PMID- 28373243
OWN - NLM
STAT- MEDLINE
DCOM- 20171023
LR  - 20220410
IS  - 2047-9980 (Electronic)
IS  - 2047-9980 (Linking)
VI  - 6
IP  - 4
DP  - 2017 Apr 3
TI  - Myocardial Damage Detected by Late Gadolinium Enhancement Cardiac Magnetic 
      Resonance Is Uncommon in Peripartum Cardiomyopathy.
LID - 10.1161/JAHA.117.005472 [doi]
LID - e005472
AB  - BACKGROUND: In peripartum cardiomyopathy, the prevalence of focal myocardial 
      damage detected by late gadolinium enhancement (LGE) cardiovascular magnetic 
      resonance is important to elucidate mechanisms of myocardial injury and cardiac 
      dysfunction. LGE equates irreversible myocardial injury, but LGE prevalence in 
      peripartum cardiomyopathy is uncertain. METHODS AND RESULTS: Among 100 women 
      enrolled within the Investigations of Pregnancy Associated Cardiomyopathy cohort, 
      we recruited 40 women at 13 centers to undergo LGE cardiovascular magnetic 
      resonance, enrolled within the first 13 weeks postpartum. Follow-up scans 
      occurred at 6 months postpartum, and death/transplant rates at 12 months. 
      Baseline characteristics did not differ significantly in the parent cohort 
      according to cardiovascular magnetic resonance enrollment except for mechanical 
      circulatory support. LGE was noted only in 2 women (5%) at baseline. While left 
      ventricular dysfunction with enlargement was prevalent at baseline cardiovascular 
      magnetic resonance scans (eg, ejection fraction 38% [Q1-Q3 31-50%], end diastolic 
      volume index=108 mL/m(2) [Q1-Q3 83-134 mL/m(2)]), most women demonstrated 
      significant improvements at 6 months, consistent with a low prevalence of LGE. 
      LGE was not related to baseline clinical variables, ejection fraction, New York 
      Heart Association heart failure class, or mortality. Neither of the 2 women who 
      died exhibited LGE. LGE was inversely associated with persistent left ventricular 
      ejection fraction at 6 months (P=0.006). CONCLUSIONS: Factors other than focal 
      myocardial damage detectable by LGE explain the initial transient depressions in 
      baseline left ventricular ejection fraction, yet focal myocardial damage may 
      contribute to persistent myocardial dysfunction and hinder recovery in a small 
      minority. Most women exhibit favorable changes in ventricular function over 
      6 months. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique 
      identifier: NCT01085955.
CI  - (c) 2017 The Authors. Published on behalf of the American Heart Association, Inc., 
      by Wiley Blackwell.
FAU - Schelbert, Erik B
AU  - Schelbert EB
AD  - University of Pittsburgh Medical Center, Pittsburgh, PA schelberteb@upmc.edu.
FAU - Elkayam, Uri
AU  - Elkayam U
AD  - University of Southern California, Los Angeles, CA.
FAU - Cooper, Leslie T
AU  - Cooper LT
AD  - Mayo Clinic, Jacksonville, FL.
FAU - Givertz, Michael M
AU  - Givertz MM
AD  - Brigham and Women's Hospital, Boston, MA.
FAU - Alexis, Jeffrey D
AU  - Alexis JD
AD  - University of Rochester School of Medicine and Dentistry, Rochester, NY.
FAU - Briller, Joan
AU  - Briller J
AD  - University of Illinois, Chicago, IL.
FAU - Felker, G Michael
AU  - Felker GM
AD  - Duke University, Durham, NC.
FAU - Chaparro, Sandra
AU  - Chaparro S
AD  - University of Miami, FL.
FAU - Kealey, Angela
AU  - Kealey A
AD  - University of Calgary, Canada.
FAU - Pisarcik, Jessica
AU  - Pisarcik J
AD  - University of Pittsburgh Medical Center, Pittsburgh, PA.
FAU - Fett, James D
AU  - Fett JD
AD  - University of Pittsburgh Medical Center, Pittsburgh, PA.
FAU - McNamara, Dennis M
AU  - McNamara DM
AD  - University of Pittsburgh Medical Center, Pittsburgh, PA.
CN  - Investigations of Pregnancy Associated Cardiomyopathy (IPAC) Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT01085955
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170403
PL  - England
TA  - J Am Heart Assoc
JT  - Journal of the American Heart Association
JID - 101580524
RN  - 0 (Contrast Media)
RN  - 0 (Heterocyclic Compounds)
RN  - 0 (Organometallic Compounds)
RN  - 0199MV609F (gadoteridol)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Canada
MH  - Cardiomyopathies/*diagnostic imaging/mortality/physiopathology/therapy
MH  - Contrast Media/*administration & dosage
MH  - Female
MH  - Fibrosis
MH  - Gadolinium/administration & dosage
MH  - Heart Transplantation
MH  - Heterocyclic Compounds/*administration & dosage
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Myocardium/*pathology
MH  - Organometallic Compounds/*administration & dosage
MH  - Peripartum Period
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/*diagnostic 
      imaging/mortality/physiopathology/therapy
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
MH  - Ventricular Dysfunction, Left/*diagnostic 
      imaging/mortality/physiopathology/therapy
MH  - *Ventricular Function, Left
MH  - Ventricular Function, Right
MH  - *Ventricular Remodeling
PMC - PMC5533034
OTO - NOTNLM
OT  - cardiovascular magnetic resonance
OT  - heart failure
OT  - myocardial fibrosis
OT  - peripartum cardiomyopathy
OT  - pregnancy and postpartum
EDAT- 2017/04/05 06:00
MHDA- 2017/10/24 06:00
PMCR- 2017/04/01
CRDT- 2017/04/05 06:00
PHST- 2017/04/05 06:00 [entrez]
PHST- 2017/04/05 06:00 [pubmed]
PHST- 2017/10/24 06:00 [medline]
PHST- 2017/04/01 00:00 [pmc-release]
AID - JAHA.117.005472 [pii]
AID - JAH32075 [pii]
AID - 10.1161/JAHA.117.005472 [doi]
PST - epublish
SO  - J Am Heart Assoc. 2017 Apr 3;6(4):e005472. doi: 10.1161/JAHA.117.005472.