Maternal Obesity Affects Cardiac Remodeling and Recovery in Women with Peripartum Cardiomyopathy

Esa M. Davis, Gregory Ewald, Michael M. Givertz, Navin Rajagopalan, Leslie T. Cooper, Joan Briller, G. Michael Felker, Biykem Bozkurt, Mark H. Drazner, Karen Hanley-Yanez, Indrani Halder, Charles F. McTiernan, Dennis M. McNamara

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective To examine the association between maternal obesity on left ventricular (LV) size and recovery in women with peripartum cardiomyopathy (PPCM). Study Design This was a prospective analysis of 100 women enrolled within 13 weeks of PPCM diagnosis and followed for a year in the Investigation of Pregnancy Associated Cardiomyopathy study. Adiposity was defined by standard body mass index (BMI) definitions for under/normal weight, overweight, and obesity. Demographic, clinical, and biomarker variables were compared across weight categories. Outcomes LV end-diastolic diameter (LVEDD) and ejection fraction were measured at entry, 6, and 12 months postpartum. Multivariable regression models examined the relationship between adiposity, LV size, and leptin levels with cardiac recovery at 6 and 12 months postpartum. Results Obese and nonobese women had similar LV dysfunction at entry. Obese women had greater LV size and less LV recovery at 6 and 12 months postpartum. BMI was positively associated with leptin and ventricular diameter. Greater BMI at entry remained associated with less ventricular recovery at 6 months (p = 0.02) in adjusted race-stratified models. LVEDD at entry predicted lower ejection fraction at 6 months (p < 0.001) and similarly at 12 months. Conclusion Obese women with PPCM had greater cardiac remodeling, higher leptin levels, and diminished cardiac recovery.

Original languageEnglish (US)
Pages (from-to)476-483
Number of pages8
JournalAmerican Journal of Perinatology
Volume36
Issue number5
DOIs
StatePublished - Jan 1 2019

Keywords

  • left ventricular ejection fraction
  • left ventricular end-diastolic diameter
  • maternal leptin
  • nonischemic cardiomyopathy
  • obesity
  • peripartum cardiomyopathy
  • pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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