Abstract：
BACKGROUND: Black women with peripartum cardiomyopathy (PPCM) have a higher prevalence of hypertensive disorders of pregnancy (HDP) and worse clinical outcomes compared with non-Black women. We examined the impact of HDP on myocardial recovery in Black women with PPCM.
METHODS: A total of 100 women were enrolled into the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6, and 12-months post-partum (PP). Women were followed for 12 months postpartum and outcomes including persistent cardiomyopathy (LVEF ≤35%), left ventricular assist device, (LVAD), cardiac transplantation, or death were examined in subsets based on race and the presence of HDP.
RESULTS: Black women with HDP were more likely to present earlier compared to Black women without HDP (days PP HDP: 34 ± 21 vs 54 ± 27 days, P = .03). There was no difference in LVEF at study entry for Black women based on HDP, but better recovery with HDP at 6 (HDP: 52 ± 11% vs no HDP: 40 ± 14%, P = .03) and 12-months (HDP:53 ± 10% vs no HDP:40 ± 16%, P = .02). At 12-months, Black women overall had a lower LVEF than non-Black women (P < .001), driven by less recovery in Black women without HDP compared to non-Black women (P < .001). In contrast, Black women with HDP had a similar LVEF at 12 months compared to non-Black women (P = .56).
CONCLUSIONS: In women with PPCM, poorer outcomes evident in Black women were driven by women without a history of HDP. In Black women, a history of HDP was associated with earlier presentation and recovery which was comparable to non-Black women.
METHODS: A total of 100 women were enrolled into the Investigation in Pregnancy Associated Cardiomyopathy (IPAC) study. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6, and 12-months post-partum (PP). Women were followed for 12 months postpartum and outcomes including persistent cardiomyopathy (LVEF ≤35%), left ventricular assist device, (LVAD), cardiac transplantation, or death were examined in subsets based on race and the presence of HDP.
RESULTS: Black women with HDP were more likely to present earlier compared to Black women without HDP (days PP HDP: 34 ± 21 vs 54 ± 27 days, P = .03). There was no difference in LVEF at study entry for Black women based on HDP, but better recovery with HDP at 6 (HDP: 52 ± 11% vs no HDP: 40 ± 14%, P = .03) and 12-months (HDP:53 ± 10% vs no HDP:40 ± 16%, P = .02). At 12-months, Black women overall had a lower LVEF than non-Black women (P < .001), driven by less recovery in Black women without HDP compared to non-Black women (P < .001). In contrast, Black women with HDP had a similar LVEF at 12 months compared to non-Black women (P = .56).
CONCLUSIONS: In women with PPCM, poorer outcomes evident in Black women were driven by women without a history of HDP. In Black women, a history of HDP was associated with earlier presentation and recovery which was comparable to non-Black women.
摘要：
背景：与非黑人妇女相比，患有围产期心肌病（PPCM）的黑人妇女妊娠高血压疾病（HDP）的患病率更高，临床结局更差。我们检查了HDP对患有PPCM的黑人女性心肌恢复的影响。
方法：共有100名妇女被纳入妊娠相关性心肌病调查（IPAC）研究。左心室射血分数（LVEF）在入口处通过超声心动图评估，产后6个月和12个月（PP）。女性随访12个月，结果包括持续性心肌病（LVEF≤35％），左心室辅助装置,(LVAD),心脏移植,根据种族和HDP的存在，在亚组中检查或死亡。
结果：与没有HDP的黑人女性相比，患有HDP的黑人女性更有可能出现更早（PPHDP：34±21天vs54±27天，P=0.03)。根据HDP，黑人女性在研究进入时的LVEF没有差异，但HDP在6时恢复更好(HDP:52±11%vs无HDP:40±14%，P=0.03）和12个月（HDP：53±10％vs无HDP：40±16％，P=0.02)。12个月时,黑人女性总体LVEF低于非黑人女性（P<0.001）。与非黑人女性相比，没有HDP的黑人女性恢复较少（P<0.001）。相比之下,与非黑人女性相比，患有HDP的黑人女性在12个月时的LVEF相似（P=0.56）。
结论：在患有PPCM的女性中，黑人女性中明显较差的结局是由没有HDP病史的女性驱动的.在黑人女性中,HDP病史与早期出现和恢复相关,与非黑人女性相当.
方法：共有100名妇女被纳入妊娠相关性心肌病调查（IPAC）研究。左心室射血分数（LVEF）在入口处通过超声心动图评估，产后6个月和12个月（PP）。女性随访12个月，结果包括持续性心肌病（LVEF≤35％），左心室辅助装置,(LVAD),心脏移植,根据种族和HDP的存在，在亚组中检查或死亡。
结果：与没有HDP的黑人女性相比，患有HDP的黑人女性更有可能出现更早（PPHDP：34±21天vs54±27天，P=0.03)。根据HDP，黑人女性在研究进入时的LVEF没有差异，但HDP在6时恢复更好(HDP:52±11%vs无HDP:40±14%，P=0.03）和12个月（HDP：53±10％vs无HDP：40±16％，P=0.02)。12个月时,黑人女性总体LVEF低于非黑人女性（P<0.001）。与非黑人女性相比，没有HDP的黑人女性恢复较少（P<0.001）。相比之下,与非黑人女性相比，患有HDP的黑人女性在12个月时的LVEF相似（P=0.56）。
结论：在患有PPCM的女性中，黑人女性中明显较差的结局是由没有HDP病史的女性驱动的.在黑人女性中,HDP病史与早期出现和恢复相关,与非黑人女性相当.
