Predicting poor left ventricular function recovery in Peripartum cardiomyopathy

Abstract

Introduction

Peripartum cardiomyopathy (PPCM) is a rare type of cardiomyopathy that manifests as acute heart failure associated with pregnancy. Delays in early identification result in poor recovery of left ventricular (LV) function; however, no risk prediction model exists. We sought to yield a scoring system known as the Padjadjaran Peripartum CardioMyopathy Recovery (PPCM recovery) score to predict the probability of poor LV function recovery in PPCM patients.

Methods

All baseline and clinical parameters were prospectively collected from a cohort of patients with PPCM admitted to Dr. Hasan Sadikin General Hospital in Bandung, Indonesia between January 2014 and December 2021. Logistic regression analyses were performed to investigate the relationship between each variable and the risk of poor LV function recovery in PPCM patients.

Results

This prospective cohort study included 113 patients with PPCM (84 recovered and 29 non-recovered patients). Significant mitral regurgitation (MR), left ventricular ejection fraction (LVEF) <30%, left ventricular end-diastolic diameter (LVEDD) ≥56 mm, and New York Heart Association functional class (NYHA FC) IV were all strong predictors of poor LV function recovery. These variables were integrated into the PPCM recovery score (AUC of 0.85). Patients with a score of ≥8 were nearly 18 times more likely to have poor LV function recovery (sensitivity 57%, specificity 93%).

Conclusion

PPCM recovery score is a convenient scoring system based on clinical and echocardiography assessment that may assist in distinguishing which patients are more likely to develop poor LV function recovery; therefore, these patients should be immediately referred to a tertiary referral hospital.

Keywords:

• Peripartum cardiomyopathy
• predictors
• scoring system
• left ventricular function
• poor recovery

Acknowledgements

Prof. Karen Sliwa for her valuable input as a PPCM expert. We would also like to thank the European Society of Cardiology/EurObservational Research Programme (ESC/EORP) and the chairs of the PPCM registry (Prof. Karen Sliwa and Prof. Johann Bauersachs) for using the PPCM registry CRF for collecting our data of PPCM patients.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data used and analyzed during the current study were available from the prospective PPCM study at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

Additional information

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.