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Circ J 2021 May 13. Epub 2021 May 13.

Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences.

Circ Heart Fail 2021 May 13:CIRCHEARTFAILURE120008223. Epub 2021 May 13.

Division of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (M.M.K.).

Heart failure (HF) is a leading cause of morbidity and mortality in pregnant women in the United States. Although peripartum cardiomyopathy is the most common diagnosis for pregnant women with HF, women with preexisting cardiomyopathies and systolic dysfunction are also at risk as the hemodynamic demands of pregnancy can lead to decompensation, arrhythmia, and rarely death. The differential diagnosis of HF in pregnancy is broad and includes Takotsubo or stress cardiomyopathy, exacerbation of a preexisting cardiomyopathy, such as familial cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or left ventricular noncompaction. Read More

J Cardiovasc Magn Reson 2021 May 10;23(1):52. Epub 2021 May 10.

Georgetown University School of Medicine, Washington, USA.

This document is a position statement from the Society for Cardiovascular Magnetic Resonance (SCMR) on recommendations for clinical utilization of cardiovascular magnetic resonance (CMR) in women with cardiovascular disease. The document was prepared by the SCMR Consensus Group on CMR Imaging for Female Patients with Cardiovascular Disease and endorsed by the SCMR Publications Committee and SCMR Executive Committee. The goals of this document are to (1) guide the informed selection of cardiovascular imaging methods, (2) inform clinical decision-making, (3) educate stakeholders on the advantages of CMR in specific clinical scenarios, and (4) empower patients with clinical evidence to participate in their clinical care. Read More

Neuromuscul Disord 2021 Apr 9. Epub 2021 Apr 9.

Department of Pediatrics, Pediatric Metabolism and Nutrition Unit, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey. Electronic address:

Very long-chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD) deficiency is an autosomal recessive fatty acid oxidation disorder characterized by rhabdomyolysis, hypoglycemia and cardiomyopathy. The general treatment approach in adult patients is based on the prevention of catabolism. High carbohydrate, low fat diet and supplementation of medium-chain triglycerides are essential in the treatment. Read More

Echocardiography 2021 May 8. Epub 2021 May 8.

Department of Cardiovascular Medicine, Dartmouth-Hitchcock Medical Center and Geisel School of Medicine, Lebanon, NH, USA.

Objectives: Data regarding the longitudinal relationship of global longitudinal strain (GLS) and echocardiographic parameters are lacking in peripartum cardiomyopathy (PPCM). We evaluated GLS and its correlation with change (∆) in left ventricular ejection fraction (LVEF).

Methods: We retrospectively identified women age ≥16 years hospitalized at Montefiore Medical Center in Bronx, NY from 1999-2015 with International Statistical Classification of Diseases and Related Health Problems, 9th revision codes for PPCM or an occurrence of unexplained heart failure during or up to 5 months postpartum. Read More

J Card Surg 2021 May 7. Epub 2021 May 7.

Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany.

Objectives: Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure occurring toward the end of pregnancy or in the period after delivery. Lack of myocardial recovery or therapy-refractory cardiogenic shock are rare complications and left ventricular assist device (LVAD) systems might be used as a life-saving option. The aim of this study was to investigate outcomes of PPCM patients supported with LVAD, registered in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). Read More

Front Endocrinol (Lausanne) 2021 20;12:645085. Epub 2021 Apr 20.

Institute for Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital & Paracelsus Medical University, Nuremberg, Germany.

Vasoinhibin is a protein hormone with antiangiogenic, antivasodilatatory, and antivasopermeability effects generated by the proteolytic cleavage of prolactin. The discovery of its role in diabetic retinopathy and peripartum cardiomyopathy led to the evaluation of new pharmacological treatments in clinical interventional trials. However, the quantitative evaluation of vasoinhibin in biological samples from patients has not been possible due to the lack of vasoinhibin-specific antibodies. Read More

ESC Heart Fail 2021 May 4. Epub 2021 May 4.

Division of Cardiology, Perelman Center for Advanced Medicine, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, 2-East Pavilion, Philadelphia, PA, 19104, USA.

We report a case series of six women with peripartum cardiomyopathy (PPCM) who incidentally underwent echocardiography prior to the clinical presentation of PPCM. For comparison, we identified controls, matched 2:1 on age, race, body mass index, gestational age, and hypertensive disorder. Among the six cases, all were diagnosed with PPCM during the post-partum period. Read More

Am Heart J 2021 Apr 24. Epub 2021 Apr 24.

Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania; Center for Pediatric Clinical Effectiveness, Children's Hospital of Pennsylvania; Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania; Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania; Department of Pediatrics, Division of Oncology, Children's Hospital of Pennsylvania. Electronic address:

Importance: Peripartum cardiomyopathy (PPCM) disproportionately affects women of African ancestry. Additionally, clinical outcomes are worse in this subpopulation compared to White women with PPCM. The extent to which socioeconomic parameters contribute to these racial disparities is not known. Read More

Int J Obstet Anesth 2021 Mar 24:102976. Epub 2021 Mar 24.

Department of Anesthesiology, Rinku General Medical Center, Izumisano, Osaka, Japan.

BMC Cardiovasc Disord 2021 Apr 22;21(1):205. Epub 2021 Apr 22.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, No. 2 Anzhen Road, Beijing, 100029, China.

Background: The aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients.

Methods: Sixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. Read More

Circulation 2021 May 20;143(19):1852-1862. Epub 2021 Apr 20.

University of Pittsburgh Medical Center, PA (D.M.M.).

Background: Peripartum cardiomyopathy (PPCM) occurs in ≈1:2000 deliveries in the United States and worldwide. The genetic underpinnings of PPCM remain poorly defined. Approximately 10% of women with PPCM harbor truncating variants in (TTNtvs). Read More

Acta Myol 2021 Mar 31;40(1):61-65. Epub 2021 Mar 31.

Dynamic Biologics Inc., Monmouth Junction, New Jersey, USA.

We report a family carrying a previously described truncating mutation, NM_001267550.2(TTN):c.107889del p. Read More

Am Heart J 2021 Apr 12. Epub 2021 Apr 12.

Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania.

Importance: Peripartum cardiomyopathy (PPCM) disproportionately affects women of African ancestry. Additionally, clinical outcomes are worse in this subpopulation compared to White women with PPCM. The extent to which socioeconomic parameters contribute to these racial disparities is not known. Read More

Anaesthesist 2021 Apr 13. Epub 2021 Apr 13.

Klinik für Anästhesiologie, Universitätsmedizin Mainz, Mainz, Deutschland.

As the incidence of diseases during pregnancy that necessitate intensive medical care is very low, intensive care physicians are faced with a multitude of unfamiliar challenges in the treatment of these patients. The physiological and pathophysiological alterations during pregnancy induce some specific features with respect to the intensive medical treatment of pregnant or postpartum patients. After the most important principles and current recommendations on the care of pregnant or postpartum patients who need intensive medical treatment were dealt with in the first article in this CME series, the second article focuses on the diagnostics and treatment of special selected pathologies. Read More

Herzschrittmacherther Elektrophysiol 2021 Mar 31. Epub 2021 Mar 31.

Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Peripartum cardiomyopathy (PPCM) is a rare but life-threatening heart disease, with onset in the last month of pregnancy or in the first months after delivery. Extensive studies on the burden of supraventricular and ventricular arrhythmias are lacking. Patients with PPCM present with electrocardiographic findings typical in acute heart failure. Read More

Womens Health Rep (New Rochelle) 2020 8;1(1):463-467. Epub 2020 Oct 8.

Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.

Some women have underlying cardiovascular disease that leads to increased morbidity and mortality with pregnancy. These women may choose to terminate a pregnancy rather than face this increased risk. The optimal approach for pregnancy termination in women with cardiomyopathy is not well defined. Read More

Eur Heart J Case Rep 2021 Mar 22;5(3):ytab088. Epub 2021 Mar 22.

University Hospital Coventry & Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK.

Background: Left ventricular non-compaction (LVNC) cardiomyopathy is a persistence of abnormal foetal myocardium and is a rare cause of cardiomyopathy in the peripartum period. Unlike other causes of peripartum cardiomyopathy which typically improve, LVNC has significant long-term personal and family implications and needs lifelong follow-up.

Case Summary: We describe a unique case of a 30-year-old woman who developed cardiomyopathy in the peripartum period which was revealed on cardiovascular magnetic resonance imaging to be due to occult LVNC. Read More

Perfusion 2021 Mar 26:2676591211004369. Epub 2021 Mar 26.

INOVA Cardiac and Thoracic Surgery, INOVA Fairfax Hospital, Falls Church, VA, USA.

Background: The use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) for cardiogenic shock in pregnant and postpartum patients remains limited by concerns of bleeding, hemolysis, and fetal risks. This case series examines the underlying characteristics and management strategies for this high-risk population.

Methods: All pregnant and post-partum patients who underwent VA ECMO in the cardiovascular intensive care unit between January 1, 2016 and November 1, 2019, were included in this retrospective study. Read More

BMJ Case Rep 2021 Mar 19;14(3). Epub 2021 Mar 19.

Medicine, Okinawa Chubu Hospital, Uruma, Okinawa, Japan

A postpartum patient with acute-onset dyspnoea and hypotention, associated with reduced left ventricular function requiring intensive blood pressure control, was initially misdiagnosed as having peripartum cardiomyopathy. Her clinical symptoms rapidly resolved. Echocardiography revealed reversible left ventricular dysfunction with apical ballooning and coronary angiography was normal. Read More

J Med Case Rep 2021 Mar 19;15(1):143. Epub 2021 Mar 19.

Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.

Background: There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis. Read More

Eur Heart J Case Rep 2021 Feb 16;5(2):ytab001. Epub 2021 Feb 16.

Department of Cardiology and Radiology, San Bassiano Hospital, Via dei Lotti 40, 36061 Bassano del Grappa, VI, Italy.

Background: Peripartum cardiomyopathy (PPCM) is usually characterized by overt heart failure, but other clinical scenarios are possible, sometimes making the diagnosis challenging.

Case Summary: We report a case series of four patients with PPCM. The first patient presented with acute heart failure due to left ventricular (LV) systolic dysfunction. Read More

Curr Cardiol Rev 2021 Mar 16. Epub 2021 Mar 16.

Trakya University, Cardiology Department, Edirne. Turkey.

Fontan operation has been defined as a palliative surgery connecting systemic venous return and pulmonary circulation in patients with certain forms of complex congenital heart disease (CHD). Fortunately, it has improved overall survival and chance of successful pregnancies among these patients. However, Fontan circulation (FC), as a potential trade off, might be associated with specific late or post-gestational complications including peripartum cardiomyopathy (PPCM) largely through its adverse effects on placenta and inflammation-oxidation stress. Read More

Am J Obstet Gynecol 2021 Mar 9. Epub 2021 Mar 9.

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Maternal tolerance of the semiallogenic fetus necessitates conciliation of competing interests. Viviparity evolved with a placenta to mediate the needs of the fetus and maternal adaptation to the demands of pregnancy and to ensure optimal survival for both entities. The maternal-fetal interface is imagined as a 2-dimensional porous barrier between the mother and fetus, when in fact it is an intricate multidimensional array of tissues and resident and circulating factors at play, encompassing the developing fetus, the growing placenta, the changing decidua, and the dynamic maternal cardiovascular system. Read More

J Matern Fetal Neonatal Med 2021 Mar 7:1-7. Epub 2021 Mar 7.

Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center; and Division of Anesthesia, Critical Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Objective: We compared pregnancy and delivery outcomes between women with cardiac disease versus matched healthy controls. The primary outcome was the frequency of unplanned cesarean delivery.

Methods: In this single-center retrospective case-control study, women with cardiac disease were identified and matched (1:2 ratio, according to maternal age, parity, number of prior cesareans, gestational age, delivery onset and fetal presentation) to healthy controls who delivered within the same year. Read More

Eur J Heart Fail 2021 Feb 20. Epub 2021 Feb 20.

Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

This position paper focusses on the pathophysiology, diagnosis and management of women diagnosed with a cardiomyopathy, or at risk of heart failure (HF), who are planning to conceive or present with (de novo or previously unknown) HF during or after pregnancy. This includes the heterogeneous group of heart muscle diseases such as hypertrophic, dilated, arrhythmogenic right ventricular and non-classified cardiomyopathies, left ventricular non-compaction, peripartum cardiomyopathy, Takotsubo syndrome, adult congenital heart disease with HF, and patients with right HF. Also, patients with a history of chemo-/radiotherapy for cancer or haematological malignancies need specific pre-, during and post-pregnancy assessment and counselling. Read More

Indian J Crit Care Med 2021 Jan;25(1):97-99

Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, UAE.

Cardioembolic stroke in a patient with peripartum cardiomyopathy (PPCM) patient is rare despite a higher incidence of thromboembolic events. We report a case of acute right middle cerebral artery territory cardioembolic stroke in a postpartum female as the initial presenting feature of PPCM. The patient was thrombolyzed with intravenous alteplase and had an almost complete neurological recovery. Read More

Eur Heart J Case Rep 2021 Feb 26;5(2):ytaa533. Epub 2020 Dec 26.

Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A.Gemelli 8, Rome 00168, Italy.

Background: Intracardiac thrombosis is a relatively common pathological condition. Often, it is diagnosed at echocardiography during the subacute or chronic phase. In the very acute phase, tissue composition can make thrombus appearance very different from that usually seen. Read More

J Card Fail 2021 Feb;27(2):157-158

Professor of Medicine, Washington University School of Medicine, St. Louis, Missouri. Electronic address:

J Card Fail 2021 Feb;27(2):153-156

Cardiovascular Division, Washington University in St. Louis, St. Louis, MO. Electronic address: