PMID- 25966297 OWN - NLM STAT- MEDLINE DCOM- 20160229 LR - 20161125 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 190 DP - 2015 TI - Low systolic blood pressure and high resting heart rate as predictors of outcome in patients with peripartum cardiomyopathy. PG - 376-82 LID - S0167-5273(15)00803-7 [pii] LID - 10.1016/j.ijcard.2015.04.081 [doi] AB - BACKGROUND: Patients with peripartum cardiomyopathy (PPCM) present with low blood pressure (SBP) often preventing uptitration of heart failure medication. We aimed to study prediction of risk and the contribution of high resting heart rate (HR) and low SBP to risk in recent onset of PPCM. METHODS: Clinical assessment with HR and SBP, echocardiography and laboratory results were obtained at baseline and at six months on 206 patients with recent onset PPCM enrolled at two tertiary care centers in South Africa. Poor outcome was defined as the combined endpoint of death, LVEF<35% or remaining in New York Heart Association (NYHA) functional class III/IV at six months. Complete LV recovery was defined as LVEF >/= 55% at six months. RESULTS: Poor outcome was observed in 110 of 220 patients (53%), with 26 patients dying at six months (12.6%). There were 98 (47.5%) patients with SBP /= 100) and low SBP (< 110 mmHg) tended to have worse outcomes than patients below the HR median and high SBP. PPCM patients with low SBP and high HR were less likely to be on ACE-inhibitors (n = 35, 69% versus n = 129, 84%, p = 0.024) and on the beta blocker carvedilol (n = 24, 47% versus n = 98, 64%, p = 0.047). Low SBP, high HR and left ventricular end diastolic diameter at baseline were predictors of poor outcome. Patients with low SBP and high HR had the highest mortality (p = 0.0023). CONCLUSIONS: These findings suggest increased risk in patients with PPCM presenting with low SBP and high HR on standard heart failure medication possibly having implications on HF management. CI - Copyright (c) 2015. Published by Elsevier Ireland Ltd. FAU - Libhaber, Elena AU - Libhaber E AD - Soweto Cardiovascular Research Unit, University of the Witwatersrand, South Africa. FAU - Sliwa, Karen AU - Sliwa K AD - Soweto Cardiovascular Research Unit, University of the Witwatersrand, South Africa. FAU - Bachelier, Katrin AU - Bachelier K AD - Universitatsklinikum des Saarlandes, Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Kirrberger Str. 1, D 66424 Homburg, Saar, Germany. FAU - Lamont, Kim AU - Lamont K AD - Soweto Cardiovascular Research Unit, University of the Witwatersrand, South Africa. FAU - Bohm, Michael AU - Bohm M AD - Universitatsklinikum des Saarlandes, Klinik fur Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Kirrberger Str. 1, D 66424 Homburg, Saar, Germany. Electronic address: michael.boehm@uks.eu. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20150411 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 SB - IM MH - Adult MH - Blood Pressure/*physiology MH - Cardiomyopathy, Dilated/*diagnostic imaging/*mortality MH - Female MH - Follow-Up Studies MH - Heart Rate/*physiology MH - Humans MH - Peripartum Period/*physiology MH - Predictive Value of Tests MH - Pregnancy MH - Pregnancy Complications, Cardiovascular/*diagnostic imaging/*mortality MH - South Africa/epidemiology MH - Survival Rate/trends MH - Treatment Outcome MH - Ultrasonography MH - Young Adult OTO - NOTNLM OT - Cardiomyopathy OT - Heart rate OT - PPCM OT - Pregnancy EDAT- 2015/05/13 06:00 MHDA- 2016/03/02 06:00 CRDT- 2015/05/13 06:00 PHST- 2014/10/13 00:00 [received] PHST- 2015/04/10 00:00 [revised] PHST- 2015/04/10 00:00 [accepted] PHST- 2015/05/13 06:00 [entrez] PHST- 2015/05/13 06:00 [pubmed] PHST- 2016/03/02 06:00 [medline] AID - S0167-5273(15)00803-7 [pii] AID - 10.1016/j.ijcard.2015.04.081 [doi] PST - ppublish SO - Int J Cardiol. 2015;190:376-82. doi: 10.1016/j.ijcard.2015.04.081. Epub 2015 Apr 11.