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Prognostic Value of speckle tracking echocardiography in peripartum cardiomyopathy patients: A long term pilot study
Research Abstract
Statement of the problem: Although peripartum cardiomyopathy (PPCM) is a rare disease, its frequency is higher in some regions including Egypt. It can result in morbidity and mortality of 5- 32%. Identifying prognostic indicators of women with PPCM is of paramount importance. Speckle tracking echocardiography (STE) was found helpful to assess early changes of left ventricular function and mechanics; however its prognostic value is still under investigation.
Methodology & Theoretical Orientation: This is a case-control prospective study that included 25 PPCM patients admitted to the cardiology and woman health hospitals of Assiut University, Egypt from September 2016 – December 2018 and 20 control pregnant women. Clinical assessment, 2-D echocardiography & STE were done to study population upon inclusion, and at scheduled quarterly visits.
Findings: Patients age was 29.9±7.68 years, 75% presented in the postpartum period. At presentation, LVEF was impaired in patients vs. controls (33.2±8.84 % vs. 62.65±5.61 %, P 0.001), STE showed reduction of GLS (-10.08±6.76 vs.-19.49±2.82) , GCS (-11.65±3.34 % vs.-23.63±2.93%) (P0.001). Patients were followed-up for a median of 13.5 months where 9 improved (LVEF ≥ 50%), 7 partially improved (LVEF =40-49%), 4 had persistent LV dysfunction (LVEF40%), 4 died. Along the study; GLS & GCS increased significantly (-13.03±4.53% to -20.18±1.75), (-13.28±3.37% to -22.53±4.82%) in improved patients. Patients who died had significantly impaired GLS and GCS vs. those improved (-9.07±0.65 vs.-16.09±2.57%, -8.17±3.1 vs. -14.02±2.62 %, P0.01)). More reduction was noted in apical GCS (-6.97±4.67 vs. -17.43±6.75%). Patients with persistent LV dysfunction and those who died were presented later than improved (18±11.79 vs.7.5±4.93 days postpartum)
Conclusion & Significance: Longitudinal and circumferential strains are depressed in PPCM patients. 2D-STE can be used as an objective marker of LV dysfunction in PPCM patients at long term.
Recommendation: A larger multicenter study is recommended. Meanwhile, STE is advised whenever PPCM is suspected.
Research Department
Research Journal
7th World Heart Congreess
Research Member
Research Pages
NULL
Research Publisher
NULL
Research Rank
3
Research Vol
NULL
Research Website
NULL
Research Year
2019