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.
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.