2015
Current Therapeutic Concepts in Peripartum Cardiomyopathy
KREJČÍ, Jan; Hana POLOCZKOVÁ a Petr NĚMECZákladní údaje
Originální název
Current Therapeutic Concepts in Peripartum Cardiomyopathy
Autoři
Vydání
Current Pharmaceutical Design, Sharjah, Bentham Science Publishers, 2015, 1381-6128
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30201 Cardiac and Cardiovascular systems
Stát vydavatele
Spojené arabské emiráty
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 3.052
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/15:00082782
Organizační jednotka
Lékařská fakulta
UT WoS
Klíčová slova anglicky
Peripartum cardiomyopathy; aetiology; diagnosis; treatment
Štítky
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 11. 2. 2016 16:38, Ing. Mgr. Věra Pospíšilíková
Anotace
V originále
Peripartum cardiomyopathy (PPCM) is a relatively rare disease characterized by systolic heart failure occuring towards the end of pregnancy or during the months following birth. It is most often seen in women of African descent, and its incidence seems to be slightly increasing in recent years. Other etiologies of heart failure should be excluded to determine the diagnosis of PPCM. The clinical picture corresponds to systolic heart failure. The rapid onset of the symptoms in relation to pregnancy is striking. The essential diagnostic procedures such as echocardiography, cardiac magnetic resonance imaging and endomyocardial biopsy may be beneficial in certain situations. The etiology of the disease remains unclear. Speculated causes include myocarditis, autoimmune disorders, cardiotropic virus infection, and abnormal responses to hemodynamic and hormonal changes during pregnancy. Particular attention is currently given to the concept of increased oxidative stress inducing production of proapoptotic, angiostatic and proinflammatory mediators. Recovery of left ventricular systolic function occurs in about half of the cases. Mortality has been decreasing in recent years, especially in the United States, but is still between 10-15% in less developed countries where therapeutic possibilities are limited. In addition to standard heart failure therapy, specific treatments (pentoxyfilline, bromocriptine, immunomodulatory therapy) have been tested. Mechanical circulatory support is sometimes needed. Heart transplantation is the therapeutic option for the most severe heart failure and is used in about 10% of the cases. Recurrence in subsequent pregnancy is common and therefore, another pregnancy is not recommended in many cases.