Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Cardiac Magnetic Resonance Imaging
2.3. Cardiac Image Analysis
2.4. Statistical Analysis
3. Results
3.1. General Characteristics
3.2. CMR Imaging Results
3.3. Subgroup Analyses of CMR Parameters in Patients with Follow-Up
3.4. Association between Imaging Parameters and LVEF Recovery
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Patients with PPCM (n = 17) | Healthy Female Controls (n =15) | p-Value |
---|---|---|---|
Clinical parameters | |||
Age (years) | 33 ± 5 | 33 ± 8 | 0.892 |
Weight (kg) | 77 ± 19 | 67 ± 13 | 0.088 |
Height (cm) | 170 ± 8 | 170 ± 7 | 0.972 |
Body mass index (kg/m²) | 27 ± 7 | 23 ± 4 | 0.077 |
Heart rate (bpm) | 78 ± 27 | 75 ± 11 | 0.052 |
NT-proBNP (pg/mL) | 8792 ± 12,308 | NA | - |
Troponin I (ng/L) | 0.12 ± 0.25 | NA | - |
C-reactive protein (mg/L) | 15.0 ± 11.1 | NA | - |
White blood cells (G/L) | 10.5 ± 3.7 | NA | - |
CMR parameters | |||
Left ventricular ejection fraction (%) | 31 ± 10 | 61 ± 6 | <0.001 |
Left ventricular end-diastolic volume index (mL/m²) | 121 ± 43 | 73 ± 9 | <0.001 |
Right ventricular ejection fraction (%) | 32 ± 13 | 57 ± 7 | <0.001 |
Right ventricular end-diastolic volume index (mL/m²) | 82 ± 24 | 75 ± 11 | 0.300 |
Cardiac index (L/min/m²) | 3.0 ± 0.7 | 3.3 ± 0.7 | 0.228 |
Left atrium volume index (mL/m²) | 75 ± 24 | 40 ± 10 | <0.001 |
Left ventricular mass index (g/m²) | 71 ± 19 | 41 ± 7 | <0.001 |
Interventricular septal thickness (mm) | 10.3 ± 1.9 | 7.9 ± 1.1 | <0.001 |
T2 signal intensity ratio | 2.10 ± 0.34 | 1.58 ± 0.21 | <0.001 |
Visual myocardial edema | 10 (59%) | 0 (0%) | <0.001 |
Visual late gadolinium enhancement | 2 (12%) | 0 (0%) | 0.484 |
Late gadolinium enhancement (%) | 3.9 ± 4.7 | 0.6 ± 0.7 | 0.013 |
Global longitudinal strain (%) | −11.8 ± 4.8 | −22.3 ± 4.2 | <0.001 |
Global circumferential strain (%) | −12.3 ± 6.3 | −24.1 ± 3.6 | <0.001 |
Global radial strain (%) | 22.8 ± 14.7 | 37.1 ± 10.2 | 0.004 |
T1 relaxation time, native (ms) | 1070 ± 51 | 980 ± 28 | 0.001 |
Extracellular volume fraction (%) | 31.7 ± 7.1 | 27.7 ± 3.2 | 0.235 |
T2 relaxation time (ms) | 63 ± 5 | 53 ± 2 | <0.001 |
Variable | Baseline (n = 6) | Follow-Up (n = 6) | p-Value |
---|---|---|---|
Left ventricular ejection fraction (%) | 38 ± 9 | 55 ± 17 | 0.011 |
Left ventricular end-diastolic volume index (mL/m²) | 89 ± 28 | 85 ± 27 | 0.651 |
Right ventricular ejection fraction (%) | 40 ± 18 | 55 ± 11 | 0.023 |
Right ventricular end-diastolic volume index (mL/m²) | 66 ± 13 | 71 ± 15 | 0.370 |
Left atrium volume index (mL/m²) | 56 ± 18 | 42 ± 10 | 0.051 |
Left ventricular mass index (g/m²) | 61 ± 14 | 52 ± 8 | 0.176 |
Interventricular septal thickness (mm) | 10 ± 2.8 | 9.1 ± 2.0 | 0.047 |
T2 signal intensity ratio | 2.1 ± 0.3 | 1.7 ± 0.3 | 0.126 |
Visual myocardial edema | 3 (50%) | 0 (0%) | 0.25 |
Visual late gadolinium enhancement | 1 (20%) | 0 (0%) | 0.99 |
Late gadolinium enhancement (%) | 4.5 ± 3.3 | 5.0 ± 2.6 | 0.363 |
Global longitudinal strain (%) | −13.5 ± 4.8 | −19.8 ± 5.8 | 0.039 |
Global circumferential strain (%) | −15.6 ± 8.1 | −18.7 ± 9.5 | 0.009 |
Global radial strain (%) | 30.1 ± 21.9 | 30.5 ± 17.6 | 0.935 |
Variable | Univariable Analysis | Multivariable Analysis | ||
---|---|---|---|---|
Hazard Ratio | p-Value | Hazard Ratio | p-Value | |
Age (per year) | 0.89 (0.77–1.03) | 0.116 | ||
Body mass index (per kg/m²) | 0.99 (0.90–1.09) | 0.841 | ||
LVEF (per %) | 1.13 (1.02–1.25) | 0.023 | ||
LVEDVI (per mL/m²) | 0.99 (0.96–1.01) | 0.228 | ||
LVMI (per g/m²) | 1.01 (0.96–1.05) | 0.790 | ||
LAI (per mL/m²) | 0.99 (0.96–1.02) | 0.585 | ||
RVEF (per %) | 1.07 (1.00–1.14) | 0.036 | ||
RVEDVI (per mL/m²) | 1.01 (0.98–1.04) | 0.422 | ||
LV GLS (per %) | 0.53 (0.34–0.84) | 0.007 | 0.51 (0.30–0.85) | 0.010 |
LV GCS (per %) | 0.81 (0.70–0.95) | 0.010 | ||
LV GRS (per %) | 1.10 (1.02–1.18) | 0.010 | ||
LGE (per %) | 1.05 (0.92–1.21) | 0.475 | ||
T2 signal intensity ratio | 1.77 (0.25–12.30) | 0.565 | ||
Visual myocardial edema (yes/no) | 10.17 (1.17–88.65) | 0.036 |
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Isaak, A.; Ayub, T.H.; Merz, W.M.; Faron, A.; Endler, C.; Sprinkart, A.M.; Pieper, C.C.; Kuetting, D.; Dabir, D.; Attenberger, U.; et al. Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage. Diagnostics 2022, 12, 378. https://doi.org/10.3390/diagnostics12020378
Isaak A, Ayub TH, Merz WM, Faron A, Endler C, Sprinkart AM, Pieper CC, Kuetting D, Dabir D, Attenberger U, et al. Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage. Diagnostics. 2022; 12(2):378. https://doi.org/10.3390/diagnostics12020378
Chicago/Turabian StyleIsaak, Alexander, Tiyasha H. Ayub, Waltraut M. Merz, Anton Faron, Christoph Endler, Alois M. Sprinkart, Claus C. Pieper, Daniel Kuetting, Darius Dabir, Ulrike Attenberger, and et al. 2022. "Peripartum Cardiomyopathy: Diagnostic and Prognostic Value of Cardiac Magnetic Resonance in the Acute Stage" Diagnostics 12, no. 2: 378. https://doi.org/10.3390/diagnostics12020378