ARYA Atherosclerosis Journal

Cardiomyopathy discovered during pregnancy: Insights from speckle tracking echocardiography in a cohort of pregnant patients

Document Type : Original Article

Authors

Parvin Bahrami 1
Azam Soleimani 2, 3
Reihane Zavar 2
Hosein Masoumi 2, 3
Farzad Adelparvar 2

1 Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

https://doi.org/10.48305/arya.2024.42400.2932
Abstract
BACKGROUND: Heart failure (HF) is considered the leading cause of cardiac-related morbidity and mortality during pregnancy. Peripartum cardiomyopathy (PPCM) presents diagnostic challenges, often mirroring dilated cardiomyopathy (DCM). The aim of the study is to evaluate echocardiographic features, including global and segmental longitudinal strain values, in pregnant women with a history of newly diagnosed left ventricular systolic dysfunction (LVSD) in the third trimester of pregnancy.
METHODS: This cross-sectional study, conducted in two referral cardio-obstetric clinics in Isfahan, Iran, enrolled pregnant women with newly diagnosed LV systolic dysfunction in the third trimester of pregnancy. A multidisciplinary pregnancy heart team assessed the patients. Reevaluation of patients and advanced echocardiographic investigation, including speckle tracking echocardiography (STE), were performed at least six months after delivery.
RESULTS: The study included 26 pregnant women. Baseline characteristics revealed varying NYHA functional classes and etiologies, including DCM or non-dilated LV cardiomyopathy and PPCM. Undiagnosed DCM with exacerbation during pregnancy or non-dilated LV cardiomyopathy were the most probable causes for LV systolic dysfunction (65.4%). In five cases, peripartum cardiomyopathy was more relevant. The mean global longitudinal strain (GLS) was -16.94% and -13.95% in PPCM and DCM, respectively. Significantly different regional longitudinal strain numbers among different LV segments in PPCM were observed (P=.042), whereas the segmental strain in DCM patients did not differ.
CONCLUSION: When LVSD is discovered late in pregnancy, it is not easy for the authors to differentiate between peripartum cardiomyopathy and other cardiomyopathies. Advanced echocardiographic techniques, particularly GLS analysis, may be valuable in differentiating between these conditions.

Keywords

Cardiomyopathy
Global Longitudinal Strain
Echocardiography
Pregnancy
Dilated Cardiomyopathy
Peripartum Period
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ARYA Atherosclerosis Journal
Volume 20, Issue 2
March and April 2024
Pages 8-16

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