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Original Article

Outcomes of Patients with Peripartum Cardiomyopathy Who Received Mechanical Circulatory Support: Data from the INTERMACS Registry

Renzo Y. Loyaga-Rendon, Salpy V. Pamboukian, Jose A. Tallaj, Deepak Acharya, Ryan Cantor, Randall C. Starling, David Naftel, James Kirklin
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https://doi.org/10.1161/CIRCHEARTFAILURE.113.000721
Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.000721
Originally published January 17, 2014
Renzo Y. Loyaga-Rendon
Section of Advanced Heart Failure, Heart Transplantation, Mechanical Circulatory Support and Pulmonary Vascular Disease, University of Alabama at Birmingham, Birmingham, AL
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  • For correspondence: rloyagar@uab.edu
Salpy V. Pamboukian
Section of Advanced Heart Failure, Heart Transplantation, Mechanical Circulatory Support and Pulmonary Vascular Disease, University of Alabama at Birmingham, Birmingham, AL
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Jose A. Tallaj
Section of Advanced Heart Failure, Heart Transplantation, Mechanical Circulatory Support and Pulmonary Vascular Disease, University of Alabama at Birmingham, Birmingham, AL
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Deepak Acharya
Section of Advanced Heart Failure, Heart Transplantation, Mechanical Circulatory Support and Pulmonary Vascular Disease, University of Alabama at Birmingham, Birmingham, AL
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Ryan Cantor
Cardiovascular Surgery Division, University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Randall C. Starling
Section of Heart Failure, Cleveland Clinic Foundation, Cleveland, OH
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David Naftel
Cardiothoracic Surgery Division, University of Alabama at Birmingham, Birmingham, AL
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James Kirklin
Cardiovascular Surgery Division, University of Alabama at Birmingham, Birmingham, AL
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Abstract

Background—We describe the characteristics and outcomes of peripartum cardiomyopathy (PPCMP) patients who received durable mechanical circulatory support and compared it with other etiologies of advanced heart failure.

Methods and Results—We analyzed 1258 women who were registered in INTERMACS between June 2006 and March 2012. Baseline characteristics implant strategies, hemodynamics, echocardiographic data and outcomes were compared. Ninety nine women had PPCMP and 1159 had non-PPCMP as primary diagnosis. PPCMP women were younger (p<0.001), more likely to be African Americans and had less comorbidities than non-PPCMP patients. PPCMP women had better survival than non-PPCMP women (p=0.01) with a two year survival of 83%. Multivariable risk factor adjustment analysis showed that the improved survival was likely due to younger age and fewer comorbidities. At 36 months a proportion of 48% PPCMP received heart transplantation. Recovery occurred at a frequency of 6% and 2% in the PPCMP and non-PPCMP groups (p=0.1). Adverse event rates were similar in PPCMP and non-PPCMP patients except for higher cardiac arrhythmias and respiratory failure in the non-PPCMP in the first 3 months post implant.

Conclusions—PPCMP women who receive durable mechanical circulatory support have a better survival than women with non-PPCPM. The improved survival observed in PPCMP is likely related to their fewer comorbidities and younger age. Myocardial recovery was uncommon and less than half of women with end stage PPCPM received heart transplantation after three years of mechanical support.

  • heart-assist device
  • postpartum
  • cardiomyopathy
  • Received June 5, 2013.
  • Accepted January 12, 2014.
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Circulation: Heart Failure
April 2018, Volume 11, Issue 4
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    Outcomes of Patients with Peripartum Cardiomyopathy Who Received Mechanical Circulatory Support: Data from the INTERMACS Registry
    Renzo Y. Loyaga-Rendon, Salpy V. Pamboukian, Jose A. Tallaj, Deepak Acharya, Ryan Cantor, Randall C. Starling, David Naftel and James Kirklin
    Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.000721, originally published January 17, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.000721

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    Outcomes of Patients with Peripartum Cardiomyopathy Who Received Mechanical Circulatory Support: Data from the INTERMACS Registry
    Renzo Y. Loyaga-Rendon, Salpy V. Pamboukian, Jose A. Tallaj, Deepak Acharya, Ryan Cantor, Randall C. Starling, David Naftel and James Kirklin
    Circulation: Heart Failure. 2014;CIRCHEARTFAILURE.113.000721, originally published January 17, 2014
    https://doi.org/10.1161/CIRCHEARTFAILURE.113.000721
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