Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine
HIGHLIGHTS Younger age, black race, normotension, and multiparity indicate a poorer prognosis for peripartum cardiomyopathy recovery, while bromocriptine therapy reduces adverse events. ABSTRACT Objectives: This study aimed to fill the significant knowledge gap regarding peripartum cardiom...
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Universitas Airlangga
2024-07-01
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| Series: | Majalah Obstetri dan Ginekologi |
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| Online Access: | https://e-journal.unair.ac.id/MOG/article/view/51257 |
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| author | I Gusti Bagus Mulia Agung Pradnyaandara Ryan Saktika Mulyana Jane Carissa Sutedja Gusti Ngurah Prana Jagannatha I Bagus Satriya Wibawa Fanny Deantri I Wayan Agus Surya Pradnyana Bryan Gervais de Liyis |
| author_facet | I Gusti Bagus Mulia Agung Pradnyaandara Ryan Saktika Mulyana Jane Carissa Sutedja Gusti Ngurah Prana Jagannatha I Bagus Satriya Wibawa Fanny Deantri I Wayan Agus Surya Pradnyana Bryan Gervais de Liyis |
| author_sort | I Gusti Bagus Mulia Agung Pradnyaandara |
| collection | DOAJ |
| description | HIGHLIGHTS
Younger age, black race, normotension, and multiparity indicate a poorer prognosis for peripartum cardiomyopathy recovery, while bromocriptine therapy reduces adverse events.
ABSTRACT
Objectives: This study aimed to fill the significant knowledge gap regarding peripartum cardiomyopathy (PPCM), a heart failure phenotype linked to pregnancy. The main objectives were to explore the factors influencing the development and progression of PPCM and to assess the outcomes of bromocriptine.
Materials and Methods: Systematic search across PubMed, ScienceDirect, and Cochrane Library identified studies until December 2022. This study includes non-randomized prospective and retrospective studies, as well as relevant randomized controlled trials. Risk factors were compared between the recovered and non-recovered PPCM groups, and bromocriptine therapy outcomes were evaluated against standard heart failure treatment as the primary endpoint.
Results: The analysis included 24 observational studies and 1 randomized controlled trial involving 1,651 PPCM patients; 9 studies evaluating the outcomes of bromocriptine therapy. The most prevalent factors were caesarean delivery (proportion=53%, 95%CI=41%-66%) and anemia (proportion=51%, 95%CI=38%-65%). Non-recovered patients were younger (MD=-1.04 years old, 95%CI=-1.82-(-0.27), p=0.008) and predominantly black (RR=1.82, 95%CI=1.43-2.31, p <0.001). Hypertensive disorders and primiparity were found less among non-recovered patients (RR=0.73, 95%CI=0.60-0.88, p=0.001; RR=0.81, 95%CI=0.66-0.99, p=0.04, respectively). Non-recovered patients also exhibited higher baseline serum creatinine levels, lower LVEF, larger left ventricular end-systolic diameter (LVESD), larger left ventricular end-diastolic diameter (LVEDD), and lower fractional shortening (all P-values<0.05). Furthermore, bromocriptine significantly reduced major adverse cardiac events (MACE), mortality, and increased LVEF (all P-values<0.05).
Conclusion: Younger maternal age, black race, absence of hypertension, and multiparity are associated with poorer prognosis for PPCM recovery. Bromocriptine therapy demonstrates superior benefits in reducing adverse events in PPCM. |
| format | Article |
| id | doaj-art-cf975ea1d8bb4b5b88fb22a8d8f2d004 |
| institution | Kabale University |
| issn | 0854-0381 2598-1013 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Universitas Airlangga |
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| series | Majalah Obstetri dan Ginekologi |
| spelling | doaj-art-cf975ea1d8bb4b5b88fb22a8d8f2d0042025-01-07T03:23:16ZengUniversitas AirlanggaMajalah Obstetri dan Ginekologi0854-03812598-10132024-07-0132211212710.20473/mog.V32I22024.112-12749415Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptineI Gusti Bagus Mulia Agung Pradnyaandara0https://orcid.org/0009-0001-9483-6508Ryan Saktika Mulyana1https://orcid.org/0000-0002-6683-5858Jane Carissa Sutedja2https://orcid.org/0000-0002-5380-2897Gusti Ngurah Prana Jagannatha3https://orcid.org/0000-0001-7371-4520I Bagus Satriya Wibawa4https://orcid.org/0009-0007-1291-9849Fanny Deantri5https://orcid.org/0009-0004-9524-3909I Wayan Agus Surya Pradnyana6https://orcid.org/0000-0002-7095-4956Bryan Gervais de Liyis7https://orcid.org/0000-0002-8272-754XFaculty of Medicine, Universitas Udayana, Denpasar, BaliDepartment of Obstetrics and Gynecology, Prof. dr. I.G.N.G Ngoerah General Hospital, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliFaculty of Medicine, Universitas Udayana, Denpasar, BaliHIGHLIGHTS Younger age, black race, normotension, and multiparity indicate a poorer prognosis for peripartum cardiomyopathy recovery, while bromocriptine therapy reduces adverse events. ABSTRACT Objectives: This study aimed to fill the significant knowledge gap regarding peripartum cardiomyopathy (PPCM), a heart failure phenotype linked to pregnancy. The main objectives were to explore the factors influencing the development and progression of PPCM and to assess the outcomes of bromocriptine. Materials and Methods: Systematic search across PubMed, ScienceDirect, and Cochrane Library identified studies until December 2022. This study includes non-randomized prospective and retrospective studies, as well as relevant randomized controlled trials. Risk factors were compared between the recovered and non-recovered PPCM groups, and bromocriptine therapy outcomes were evaluated against standard heart failure treatment as the primary endpoint. Results: The analysis included 24 observational studies and 1 randomized controlled trial involving 1,651 PPCM patients; 9 studies evaluating the outcomes of bromocriptine therapy. The most prevalent factors were caesarean delivery (proportion=53%, 95%CI=41%-66%) and anemia (proportion=51%, 95%CI=38%-65%). Non-recovered patients were younger (MD=-1.04 years old, 95%CI=-1.82-(-0.27), p=0.008) and predominantly black (RR=1.82, 95%CI=1.43-2.31, p <0.001). Hypertensive disorders and primiparity were found less among non-recovered patients (RR=0.73, 95%CI=0.60-0.88, p=0.001; RR=0.81, 95%CI=0.66-0.99, p=0.04, respectively). Non-recovered patients also exhibited higher baseline serum creatinine levels, lower LVEF, larger left ventricular end-systolic diameter (LVESD), larger left ventricular end-diastolic diameter (LVEDD), and lower fractional shortening (all P-values<0.05). Furthermore, bromocriptine significantly reduced major adverse cardiac events (MACE), mortality, and increased LVEF (all P-values<0.05). Conclusion: Younger maternal age, black race, absence of hypertension, and multiparity are associated with poorer prognosis for PPCM recovery. Bromocriptine therapy demonstrates superior benefits in reducing adverse events in PPCM.https://e-journal.unair.ac.id/MOG/article/view/51257bromocriptinecardiomyopathiesheart failurepregnancyrisk factorsmaternal health |
| spellingShingle | I Gusti Bagus Mulia Agung Pradnyaandara Ryan Saktika Mulyana Jane Carissa Sutedja Gusti Ngurah Prana Jagannatha I Bagus Satriya Wibawa Fanny Deantri I Wayan Agus Surya Pradnyana Bryan Gervais de Liyis Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine Majalah Obstetri dan Ginekologi bromocriptine cardiomyopathies heart failure pregnancy risk factors maternal health |
| title | Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| title_full | Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| title_fullStr | Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| title_full_unstemmed | Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| title_short | Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| title_sort | maternal related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine |
| topic | bromocriptine cardiomyopathies heart failure pregnancy risk factors maternal health |
| url | https://e-journal.unair.ac.id/MOG/article/view/51257 |
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