyzed.
- Patients were categorized into recovery (32) and non-recovery (28) groups.
- Clinical data, echocardiography, ECG, and lab results were compared; logistic regression identified risk factors.
Main Results:
- The non-recovery group exhibited higher rates of multiparity, advanced heart failure (NYHA class III-IV), and AKI.
- Acute kidney injury (AKI) was independently associated with non-recovery (OR: 10.556, P=0.035).
- Reduced left ventricular ejection fraction (LVEF < 40%) also predicted non-recovery (OR: 4.533, P=0.034).
Conclusions:
- Patients with PPCM and concurrent AKI demonstrate a poorer in-hospital prognosis.
- AKI is a significant independent risk factor for impaired LV function recovery in PPCM.
- Increased clinical vigilance for AKI in PPCM patients is warranted.
Background:
The aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients.
Methods:
Sixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. We further determined the risk factors associated with nonrecovery and the influence posed by AKI on the LV function of the patients.
Results:
Compared with the patients in the recovery group, those in the nonrecovery group had higher proportions of multiparity [78.6% (22/28) vs. 43.8% (14/32)], function class III- IV heart failure [92.9% (26/28) vs. 71.9% (23/32)], and a higher incidence of AKI [35.7% (10/28) vs. 3.1% (1/32)]. Logistic regression analysis showed that having AKI [odds ratio (OR): 10.556; 95% confidence interval (CI) 1.177-94.654; P = 0.035] and left ventricular ejection fraction (LVEF) < 40% [OR: 4.533; 95% CI 1.118-18.382; P = 0.034] were independently associated with nonrecovery of PPCM.
Conclusions:
The prognosis of patients with PPCM and AKI during hospitalization was poor compared to those without AKI; therefore, clinicians should pay more attention to this phenomenon.
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