Abstract Body (Do not enter title and authors here): Background:Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening form of heart failure (HF) occurring toward the end of pregnancy or early after delivery with variable clinical presentations which differs across different regions.
Research Questions:We report the clinical and echocardiographic data of an Italian multicenter, observational registry of PPCM patients (NCT05878041).
Methods:Women with history or recent diagnosis of PPCM were considered eligible. Inclusion criteria were (i) age ≥18 years; (ii) onset of HF signs or symptoms in the last month of pregnancy or within 5 months of delivery, (iii) no identifiable cause of heart failure; (iv) left ventricle ejection fraction (LVEF) ≤45 % (v) no known structural heart disease before pregnancy. Data included clinical, echocardiographic parameters, and blood samples for multi-omic analysis.
Results:Twenty-eight women with confirmed PPCM diagnosis were enrolled. The mean age at clinical onset was 33.9 ± 5.1 years. Hypertensive disorders of pregnancy occurred in 21.4% of cases, and 14.3% developed pre-eclampsia. Overweight was reported in 25% of patients, and 11% were severely obese. Two thirds of women presented with severe symptoms (NYHA class III/IV) within the first month after delivery, and 67% had an initial LVEF ≤35%. In 25% of cases, the clinical presentation included an arrhythmic phenotype. A persistent severe LV dysfunction (LVEF<35%) was reported in 14% of patients, requiring cardioverter-defibrillator implantation. However, 50% of patients showed complete recovery of systolic function over an average follow-up of 11 ± 19 months, with no reported deaths. On transthoracic echocardiography, compared to women with recovered LV function, those with persisting LV dysfunction had more dilated LV (end-diastolic diameter 61.2±8.1 mm in LVEF<35% group vs 51.8±6.9 mm in 35%Conclusions:Despite frequent severe onset, many PPCM patients experience favorable outcomes. Factors predicting LVEF recovery remain unclear, hence the need for further research, particularly into underlying mechanisms and long-term outcomes using integrated multi-omics approaches.