Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: Practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy

Journal article

Sliwa-Hahnle, Karen, Petrie, Mark C., Hilfiker-Kleiner, Denise, Mebazaa, Alexandre, Jackson, Alice, Johnson, Mark R., van der Meer, Peter, Mbakwem, Amam and Bauersachs, J.. (2018). Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: Practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy. European Journal of Heart Failure. 20(6), pp. 951 - 962. https://doi.org/10.1002/ejhf.1178
AuthorsSliwa-Hahnle, Karen, Petrie, Mark C., Hilfiker-Kleiner, Denise, Mebazaa, Alexandre, Jackson, Alice, Johnson, Mark R., van der Meer, Peter, Mbakwem, Amam and Bauersachs, J.
Abstract

Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long‐term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long‐term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre‐ and postpartum management algorithms for women undergoing a subsequent pregnancy is presented.

KeywordsPeripartum cardiomyopathy; Subsequent pregnancy; Mortality
Year2018
JournalEuropean Journal of Heart Failure
Journal citation20 (6), pp. 951 - 962
PublisherJohn Wiley & Sons
ISSN1388-9842
Digital Object Identifier (DOI)https://doi.org/10.1002/ejhf.1178
Scopus EID2-s2.0-85044435828
Page range951 - 962
Research GroupMary MacKillop Institute for Health Research
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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Gender disparities in pulmonary hypertension at a tertiary centre in Cameroon
Aminde, Leopold N., Dzudie, Anastase, Kengne, Andre P., Ndjebet, J., Mapoh, S., Kuelang, X., Kamdem, F., Ngahane, B. H. M., Doualla, M. S., Ngu, K. B., Sliwa-Hahnle, Karen and Thienemann, Friedrich. (2017). Gender disparities in pulmonary hypertension at a tertiary centre in Cameroon. SAMJ South African Medical Journal. 107(10), pp. 892 - 899. https://doi.org/10.7196/SAMJ.2017.v107i10.12321
Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study
Hilfiker-Kleiner, Denise, Haghikia, A., Berliner, Dominik, Vogel-Claussen, Jens, Schwab, Johannes, Franke, Annegret, Schwarzkopf, Marziel, Ehlermann, Philipp, Pfister, Roman, Michels, Guido, Westenfeld, Ralf, Stangl, Verena, Kindermann, Ingrid, Kühl, Uwe, Angermann, Christiane E., Schlitt, Axel, Fischer, D., Podewski, Edith, Bohm, Michael, ... Bauersachs, J.. (2017). Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. European Heart Journal. 38(35), pp. 2671 - 2679. https://doi.org/10.1093/eurheartj/ehx355
Soluble ST2 correlates with some indicators of right ventricular function in hypertensive heart failure
Ojji, Dike, Lecour, Sandrine, Adeyemi, O. M. and Sliwa-Hahnle, Karen. (2017). Soluble ST2 correlates with some indicators of right ventricular function in hypertensive heart failure. Vascular Health and Risk Management. 13, pp. 311 - 316. https://doi.org/10.2147/VHRM.S127430
Organisation of care for pregnancy in patients with congenital heart disease
Roos-Hesselink, Jolien W., Budts, Werner, Walker, Fiona, De Backer, Julie F. A., Swan, Lorna, Stones, William, Kranke, Peter, Sliwa-Hahnle, Karen and Johnson, Mark R.. (2017). Organisation of care for pregnancy in patients with congenital heart disease. Heart. 103(23), pp. 1854 - 1859. https://doi.org/10.1136/heartjnl-2017-311758
Addressing the shortage of research capacity in cardiovascular disease in Africa via leadership training
Dzudie, Anastase and Sliwa-Hahnle, Karen. (2017). Addressing the shortage of research capacity in cardiovascular disease in Africa via leadership training. Heart Asia. 9(1), pp. 96 - 98. https://doi.org/10.1136/heartasia-2016-010834
Parvovirus b19-induced vascular damage in the heart is associated with elevated circulating endothelial microparticles
Bachelier, Katrin, Biehl, Susanne, X., Viktoria, Kindermann, Ingrid, Kandolf, Reinhard, Sauter, Martina, Ukena, C., Yilmaz, Ali, Sliwa-Hahnle, Karen, Bock, Claus-Thomas, Klingel, Karin and Bohm, Michael. (2017). Parvovirus b19-induced vascular damage in the heart is associated with elevated circulating endothelial microparticles. PLoS ONE. 12(5), pp. 1 - 13. https://doi.org/10.1371/journal.pone.0176311
Imbalanced angiogenesis in peripartum cardiomyopathy: diagnostic value of placenta growth factor
Mebazaa, Alexandre, Seronde, Marie-France, Gayat, Etienne, Tibazarwa, Kemi, Anumba, Dilly O. C., Akrout, Najla, Sadoune, Malha, Sarb, Jamela, Arrigo, M., Motiejunaite, Justina, Laribi, Said, Legrand, Matthieu, Deschamps, Lydia, Fazal, Loubina, Bouadma, Lila, Collet, Corinne, Manivet, Philippe, Solal, Alain Cohen, Launay, Jean-Marie, ... Sliwa-Hahnle, Karen. (2017). Imbalanced angiogenesis in peripartum cardiomyopathy: diagnostic value of placenta growth factor. Circulation Journal. 81(11), pp. 1654 - 1661. https://doi.org/10.1253/circj.CJ-16-1193
Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study
Dokainish, Hisham, Teo, Koon K., Zhu, Jun, Roy, Ambuj, Alhabib, Khalid F., Elsayed, Ahmed, Palileo-Villaneuva, Lia, Lopez-Jaramillo, Patricio, Karaye, Kamilu M., Yusoff, Khalid, Orlandini, Andres, Sliwa-Hahnle, Karen, Mondo, Charles, Lanas, Fernando, Prabhakaran, Dorairaj, Badr, Amr, Elmaghawry, Mohamed, Damasceno, Albertino, Tibazarwa, Kemi, ... Yusuf, Salim. (2017). Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study. The Lancet Global Health. 5(7), pp. 665 - 672. https://doi.org/10.1016/S2214-109X(17)30196-1
Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM)
Sliwa-Hahnle, Karen, Mebazaa, Alexandre, Hilfiker-Kleiner, Denise, Petrie, Mark C., Maggioni, Aldo P., Laroche, Cecile, Regitz-Zagrosek, Vera, Schaufelberger, Maria, Tavazzi, Luigi, van der Meer, Peter, Roos-Hesselink, Jolien W., Seferovic, Petar, van Spandonck-Zwarts, Karin, Mbakwem, Amam, Bohm, Michael, Mouquet, Frederic, Pieske, Burkert, Hall, Roger, Ponikowski, Piotre and Bauersachs, J.. (2017). Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM). European Journal of Heart Failure. 19(9), pp. 1131 - 1141. https://doi.org/10.1002/ejhf.780
Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa
Ojji, Dike, Lamont, Kim, Ojji, Olubunmi I., Egenti, Bibiana N. and Sliwa-Hahnle, Karen. (2017). Primary care in the prevention, treatment and control of cardiovascular disease in sub-Saharan Africa. Cardiovascular Journal of Southern Africa (South Africa). 28(4), pp. 251 - 256. https://doi.org/10.5830/CVJA-2016-082
Prevalence and predictive value of electrocardiographic abnormalities in pulmonary hypertension: evidence from the pan-African pulmonary hypertension cohort (PAPUCO) study
Balieva, Irina, Dzudie, Anastase, Thienemann, Friedrich, Mocumbi, Ana O., Karaye, Kamilu M., Sani, Mahmoud U., Ogah, Okechukwu, Voors, Adriaan A., Kengne, Andre Pascal and Sliwa-Hahnle, Karen. (2017). Prevalence and predictive value of electrocardiographic abnormalities in pulmonary hypertension: evidence from the pan-African pulmonary hypertension cohort (PAPUCO) study. Cardiovascular Journal of Southern Africa (South Africa). 28(6), pp. 370 - 376. https://doi.org/10.5830/CVJA-2017-020
Echocardiographic predictors of outcome in acute heart failure patients in sub-saharan africa: insights from THESUS-HF
Sani, Mahmoud U., Davidson, Beth A., Cotter, Gad, Damasceno, Albertino, Mayosi, Bongani, Ogah, Okechukwu, Mondo, Charles, Dzudie, Anastase, Ojji, Dike, Kouam, Charles K., Suliman, Ahmed, Yonga, Gerald, Ba, Sergine A., Maru, Fikru, Alemayehu, Bekele, Edwards, Christopher and Sliwa-Hahnle, Karen. (2017). Echocardiographic predictors of outcome in acute heart failure patients in sub-saharan africa: insights from THESUS-HF. Cardiovascular Journal of Africa. 28(1), pp. 60 - 67. https://doi.org/10.5830/CVJA-2016-070
Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials
Bohm, Michael, Schumacher, Helmut, Teo, Koon K., Lonn, Eva M., Mahfoud, Felix, Mann, Johannes F.E., Mancia, Giuseppe, Redon, Josep, Schmieder, Roland E., Sliwa-Hahnle, Karen, Weber, Michael A., Williams, Bryan and Yusuf, Salim. (2017). Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. The Lancet. 389(10085), pp. 2226 - 2237. https://doi.org/10.1016/S0140-6736(17)30754-7
Roadmap to achieve 25% hypertension control in Africa by 2025
Dzudie, Anastase, Rayner, Brian, Ojji, Dike, Schutte, Aletta E., Twagirumukiza, Marc, Damasceno, A., Ba, Seringe A., Kane, Abdoul, Kramoh, Euloge, Kacou, Jean B.A., Onwubere, Basden, Cornick, Ruth, Sliwa-Hahnle, Karen, Anisiuba, Benedict, Mocumbi, Ana O., Ogola, Elijah, Awad, Mohamed, Nel, George, Otieno, Harun, ... Mayosi, Bongani. (2017). Roadmap to achieve 25% hypertension control in Africa by 2025. SAMJ South African Medical Journal. 28(4), pp. 262 - 273. https://doi.org/10.5830/CVJA-2017-040
Ventricular tachyarrhythmia during pregnancy in women with heart disease : Data from the ROPAC, a registry from the European Society of Cardiology
Ertekin, Ebru, van Hagen, Iris M., Salam, Amar M., Ruys, Titia P. E., Johnson, Mark R., Popelova, Jana, Parsonage, William A., Ashour, Zeinab, Shotan, Avraham, Oliver, José M., Veldtman, Gruschen R., Hall, Roger, Roos-Hesselink, Jolien W., ROPARC Investigators* and Sliwa, Karen. (2016). Ventricular tachyarrhythmia during pregnancy in women with heart disease : Data from the ROPAC, a registry from the European Society of Cardiology. International Journal of Cardiology. 220, pp. 131-136. https://doi.org/10.1016/j.ijcard.2016.06.061
Health in times of uncertainty in the eastern Mediterranean region, 1990-2013 : A systematic analysis for the Global Burden of Disease Study 2013
Mokdad, Ali H., Forouzanfar, Mohammad Hossein, Daoud, Farah, El Bcheraoui, Charbel, Moradi-Lakeh, Maziar, Khalil, Ibrahim, Afshin, Ashkan, Tuffaha, Marwa, Charara, Raghid, Barber, Ryan M., Wagner, Joseph, Cercy, Kelly, Kravitz, Hannah, Coates, Matthew M., Robinson, Margaret, Estep, Kara, Steiner, Caitlyn, Jaber, Sara, Mokdad, Ali A., ... Murray, Christopher J. L.. (2016). Health in times of uncertainty in the eastern Mediterranean region, 1990-2013 : A systematic analysis for the Global Burden of Disease Study 2013. The Lancet Global Health. 4(10), pp. e704-e713. https://doi.org/10.1016/S2214-109X(16)30168-1
A global view of pulmonary hypertension
Hoeper, Marius, Humbert, Marc, Souza, Rogerio, Idrees, Majdy, Kawut, Steven M., Sliwa-Hahnle, Karen, Jing, Zhi-Cheng and Gibbs, J. Simon. (2016). A global view of pulmonary hypertension. The Lancet Respiratory Medicine. 4(4), pp. 306 - 322. https://doi.org/10.1016/S2213-2600(15)00543-3
Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology
Sliwa-Hahnle, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vasquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger and Roos-Hesselink, Jolien W.. (2016). Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology. European Journal of Heart Failure. 18(9), pp. 1119 - 1128. https://doi.org/10.1002/ejhf.594
Risk assessment for pregnancy with cardiac disease - A global perspective
Sliwa-Hahnle, Karen and Anthony, John. (2016). Risk assessment for pregnancy with cardiac disease - A global perspective. European Journal of Heart Failure. 18(5), pp. 534 - 536. https://doi.org/10.1002/ejhf.522
Comparison of the American PPCM registry data with international registries
Hilfiker-Kleiner, Denise, Sliwa-Hahnle, Karen and Bauersachs, J.. (2016). Comparison of the American PPCM registry data with international registries. Journal of the American College of Cardiology. 67(6), pp. 733 - 734. https://doi.org/10.1016/j.jacc.2015.09.112
The heart of Africa: Succeeding against the odds
Sliwa-Hahnle, Karen. (2016). The heart of Africa: Succeeding against the odds. The Lancet. 388(10063), pp. 28 - 36. https://doi.org/10.1016/S0140-6736(16)31660-9
Current management of patients with severe acute peripartum cardiomyopathy: Practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy
Bauersachs, Johann, Arrigo, Mattia, Hilfiker-Kleiner, Denise, Veltmann, Christian, Coats, Andrew J. S., Crespo-Leiro, Maria G., de Boer, Rudolf A., van der Meer, Peter, Maack, Christoph, Mouquet, Frederic, Petrie, Mark C., Piepoli, Massimo F., Regitz-Zagrosek, Vera, Schaufelberger, Maria, Seferovic, Petar, Tavazzi, Luigi, Ruschitzka, Frank, Mebazaa, Alexandre and Sliwa-Hahnle, Karen. (2016). Current management of patients with severe acute peripartum cardiomyopathy: Practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. European Journal of Heart Failure. 18(9), pp. 1096 - 1105. https://doi.org/10.1002/ejhf.586
Human immunodeficiency virus-related heart disease
Thienemann, Friedrich, Carrington, Melinda, Sliwa-Hahnle, Karen, Ntsekhe, Mpiko and Stewart, Simon. (2016). Human immunodeficiency virus-related heart disease. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 145 - 154 John Wiley & Sons. https://doi.org/10.1002/9781119097136.ch9
Topic reviews need to be robust
Ntusi, Ntobeko B. A., Kraus, Sarah, Ogunbanjo, Gboyega and Sliwa-Hahnle, Karen. (2016). Topic reviews need to be robust. South African Medical Journal. 106(7), pp. 644 - 645. https://doi.org/10.7196/SAMJ.2016v106i7.10903
Rheumatic heart disease
Stewart, Simon, Carrington, Melinda and Sliwa-Hahnle, Karen. (2016). Rheumatic heart disease. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 121 - 135 John Wiley & Sons. https://doi.org/10.1002/9781119097136.ch7
The causes, treatment, and outcome of pulmonary hypertension in Africa: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry
Thienemann, Friedrich, Dzudie, Anastase, Mocumbi, Ana, Blauwet, Lori, Sani, Mahmoud U., Karaye, Kamilu M., Ogah, Okechukwu, Mbanze, Irina, Mbakwem, Amam, Udo, Patience, Tibazarwa, Kemi, Damasceno, Albertino, Keates, Ashley K., Stewart, Simon and Sliwa-Hahnle, Karen. (2016). The causes, treatment, and outcome of pulmonary hypertension in Africa: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry. International Journal of Cardiology. 221, pp. 205 - 211. https://doi.org/10.1016/j.ijcard.2016.06.242
The African INTERHEART study
Steyn, Krisela and Sliwa-Hahnle, Karen. (2016). The African INTERHEART study. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 1 - 9 John Wiley & Sons.
Bi treatment with hydralazine/nitrates vs. placebo in Africans admitted with acute HEart Failure (BA-HEF)
Sliwa-Hahnle, Karen, Damasceno, Albertino, Davidson, Beth A., Mayosi, Bongani, Sani, Mahmoud U., Ogah, Okechukwu, Mondo, Charles, Ojji, Dike, Dzudie, Anastase, Kouam, Charles Kouam, Yonga, Gerald, Ba, Serigne Abdou, Ogola, Elijah, Edwards, Christopher, Milo, Olga and Cotter, Gad. (2016). Bi treatment with hydralazine/nitrates vs. placebo in Africans admitted with acute HEart Failure (BA-HEF). European Journal of Heart Failure. 18(10), pp. 1248 - 1258. https://doi.org/10.1002/ejhf.581
Late maternal deaths: A neglected responsibility
Sliwa-Hahnle, Karen and Anthony, John. (2016). Late maternal deaths: A neglected responsibility. The Lancet. 387(10033), pp. 2072 - 2073. https://doi.org/10.1016/S0140-6736(16)30391-9
Ten-year coronary artery disease risk in 1571 newly presenting hypertensive black subjects
Ojji, Dike, Stewart, Simon, Atherton, John J., Ajayi, Samuel, Mamven, Manmak H., Ngabea, Murtala, Ojji, O. and Sliwa-Hahnle, Karen. (2016). Ten-year coronary artery disease risk in 1571 newly presenting hypertensive black subjects. Journal of Community Medicine & Health Education (online). 6(3), pp. 1 - 5. https://doi.org/10.4172/2161-0711.1000442
Cord blood samples: A less explored tool in early diagnosis of neonatal cardiovascular disease
Sliwa-Hahnle, Karen and Hilfiker-Kleiner, Denise. (2015). Cord blood samples: A less explored tool in early diagnosis of neonatal cardiovascular disease. Journal of the American College of Cardiology. 66(8), pp. 940 - 942. https://doi.org/10.1016/j.jacc.2015.07.001
Heart failure in the developing world
Sliwa-Hahnle, Karen and Stewart, Simon. (2014). Heart failure in the developing world. In In D. L. Mann and G. Michael Felker (Ed.). Heart Failure: A Companion to Braunwald's Heart Disease pp. 410 - 419 Elsevier.
Pathophysiology and epidemiology of peripartum cardiomyopathy
Hilfiker-Kleiner, Denise and Sliwa-Hahnle, Karen. (2014). Pathophysiology and epidemiology of peripartum cardiomyopathy. Nature Reviews Cardiology. 11(6), pp. 364 - 370. https://doi.org/10.1038/nrcardio.2014.37
Is all heart failure the same around the globe?
Sliwa-Hahnle, Karen. (2013). Is all heart failure the same around the globe? European Heart Journal. 34(40), pp. 3091 - 3092. https://doi.org/10.1093/eurheartj/eht385
Acute heart failure: Is it peripartum cardiomyopathy or not?
Bachelier-Walenta, Katrin, Hilfiker-Kleiner, Denise and Sliwa-Hahnle, Karen. (2013). Acute heart failure: Is it peripartum cardiomyopathy or not? Obstetric Medicine. 6(1), pp. 42 - 44. https://doi.org/10.1258/OM.2012.120042
Sex and gender differences in cardiovascular disease
Sliwa-Hahnle, Karen. (2012). Sex and gender differences in cardiovascular disease. European Heart Journal. 33(11), pp. 1298 - 1299. https://doi.org/10.1093/eurheartj/ehs103