Myocarditis and long-term survival in peripartum cardiomyopathy

G. Michael Felker, Christopher J. Jaeger, Elizabeth Klodas, David R. Thiemann, Joshua Hare, Ralph H. Hruban, Edward K. Kasper, Kenneth L. Baughman

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Background: The reported mortality rate of peripartum cardiomyopathy (PPCM) is high, although the potential for spontaneous recovery of ventricular function is well established. The prevalence of myocarditis in PPCM has varied widely between studies. The purposes of this study were to define the long-term prognosis in a referral population of patients with PPCM, to determine the prevalence of myocarditis on endomyocardial biopsy in this population, and to identify clinical variables associated with poor outcome. Methods: We analyzed clinical, echocardiographic, hemodynamic, and histologic features of 42 women with PPCM evaluated at our institution over a 15-year period. Each patient underwent an extensive evaluation, including echocardiography, endomyocardial biopsy, and right heart catheterization. Data were analyzed to identify features at initial examination associated with the combined end point of death or cardiac transplantation by the use of Kaplan-Meier survival curves and a Cox proportional hazards model. Results: Three (7%) patients died and 3 (7%) patients underwent heart transplantation during a median follow-up of 8.6 years. Endomyocardial biopsy demonstrated a high prevalence of myocarditis (62%), but the presence or absence of myocarditis was not associated with survival. Of the prespecified variables assessed, only decreased left ventricular stroke work index was associated with worsened outcome. Conclusions: In patients with PPCM, (1) long-term survival is better than has been historically reported, (2) the prevalence of myocarditis is high, and (3) decreased left ventricular stroke work index is associated with worse clinical outcomes.

Original languageEnglish
Pages (from-to)785-791
Number of pages7
JournalAmerican Heart Journal
Volume140
Issue number5
DOIs
StatePublished - Nov 15 2000
Externally publishedYes

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Peripartum Period
Myocarditis
Cardiomyopathies
Survival
Heart Transplantation
Biopsy
Stroke
Ventricular Function
Recovery of Function
Kaplan-Meier Estimate
Cardiac Catheterization
Proportional Hazards Models
Population
Echocardiography
Referral and Consultation
Hemodynamics
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Felker, G. M., Jaeger, C. J., Klodas, E., Thiemann, D. R., Hare, J., Hruban, R. H., ... Baughman, K. L. (2000). Myocarditis and long-term survival in peripartum cardiomyopathy. American Heart Journal, 140(5), 785-791. https://doi.org/10.1067/mhj.2000.110091

Myocarditis and long-term survival in peripartum cardiomyopathy. / Felker, G. Michael; Jaeger, Christopher J.; Klodas, Elizabeth; Thiemann, David R.; Hare, Joshua; Hruban, Ralph H.; Kasper, Edward K.; Baughman, Kenneth L.

In: American Heart Journal, Vol. 140, No. 5, 15.11.2000, p. 785-791.

Research output: Contribution to journalArticle

Felker, GM, Jaeger, CJ, Klodas, E, Thiemann, DR, Hare, J, Hruban, RH, Kasper, EK & Baughman, KL 2000, 'Myocarditis and long-term survival in peripartum cardiomyopathy', American Heart Journal, vol. 140, no. 5, pp. 785-791. https://doi.org/10.1067/mhj.2000.110091
Felker GM, Jaeger CJ, Klodas E, Thiemann DR, Hare J, Hruban RH et al. Myocarditis and long-term survival in peripartum cardiomyopathy. American Heart Journal. 2000 Nov 15;140(5):785-791. https://doi.org/10.1067/mhj.2000.110091
Felker, G. Michael ; Jaeger, Christopher J. ; Klodas, Elizabeth ; Thiemann, David R. ; Hare, Joshua ; Hruban, Ralph H. ; Kasper, Edward K. ; Baughman, Kenneth L. / Myocarditis and long-term survival in peripartum cardiomyopathy. In: American Heart Journal. 2000 ; Vol. 140, No. 5. pp. 785-791.
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