Left ventricular function after a new pregnancy in patients with peripartum cardiomyopathy

Background: A new pregnancy is usually discouraged in patients with peripar tum cardiomyopathy (PPCM), particularly when there is persistent left ventr icular dysfunction. This study was undertaken to evaluate left ventricular systolic function after a new pregnancy in patients with PPCM. Methods and Results: Nine of 44 patients with PPCM became pregnant and were selected for this study. Two patients were lost to follow-up, 1 immediatel y after the new pregnancy diagnosis. and the other 1 after the latest deliv ery, and, thus, were excluded. The remaining 7 patients had regular clinica l and obstetric examinations until delivery, continued follow-up, and were submitted to echocardiography 6 to 12 months thereafter. Pregnancy was rela tively well tolerated in the patients, and they gave birth to 7 healthy new borns. After this latest pregnancy, 4 patients with heart failure functiona l class II and 2 patients with functional class III remained unchanged. A p atient, initially in functional class III, improved and was then in Functio nal class II. Although left ventricular end-diastolic diameter did not chan ge (61 to 58 mm). left ventricular end-systolic dimension decreased (50 to 47 mm, P = .008), resulting in a significant increase in left ventricular f ractional shortening (19% to 23%, P = .02). Conclusion: Although based only in a small number of patients, the present results suggest that cardiac function does not deteriorate during a new pre gnancy in patients with PPCM.