Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports.
Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports.
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DOI：
10.1186/1752-1947-4-80
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发表时间：
2010-03-04
影响因子：
1
通讯作者：
Hilfiker-Kleiner D
中科院分区：
文献类型：
--
作者：
Meyer GP;Labidi S;Podewski E;Sliwa K;Drexler H;Hilfiker-Kleiner D
围产期心肌病是一种罕见的心肌病，在产前一个月和产后六个月之间的妇女中发生异质性表现。它的预后很差，死亡风险很高。我们报告的发展围产期心肌病的两个姐妹篇，27岁和35岁的非洲妇女，其中一人提出了一个大的左心室血栓。随后，2例患者均接受溴隐亭、肝素和心力衰竭标准治疗（血管紧张素转换酶抑制剂、β受体阻滞剂和利尿剂）。在随访期间，在1例患者中观察到的左心室血栓退化。两例患者均未发生血栓形成事件，两例患者的心脏功能和纽约心脏协会分期均持续改善。两姐妹篇围产期心肌病的发展表明，这种类型的心肌病可能有遗传基础，并且具有围产期心肌病阳性家族史的女性可能会增加患该病的风险。这也是首次报告的患者经历降解的一个大的左心室血栓的标准治疗心力衰竭与溴隐亭。这表明，使用溴隐亭与适当的抗凝和心力衰竭治疗可能是有益的和安全的。
Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality. We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics). During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage. The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.