Pathophysiology and risk factors of peripartum cardiomyopathy

Hoes, M. F., Arany, Z., Bauersachs, J., Hilfiker-Kleiner, D., Petrie, M. C. , Sliwa, K. and van der Meer, P. (2022) Pathophysiology and risk factors of peripartum cardiomyopathy. Nature Reviews Cardiology, (doi: 10.1038/s41569-021-00664-8) (PMID:35017720) (Early Online Publication)

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Abstract

Peripartum cardiomyopathy (PPCM) is a potentially fatal form of idiopathic heart failure with variable prevalence across different countries and ethnic groups. The cause of PPCM is unclear, but environmental and genetic factors and pregnancy-associated conditions such as pre-eclampsia can contribute to the development of PPCM. Furthermore, animal studies have shown that impaired vascular and metabolic function might be central to the development of PPCM. A better understanding of the pathogenic mechanisms involved in the development of PPCM is necessary to establish new therapies that can improve the outcomes of patients with PPCM. Pregnancy hormones tightly regulate a plethora of maternal adaptive responses, including haemodynamic, structural and metabolic changes in the cardiovascular system. In patients with PPCM, the peripartum period is associated with profound and rapid hormonal fluctuations that result in a brief period of disrupted cardiovascular (metabolic) homeostasis prone to secondary perturbations. In this Review, we discuss the latest studies on the potential pathophysiological mechanisms of and risk factors for PPCM, with a focus on maternal cardiovascular changes associated with pregnancy. We provide an updated framework to further our understanding of PPCM pathogenesis, which might lead to an improvement in disease definition.

Item Type:Articles
Additional Information:M.F.H. was supported by the Dutch Heart Foundation (2021T017). Z.A. is supported by the Department of Defense (grant W81XWH18-1-0503). D.H.-K. is supported by Fondation Leducq and the German Research Foundation (grants HI 842/4-3). M.C.P. is supported by the British Heart Foundation Centre of Research Excellence Award (RE/13/5/30177 and RE/18/6/34217+). K.S. is supported by Hippocrate Foundation Servier. P.v.d.M. is supported by the European Research Council (715732, ERC-2016-STG).
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Petrie, Professor Mark
Authors: Hoes, M. F., Arany, Z., Bauersachs, J., Hilfiker-Kleiner, D., Petrie, M. C., Sliwa, K., and van der Meer, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Nature Reviews Cardiology
Publisher:Nature Research
ISSN:1759-5002
ISSN (Online):1759-5010
Published Online:11 January 2022
Copyright Holders:Copyright © Springer Nature Limited 2022
First Published:First published in Nature Reviews Cardiology 2022
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences
303944BHF Centre of ExcellenceColin BerryBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science