怀孕相关心肌病:临床特征和早期和晚期表现之间的比较
Uri Elkayam1, Mohammed W Akhter, Harpreet Singh
1Heart Failure Program, Division of Cardiovascular Medicine, and Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA. elkayam@usc.edu
Circulation
|April 27, 2005
概括
怀孕相关心肌病,包括周边心肌病,呈现类似,并具有相似的结果,无论诊断时间. 早期诊断和干预可以改善左心室喷射分数的正常化.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 孕产妇健康 孕产妇健康
背景情况:
- 几十年来,怀孕相关心肌病 (PACM) 已经得到认可,但由于罕见性和地理差异,其定义仍然不完全.
- 了解PACM的临床特征和结果对于及时诊断和管理至关重要.
研究的目的:
- 定义在美国诊断的与怀孕相关心肌病的临床特征.
- 为了比较早期怀孕相关心肌病与传统周边心肌病的临床表现和结果.
主要方法:
- 对123名在怀孕期间或产后被诊断患有心肌病的妇女进行了回顾性审查.
- 分类为周产期心肌病 (PPCM) 和早期怀孕相关心肌病 (EPAC) 组.
- 对人口统计学,相关疾病,左心室喷射率 (LVEF) 和母体结果的分析.
主要成果:
- 在诊断和随访时,PPCM患者 (n=100) 和EPAC患者 (n=23) 在年龄,种族,并发症或LVEF方面没有显著差异.
- 平均LVEF从29%提高到46% (P<0.0001),其中54%实现正常化.
- 产妇死亡率为9%;初始LVEF>30%的LVEF正常化更有可能发生.
结论:
- 在怀孕早期诊断的PACM与传统的PPCM具有相似的临床特征和结果.
- 这些情况可能代表相同的潜在疾病过程的光谱.
- 确定临床概况有助于管理这种罕见但严重的疾病.
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