Trends in Initial Cardiac Function, Treatment, and Outcomes in Peripartum Cardiomyopathy

BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare disease that causes heart failure during pregnancy or in the early postpartum period, and there were no reports on the trend of clinical condition and treatment in Japan. This explanatory retrospective study aimed to investigate the changes in clinical conditions and treatment in patients with PPCM. METHODS: Twenty-three patients (aged 22-43 years; mean age, 32 years) with PPCM from four hospitals in Nagasaki Prefecture were included. We compared the heart failure status and treatments of PPCM between the 10 years from January 2002 to December 2011 (first era) (N = 10) and the 11 years from January 2012 to December 2022 (second era) (N = 13). RESULTS: Left ventricular ejection fraction (LVEF) on admission was higher (first era 20% (interquartile range (IQR) 17-34) vs. second era 34% (IQR 25-37), p = 0.0213), and less patients treated with inotropes in patients in second era than those in first era (first era 6/10 (60%) vs. second era 2/13 (15%), p = 0.0393). Hospitalization period was shorter in second era than those in first era (first era 38 days (IQR 22-45) vs. second era 19 days (IQR 16-22), p = 0.0159). CONCLUSION: In recent years, patients with PPCM have been admitted before progression of LV dysfunction, and that may be related to a decrease in use of inotropes and hospitalization period in Japan.