Pregnancies in women after peri-partum cardiomyopathy: the global European Society of Cardiology EuroObservational Research Programme Peri-Partum Cardiomyopathy Registry

作者：Karen Sliwa, Alice M. Jackson, Charle Viljoen, Albertino Damasceno, Irina Mbanze, Hassan Al Farhan, Israa Fadhil Yaseen, Amam Mbakwem, Triwedya Indra Dewi, Zofia Dzielińska, Т. А. Абдуллаев, Sorel Goland, Denise Hilfiker‐Kleiner, Julia Hähnle, Carmen Basic, Alexandra Frogoudaki, Petar Seferović, Peter van der Meer, Mark C. Petrie, Johann Bauersachs · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf006 · 被引用次数：22 · 研究领域：Cardiovascular Issues in Pregnancy、Cardiac Structural Anomalies and Repair、Maternal and fetal healthcare

BACKGROUND AND AIMS: The risk of heart failure progression or mortality in patients with peri-partum cardiomyopathy (PPCM) during subsequent pregnancies (SSPs) is a significant concern for patients, their families, and healthcare providers. However, there is limited contemporary, prospective data on SSP outcomes in PPCM patients from diverse ethnic and sociodemographic groups. This study aimed to assess maternal and neonatal outcomes in PPCM patients undergoing SSPs. METHODS: This is a sub-study on PPCM and SSPs of the global European Society of Cardiology PPCM Registry that recruited patients from 2012 to 2023. Maternal and neonatal outcomes were reported. RESULTS: From 332 patients with PPCM, there were 98 SSPs among 73 women. Of these, 25 (26%) SSPs ended prematurely due to therapeutic termination (20/25), miscarriage (4/25), and stillbirth (1/25). The median follow-up from the end of the SSP was 198 days (inter-quartile range 160-240). Left ventricular ejection fraction (LVEF) was persistently reduced to <50% prior to the SSP in 26% of patients, with only 6% having an LVEF <40%. Patient characteristics were similar, irrespective of SSP baseline LVEF. Clinical worsening [composite of all-cause death, cardiovascular rehospitalization, or decline in LVEF ≥10% (percentage points) and to <50%] occurred in 20% SSPs, with 2% all-cause maternal mortality. Signs/symptoms of heart failure and worsening of New York Heart Association class occurred in 26% and 22% of SSPs, respectivel...