Predictors of ejection fraction recovery and baseline differences in patients with peripartum cardiomyopathy and dilated cardiomyopathy

Abstract

Aims: Dilated cardiomyopathy (DCM) and peripartum cardiomyopathy (PPCM) are heart failure conditions with similar clinical, morphological and pathophysiological features but different underlying pathways. In PPCM and DCM patients, improvement in left ventricular ejection fraction (LVEF) varies depending on a number of factors. In this study, we aimed to determine the main differences between DCM and PPCM patients and the predictors of LVEF recovery in these patients. Methods: This cross-sectional, observational study included 33 consecutive female patients, 10 with PPCM and 23 with DCM, attending a tertiary cardiac center between March 2020 and April 2023. We performed a retrospective analysis of some clinical data and LVEF measurements. The main outcome was accepted as EF improvement at a follow-up of at least 12 months. Binary logistic analysis was conducted to assess predictive factors linked to LVEF recovery. This involved using binary logistic regression analysis to figure out odds ratio (OR) and 95% confidence interval (CI). Results: The PPCM group had a higher mean follow-up LVEF and LVEF value increase (p<0.001). A total of 10 patients (30%), 4 (17%) in the DCM group, and 6 (60%) in the PPCM group revealed evidence of LVEF recovery. Left atrium anteroposterior (LA-AP) diameter emerged as an independent predictor of EF recovery in the multivariate analysis (OR:0.566, 95 CI%; 0.322-0.995, p=0.048). Furthermore, the receiver operating characteristic (ROC) curve analysis identified a cutoff value of <37.5 mm for LA-AP diameter as the optimal threshold for predicting EF recovery, with 80% sensitivity and 78% specificity. Conclusion: LA-AP diameter was a significant indicator of LVEF recovery in patients with DCM and PPCM.

Keywords

• Dilated cardiomyopathy
• ejection fraction recovery
• peripartum cardiomyopathy

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