Peri/Post Partum Cardiomyopathy (PPCM)

Abstract: Peri/Post partum cardiomyopathy (PPCM) is a rare and potentially fatal disease which presents itself with symptoms of heart failure primarily due to left ventricular systolic dysfunction in the last month of pregnancy and up to 5-6 months after delivery. The incidence of this disease is increasing and is a significant cause of maternal deaths in the United States with reported mortalities ranging from 18%-56%. Unfortunately, even after survival from PPCM, some women do not recover and require chronic therapy for heart failure and may ultimately undergo cardiac transplantation. There is no currently known etiology for PPCM, but a number of factors have been proposed for its development based on the results of clinical and experimental studies. These include: diabetes, apoptosis, myocarditis, multi-fetal pregnancy, advanced age, pre-eclampsia, inflammatory and auto-immune reactions, cardiotrophic viral infections, and hypertension. The purpose of this research is to determine potential mechanistic pathways for PPCM by critical analysis of anatomic, histologic, physiologic, immunologic and inflammatory cascade data derived from currently available experimental and clinical studies. From this analysis, I will purpose a theoretical mechanism(s) for an auto immune reaction that results in PPCM that can be evaluated by well designed studies with the ultimate goals of developing novel preventative measures and therapeutic approaches for this disease