%0 Journal Article
%T Race, hypertensive disorders of pregnancy and outcomes in peripartum cardiomyopathy.
%A Polsinelli VB
%A Koczo A
%A Johnson AE
%A Elkayam U
%A Cooper LT
%A Gorcsan J
%A Briller J
%A Fett J
%A McNamara DM
%A  
%J Am Heart J
%V 276
%N 0
%D 2024 Jul 10
%M 38996860
%F 5.099
%R 10.1016/j.ahj.2024.07.002
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.