Race, Hypertensive Disorders of Pregnancy and Outcomes in Peripartum Cardiomyopathy – PubMed

Background:

Black women with peripartum cardiomyopathy (PPCM) have a higher prevalence of hypertensive disorders of pregnancy (HDP) and worse clinical outcomes compared with non-Black women. We examined the impact of HDP on myocardial recovery in Black women with PPCM.

Methods:

A total of 100 women were enrolled into the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6, and 12-months post-partum (PP). Women were followed for 12 months postpartum and outcomes including persistent cardiomyopathy (LVEF≤35%), left ventricular assist device, (LVAD), cardiac transplantation, or death were examined in subsets based on race and the presence of HDP.

Results:

Black women with HDP were more likely to present earlier compared to Black women without HDP (days PP HDP: 34±21 vs 54±27 days, P=0.03). There was no difference in LVEF at study entry for Black women based on HDP, but better recovery with HDP at 6 (HDP:52±11% vs no HDP: 40±14%, P=0.03) and 12-months (HDP:53±10% vs no HDP:40±16%, P=0.02). At 12-months, Black women overall had a lower LVEF than non-Black women (P

Conclusions:

In women with PPCM, poorer outcomes evident in Black women were driven by women without a history of HDP. In Black women, a history of HDP was associated with earlier presentation and recovery which was comparable to non-Black women.