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Eur J Heart Fail. 2019 Dec;21(12):1534-1542. doi: 10.1002/ejhf.1624. Epub 2019 Nov 13.

Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities.

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Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Department of Cardiology, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany.
Department of Cardiology, Pulmonology, and Vascular Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Department of Cardiology, Charité Universitätsmedizin, Campus Benjamin Franklin, Berlin, Germany.
Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany.



Peripartum cardiomyopathy (PPCM) establishes late in pregnancy or in the first postpartum months. Many patients recover well within the first year, but long-term outcome studies on morbidity and mortality are rare. Here, we present 5-year follow-up data of a German PPCM cohort.


Five-year follow-up data were available for 66 PPCM patients (mean age 34 ± 5 years) with a mean left ventricular ejection fraction (LVEF) of 26 ± 9% at diagnosis. Ninety-eight percent initially received standard heart failure therapy (beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and/or mineralocorticoid receptor antagonists), and 86% were additionally treated with dopamine D2 receptor agonists (mainly bromocriptine) and anticoagulation. After 1 year, mean LVEF had improved to 50 ± 11% (n = 48) and further increased to 54 ± 7% at 5-year follow-up with 72% of patients having achieved full cardiac recovery (LVEF >50%). At 5-year follow-up, only three patients (5%) displayed no recovery, of whom one had died. However, 20% had arterial hypertension and 17% arrhythmias, including paroxysmal supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation. Moreover, 70% were still on at least one heart failure drug. Subsequent pregnancy occurred in 16 patients with two abortions and 14 uneventful pregnancies. Mean LVEF was 55 ± 7% at 5-year follow-up in these patients.


Our PPCM collective treated with standard therapy for heart failure, dopamine D2 receptor agonists, and anticoagulation displays a high and stable long-term recovery rate with low mortality at 5-year follow-up. However, long-term use of cardiovascular medication, persisting or de novo hypertension and arrhythmias were frequent.


Co-morbidities; Heart failure; Medication; Peripartum cardiomyopathy; Subsequent pregnancy


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