Abstract：
Peripartum cardiomyopathy is a rare type of heart failure manifesting towards the end of pregnancy or in the months following delivery, in the absence of any other cause of heart failure. There is a wide range of incidence across countries reflecting different population demographics, uncertainty over definitions and under-reporting. Race, ethnicity, multiparity and advanced maternal age are considered important risk factors for the disease. Its etiopathogenesis is incompletely understood and is likely multifactorial, including hemodynamic stresses of pregnancy, vasculo-hormonal factors, inflammation, immunology and genetics. Affected women present with heart failure secondary to reduced left ventricular systolic function (LVEF <45%) and often with associated phenotypes such as LV dilatation, biatrial dilatation, reduced systolic function, impaired diastolic function, and increased pulmonary pressure. Electrocardiography, echocardiography, magnetic resonance imaging, endomyocardial biopsy, and certain blood biomarkers aid in diagnosis and management. Treatment for peripartum cardiomyopathy depends on the stage of pregnancy or postpartum, disease severity and whether the woman is breastfeeding. It includes standard pharmacological therapies for heart failure, within the safety restrictions for pregnancy and lactation. Targeted therapies such as bromocriptine have shown promise in early, small studies, with large definitive trials currently underway. Failure of medical interventions may require mechanical support and transplantation in severe cases. Peripartum cardiomyopathy carries a high mortality rate of up to 10% and a high risk of relapse in subsequent pregnancies, but over half of women present normalization of LV function within a year of diagnosis.
摘要：
围产期心肌病是一种罕见的心力衰竭，在妊娠末期或分娩后几个月表现出来，在没有任何其他心力衰竭原因的情况下。各国的发病率范围很广，反映了不同的人口统计，定义的不确定性和报告不足。种族,种族,多产和高龄被认为是该疾病的重要危险因素。其病因尚未完全了解，可能是多因素的，包括妊娠的血流动力学应激,血管激素因子,炎症,免疫学和遗传学。受影响的女性出现心力衰竭继发于左心室收缩功能降低（LVEF<45％），并且通常伴有相关表型，如LV扩张，双心房扩张,收缩功能降低,舒张功能受损，肺压升高.心电图,超声心动图,磁共振成像，心内膜活检,某些血液生物标志物有助于诊断和管理。围产期心肌病的治疗取决于妊娠或产后阶段，疾病的严重程度以及该女性是否正在母乳喂养。它包括心力衰竭的标准药物治疗，在怀孕和哺乳的安全限制内。溴隐亭等靶向疗法在早期就显示出了希望，小型研究,目前正在进行大型确定性试验。在严重的情况下，医疗干预失败可能需要机械支持和移植。围产期心肌病具有高达10％的高死亡率，并且在随后的怀孕中复发的风险很高。但超过一半的女性在诊断后一年内表现出LV功能正常化。
