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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy
Basic Research in Cardiology, Volume 108, No. 4, Article 366, Year 2013
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Description
Peripartum cardiomyopathy (PPCM) is a life-threatening heart disease developing towards the end of pregnancy or in the months following delivery in previously healthy women in terms of cardiac disease. Enhanced oxidative stress and the subsequent cleavage of the nursing hormone Prolactin into an anti-angiogenic 16 kDa subfragment emerged as a potential causal factor of the disease. We established a prospective registry with confirmed PPCM present in 115 patients (mean baseline left ventricular ejection fraction, LVEF: 27 ± 9 %). Follow-up data (6 ± 3 months) showed LVEF improvement in 85 % and full recovery in 47 % while 15 % failed to recover with death in 2 % of patients. A positive family history of cardiomyopathy was present in 16.5 %. Pregnancy-associated hypertension was associated with a better outcome while a baseline LVEF ≤ 25 % was associated with a worse outcome. A high recovery rate (96 %) was observed in patients obtaining combination therapy with beta-blocker, angiotensin-converting enzyme (ACE) inhibitors/angiotensin- receptor-blockers (ARBs) and bromocriptine. Increased serum levels of Cathepsin D, the enzyme that generates 16 kDa Prolactin, miR-146a, a direct target of 16 kDa Prolactin, N-terminal-pro-brain-natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) emerged as biomarkers for PPCM. In conclusion, low baseline LVEF is a predictor for poor outcome while pregnancy-induced hypertensive disorders are associated with a better outcome in this European PPCM cohort. The high recovery rate in this collective is associated with a treatment concept using beta-blockers, ACE inhibitors/ARBs and bromocriptine. Increased levels of Cathepsin D activity, miR-146a and ADMA in serum of PPCM patients support the pathophysiological role of 16 kDa Prolactin for PPCM and may be used as a specific diagnostic marker profile. © 2013 The Author(s).
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3709080/bin/395_2013_366_MOESM1_ESM.doc
Authors & Co-Authors
Haghikia, Arash
Germany, Hannover
Hannover Medical School
Podewski, Edith Katharina
Germany, Hannover
Hannover Medical School
Libhaber, Elena N.
South Africa, Cape Town
University of Cape Town
South Africa, Johannesburg
University of the Witwatersrand
Labidi, Saida
Germany, Hannover
Hannover Medical School
Fischer, Dieter
Germany, Hannover
Hannover Medical School
Roentgen, Philipp
Germany, Hannover
Hannover Medical School
Tsikas, D.
Germany, Hannover
Hannover Medical School
Jordan, Jens Friedrich
Germany, Hannover
Hannover Medical School
Lichtinghagen, Ralf
Germany, Hannover
Hannover Medical School
von Kaisenberg, Constantin Sylvius
Germany, Hannover
Hannover Medical School
Struman, Ingrid
Belgium, Liege
Université de Liège
Bovy, N.
Belgium, Liege
Université de Liège
Sliwa, Karen S.
South Africa, Cape Town
University of Cape Town
Bauersachs, Johann
Germany, Hannover
Hannover Medical School
Hilfiker-Kleiner, Denise
Germany, Hannover
Hannover Medical School
Statistics
Citations: 284
Authors: 15
Affiliations: 4
Identifiers
Doi:
10.1007/s00395-013-0366-9
ISSN:
03008428
e-ISSN:
14351803
Research Areas
Maternal And Child Health
Noncommunicable Diseases
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Female