Влияние пролактина на желудочковые аритмии при перипартальной кардиомиопатии: клиническое исследование

Background. To assess the frequency and characteristics of cardiac arrhythmias in relation to cardiac remodeling and blood prolactin levels in patients with peripartum cardiomyopathy (PPCM). Materials and methods. The study included 104 patients with a confirmed diagnosis of PPCM, classified according to the 1995 WHO guidelines and recommendations from the 2010 Working Group on Peripartum Cardiomyopathy, Association of Heart Failure, EOC. All patients received optimized pharmacological therapy for heart failure (HF). Patients were divided into two groups based on prolactin levels: Group I included 30 patients with elevated prolactin levels exceeding 496 uU/ml (mean 612.2±65.9 uU/ml), and Group II comprised 74 patients with normal prolactin levels below 496 uU/ml (mean 236.3±75.9 uU/ml). Blood samples for prolactin were collected during the manifestation of clinical HF symptoms, from initial inpatient admission up to the 3rd-4th month postpartum. Results. Comparative analysis revealed that the total number of left ventricular rhythm disturbances (LVRS) was similar across groups, averaging 456.9±215.89 per day in Group I and 398.69±315.89 in Group II (p>0.05). Both groups exhibited a higher prevalence of ventricular ectopic activity during the daytime, with a day/night ratio of 1.34±0.3 in Group I and 1.5±0.44 in Group II (p>0.05). Conclusion. The findings indicate that patients with PPCM and elevated blood prolactin levels experience significantly more frequent and complex ventricular extrasystole, which could have predictive implications for patient prognosis. Further research is needed to explore the prognostic value of prolactin levels in managing ventricular arrhythmias in PPCM patients.