Ultrasound Research Today is a free monthly online journal that collates and summarizes the latest research about Ultrasound, including details on screening, diagnosis, pregnancy, detection.

Risk stratification of women with peripartum cardiomyopathy at initial presentation: a dobutamine stress echocardiography study.

Dorbala S, Brozena S, Zeb S, Galatro K, Homel P, Ren JF, Chaudhry FA

Division of Cardiology, Department of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania.

OBJECTIVES: We sought to determine the prognostic use of inotropic contractile reserve on risk stratification and prognostication of women with peripartum cardiomyopathy. BACKGROUND: Peripartum cardiomyopathy is a rare disorder effecting women in their prime years of life. There appears to be an initial high-risk period with 25% to 50% of women dying within the first 3 months postpartum. Early risk stratification and prognostication are, thus, crucial. However, only limited data are available. METHODS: In all, 7 women (mean age 31.8 years) with peripartum cardiomyopathy and severe left ventricular (LV) dysfunction (mean LV ejection fraction [LVEF] 25.3 +/- 9.5%) were studied. Of these, 6 underwent dobutamine stress echocardiography at baseline and a follow-up resting echocardiogram at a mean of 4.7 +/- 0.9 months after initial presentation. Resting and peak inotropic contractile reserve, and follow-up LVEF, were computed. RESULTS: The mean LVEF improved significantly from baseline (25.3 +/- 9.5%) to maximal inotropic contractile reserve (53.8 +/- 12.6%) (P = .0004) and at follow-up (53.0 +/- 16.4%) (P = .006). Importantly, LVEF at maximal inotropic contractile reserve and at follow-up (5.6 months) did not differ significantly (P = .5). The mean LVEF at maximal inotropic contractile reserve correlated well with the follow-up (LVEF R = 0.79). However, the baseline LVEF did not correlate with follow-up LVEF (P = not significant). CONCLUSIONS: In patients presenting with peripartum cardiomyopathy, inotropic contractile reserve during dobutamine stress echocardiography accurately correlates with subsequent recovery of LV function and confers a benign prognosis.

Published 7 January 2005 in J Am Soc Echocardiogr, 18(1): 45-8.
Full-text of this article is available online (may require subscription).

© 2004-2008 Ultrasound Research Today. All Rights Reserved.