Differences in clinical profile of African-American women with peripartum cardiomyopathy in the United States

J Card Fail. 2013 Apr;19(4):214-8. doi: 10.1016/j.cardfail.2013.03.004.

Abstract

Background: Peripartum cardiomyopathy (PPCM) is a rare and heterogeneous disease with a higher prevalence in African Americans (AAs) in the USA. The clinical features and prognosis of PPCM in AAs have not been sufficiently characterized.

Methods: We studied 52 AA patients with PPCM and compared clinical characteristics and outcome with those of 104 white patients.

Results: AA patients were significantly younger (26 ± 7 vs 30 ± 6 years; P < .001), had a higher prevalence of gestational hypertension (61% vs 41%; P = .03), and were diagnosed more commonly postpartum rather then antepartum (83% vs 64%; P = .03). The rate of left ventricular (LV) recovery (LV ejection fraction [LVEF] ≥50%) was significantly lower in AAs (40% vs 61%; P = .02). AA women also had a larger LV end-diastolic diameter (57 ± 10 vs 51 ± 6 mm; P = .004) as well as lower LVEF (40% ± 16.7% vs 46% ± 14%; P = .002) at the last follow-up. Moreover, AA patients had a significantly higher incidence of the combined end points of mortality and cardiac transplantation (P = .03) and showed a strong trend (P = .09) for increased mortality.

Conclusions: AA patients with PPCM in the USA have a different clinical profile and worse prognosis compared with white patients. Further research to evaluate potentially correctable causes for these differences is warranted.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • African Americans / ethnology*
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / ethnology*
  • Cardiomyopathies / physiopathology
  • European Continental Ancestry Group / ethnology*
  • Female
  • Humans
  • Peripartum Period / physiology*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Cardiovascular / ethnology*
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Retrospective Studies
  • Stroke Volume / physiology
  • United States / ethnology
  • Young Adult