Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy.
Phenotyping and outcome on contemporary management in a German cohort of patients with peripartum cardiomyopathy.
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DOI：
10.1007/s00395-013-0366-9
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发表时间：
2013-07
影响因子：
9.5
通讯作者：
Hilfiker-Kleiner D
中科院分区：
文献类型：
--
作者：
Haghikia A;Podewski E;Libhaber E;Labidi S;Fischer D;Roentgen P;Tsikas D;Jordan J;Lichtinghagen R;von Kaisenberg CS;Struman I;Bovy N;Sliwa K;Bauersachs J;Hilfiker-Kleiner D
围产期心肌病（PPCM）是一种危及生命的心脏病，发生于妊娠末期或分娩后几个月，发生于以前健康的心脏病妇女。增强的氧化应激和随后的哺乳激素催乳素裂解成抗血管生成的16 kDa亚片段成为该疾病的潜在致病因素。我们建立了一项前瞻性登记研究，在115例患者中证实存在PPCM（平均基线左心室射血分数，LVEF：27 ± 9%）。随访数据（6 ± 3个月）显示85%的患者LVEF改善，47%的患者完全恢复，15%的患者未能恢复，2%的患者死亡。16.5%的患者有心肌病家族史。妊娠相关高血压与更好的结局相关，而基线LVEF ≤ 25%与更差的结局相关。在接受β受体阻滞剂、血管紧张素转换酶（ACE）抑制剂/血管紧张素受体阻滞剂（ARB）和溴隐亭联合治疗的患者中观察到较高的恢复率（96%）。组织蛋白酶D（产生16 kDa催乳素的酶）、miR-146 a（16 kDa催乳素的直接靶点）、N-末端脑利钠肽原（NT-proBNP）和不对称二甲基精氨酸（ADMA）的血清水平升高是PPCM的生物标志物。总之，在欧洲PPCM队列中，低基线LVEF是不良结局的预测因子，而妊娠高血压疾病与较好的结局相关。在这一集体的高恢复率与使用β受体阻滞剂，ACE抑制剂/ARB和溴隐亭的治疗概念。PPCM患者血清中组织蛋白酶D活性、miR-146 a和ADMA水平升高支持16 kDa催乳素对PPCM的病理生理作用，并可用作特异性诊断标志物谱。本文的在线版本（doi：10.1007/s 00395 -013-0366-9）包含补充材料，可供授权用户使用。
Peripartum cardiomyopathy (PPCM) is a life-threatening heart disease developing towards the end of pregnancy or in the months following delivery in previously healthy women in terms of cardiac disease. Enhanced oxidative stress and the subsequent cleavage of the nursing hormone Prolactin into an anti-angiogenic 16 kDa subfragment emerged as a potential causal factor of the disease. We established a prospective registry with confirmed PPCM present in 115 patients (mean baseline left ventricular ejection fraction, LVEF: 27 ± 9 %). Follow-up data (6 ± 3 months) showed LVEF improvement in 85 % and full recovery in 47 % while 15 % failed to recover with death in 2 % of patients. A positive family history of cardiomyopathy was present in 16.5 %. Pregnancy-associated hypertension was associated with a better outcome while a baseline LVEF ≤ 25 % was associated with a worse outcome. A high recovery rate (96 %) was observed in patients obtaining combination therapy with beta-blocker, angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor-blockers (ARBs) and bromocriptine. Increased serum levels of Cathepsin D, the enzyme that generates 16 kDa Prolactin, miR-146a, a direct target of 16 kDa Prolactin, N-terminal-pro-brain-natriuretic peptide (NT-proBNP) and asymmetric dimethylarginine (ADMA) emerged as biomarkers for PPCM. In conclusion, low baseline LVEF is a predictor for poor outcome while pregnancy-induced hypertensive disorders are associated with a better outcome in this European PPCM cohort. The high recovery rate in this collective is associated with a treatment concept using beta-blockers, ACE inhibitors/ARBs and bromocriptine. Increased levels of Cathepsin D activity, miR-146a and ADMA in serum of PPCM patients support the pathophysiological role of 16 kDa Prolactin for PPCM and may be used as a specific diagnostic marker profile. The online version of this article (doi:10.1007/s00395-013-0366-9) contains supplementary material, which is available to authorized users.
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影响因子：
3.3
作者：
Kamiya, Chizuko A.;Kitakaze, Masafumi;Ikeda, Tomoaki
通讯作者：
Ikeda, Tomoaki
影响因子：
120.7
作者：
Pearson, GD;Veille, JC;Baughman, KL
通讯作者：
Baughman, KL
影响因子：
18.2
作者：
Sliwa, Karen;Hilfiker-Kleiner, Denise;McMurray, John J. V.
通讯作者：
McMurray, John J. V.
影响因子：
18.2
作者：
Forster, Olaf;Hilfiker-Kleiner, Denise;Sliwa, Karen
通讯作者：
Sliwa, Karen
DOI：
10.1007/bf03010571
发表时间：
1995-01-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
--
作者：
ROSS, RM;BAKER, T
通讯作者：
BAKER, T