OBJECTIVE

To study the features of course and prognosis of life in patients with peripartum cardiomyopathy (PCMP) over a 5-year follow-up period.

MATERIAL AND METHODS

The study included 51 patients with PPCM who underwent standard examination. Patients were divided into several groups depending on 5-year outcomes: group 1 — normalization of LVEF (> 50%) and no clinical signs of heart failure; group 2 — death due to progression of heart failure (HF) or sudden cardiac death (SCD), group 3 — patients with echocardiography data abnormalities (enlarged heart chambers, LVEF <50%).

RESULTS

Normalization of LVEF was observed in 22 (43%) women. After a year, mortality from heart failure progression was 5% (n=3). SCD occurred in 1 case. Within 2 years, 3 patients died due to progression of heart failure. Overall mortality was 11% (n=6). Overall 5-year mortality was 24% (n=12), where SCD was established only in 3 cases (one patient after repeated birth within a year after onset of disease). Age of patients, high heart rate and hemoglobin were not significant predictors in patients with PPCM. There was a higher baseline tolerance to physical activity in the 1^st group. The worst echocardiography parameters were noted in patients with fatal outcomes (LV EDD 67.7±8.1 and 66.7±5.8 in groups 2 and 3, respectively, p<0.05). In the same groups, incidence of left bundle branch block (LBBB) was 33.3%, no R or Q-S wave was recorded in 58.3% of cases.

CONCLUSION

Patients with unfavorable course of disease (exitus letalis or persistent heart failure) are characterized by low functional status and severe LV systolic dysfunction. ECG changes (LBBB and no R wave) were more common in deceased patients.