PDF icon Download PDF
Am J Perinatol 2019; 36(05): 476-483
DOI: 10.1055/s-0038-1669439
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy

Esa M. Davis
1   Department of Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
,
Gregory Ewald
2   Department of Medicine, Washington University, St. Louis, Missouri
,
Michael M. Givertz
3   Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
,
Navin Rajagopalan
4   Department of Medicine, University of Kentucky, Lexington, Kentucky
,
Leslie T. Cooper Jr
5   Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida
,
Joan Briller
6   Department of Medicine, University of Illinois at Chicago, Illinois
,
G. Michael Felker
7   Department of Medicine, Duke University, Durham, North Carolina
,
Biykem Bozkurt
8   Department of Medicine, Baylor College of Medicine, Houston, Texas
,
Mark H. Drazner
9   Department of Medicine, UT Southwestern Medical Center, Dallas, Texas
,
Karen Hanley-Yanez
10   Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Indrani Halder
10   Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Charles F. McTiernan
10   Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
,
Dennis M. McNamara
10   Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
,
on behalf of the IPAC Investigators› Author Affiliations
Funding This study was supported by the National Institutes of Health (NIH) contracts HL102429 and HL069912 and by an internal PATH grant through the University of Pittsburgh School of Medicine. The NIH had no involvement in the study design, data collection, interpretation or analysis, writing of the manuscript, or submission for publication.
Further Information

Publication History

09 May 2018

11 July 2018

Publication Date:
05 September 2018 (online)

Also available ateRefHebammen
   Permissions and Reprints
Preview

Abstract

Objective To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM).

Study Design This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity. Demographic, clinical, and biomarker variables were compared across weight categories.

Outcomes LV end-diastolic diameter (LVEDD) and ejection fraction were measured at entry, 6, and 12 months postpartum. Multivariable regression models examined the relationship between adiposity, LV size, and leptin levels with cardiac recovery at 6 and 12 months postpartum.

Results Obese and nonobese women had similar LV dysfunction at entry. Obese women had greater LV size and less LV recovery at 6 and 12 months postpartum. BMI was positively associated with leptin and ventricular diameter. Greater BMI at entry remained associated with less ventricular recovery at 6 months (p = 0.02) in adjusted race-stratified models. LVEDD at entry predicted lower ejection fraction at 6 months (p < 0.001) and similarly at 12 months.

Conclusion Obese women with PPCM had greater cardiac remodeling, higher leptin levels, and diminished cardiac recovery.

Keywords

peripartum cardiomyopathy - obesity - pregnancy - nonischemic cardiomyopathy - maternal leptin - left ventricular ejection fraction - left ventricular end-diastolic diameter

Note

Findings from this study were presented in a poster presentation at the 2015 American Heart Association Annual Meeting, November 8, 2015, Orlando, FL.


Ethical Approval

Drs. McNamara and Davis had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis. All the authors have met the journal's requirements for authorship.


* Please see Appendix A for the full list of IPAC investigators.


Supplementary Material