Molecular mechanisms of peripartum cardiomyopathy: A vascular/hormonal hypothesis

Trends Cardiovasc Med. 2015 Aug;25(6):499-504. doi: 10.1016/j.tcm.2015.01.004. Epub 2015 Jan 15.


Peripartum cardiomyopathy (PPCM) is characterized by the development of systolic heart failure in the last month of pregnancy or within the first 5 months postpartum. The disease affects between 1:300 and 1:3000 births worldwide. Heart failure can resolve spontaneously but often does not. Mortality rates, like incidence, vary widely based on location, ranging from 0% to 25%. The consequences of PPCM are thus often devastating for an otherwise healthy young woman and her newborn. The cause of PPCM remains elusive. Numerous hypotheses have been proposed, with mixed supporting evidence. Recent work has suggested that PPCM is a vascular disease, triggered by the profound hormonal changes of late gestation. We focus here on these new mechanistic findings, and their potential implication for understanding and treating PPCM.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Female
  • Gestational Age
  • Heart Failure, Systolic / diagnosis*
  • Heart Failure, Systolic / therapy
  • Humans
  • Maternal Death / trends
  • Molecular Biology
  • Peripartum Period
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis*
  • Pregnancy Complications, Cardiovascular / mortality
  • Pregnancy Complications, Cardiovascular / therapy
  • Progesterone / metabolism*
  • Rare Diseases
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Vascular Diseases / physiopathology*


  • Progesterone