Sharieff S, Zaman K S.
Prognostic factors at initial presentation in patients with Peripartum Cardiomyopathy.
J Pak Med Assoc Jan ;53(7):297-300.

Objectives: To describe the prognostic factors at initial presentation of patients with peripartum cardiomyopathy (PPCM). Setting: Department of Adult Cardiology, National Institute of Cardio-vascular Diseases Karachi, Pakistan, from December 1999 to August 2001. Method: A total of 35 patients diagnosed to have peripartum cardiomyopathy (PPCM) were studied. A detail clinical history was taken in each case and two-dimensional Doppler echocardiogram was done at the time of diagnosis and later repeated at the end of six months to assess the recovery or progress of the disease. Results: The mean age at the time of diagnosis was 30.8 ± 6.74 years; 77% were from lower socio-economic class with poor nutritional status; 77.14% Multiparous; 25.7% had recurrent PPCM and 71.4% presented during post-partum period. 71.4% had ejection fraction < 30% and 74% had >55 mm of left ventricular end-diastolic dimension. Patients who improved, as compared to those who deteriorated, were significantly younger (26.2 ± 5.8 v/s 33.3 ± 5.5 years, p-value <0.001), fair socio-economic class with better nutritional status (p-value <0.011), lower LVEDD (55.92 ± 5.2 v/s 60.96 ± 4.41 mm, p-value <0.005), and a better ejection fraction (30.1 ± 3.75 v/s 25.4 ± 5.6, p-value <0.006). Mortality at six months was 22.8%; 42.9% had persistent disease and only 34.3% recovered completely. Conclusion: Advanced age (>30 years), lower socio-economic status with poor nutritional status, poor ejection fraction and increased left ventricular end-diastolic dimension were found as poor prognostic factors (JPMA 53:297;2003).

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