TY - JOUR
T1 - Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy
AU - Davis, Esa M.
AU - Ewald, Gregory
AU - Givertz, Michael M.
AU - Rajagopalan, Navin
AU - Cooper, Leslie T.
AU - Briller, Joan
AU - Felker, G. Michael
AU - Bozkurt, Biykem
AU - Drazner, Mark H.
AU - Hanley-Yanez, Karen
AU - Halder, Indrani
AU - McTiernan, Charles F.
AU - McNamara, Dennis M.
N1 - Publisher Copyright:
Copyright © 2019 by Thieme Medical Publishers, Inc.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - left ventricular ejection fraction
KW - left ventricular end-diastolic diameter
KW - maternal leptin
KW - nonischemic cardiomyopathy
KW - obesity
KW - peripartum cardiomyopathy
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85063774480&partnerID=8YFLogxK
U2 - 10.1055/s-0038-1669439
DO - 10.1055/s-0038-1669439
M3 - Article
C2 - 30184556
AN - SCOPUS:85063774480
SN - 0735-1631
VL - 36
SP - 476
EP - 483
JO - American journal of perinatology
JF - American journal of perinatology
IS - 5
ER -