Race Drives Peripartum Cardiomyopathy Outcomes


NEW ORLEANS — Full recovery of left ventricular function is significantly less likely in black patients than in white patients with peripartum cardiomyopathy, Dr. Sorel Goland reported at the annual meeting of the American College of Cardiology.

There are other intriguing racial differences in the clinical profiles of patients with peripartum cardiomyopathy (PPCM).

Black patients are significantly younger at diagnosis, more likely to have gestational hypertension, and less likely to present with symptoms prior to delivery, and they tend to have worse outcomes, according to Dr. Goland of the University of Southern California, Los Angeles.

She presented a retrospective study involving 52 black and 104 white women with PPCM.

Baseline left ventricular ejection fraction averaged 28% in both groups, with half of all patients having an ejection fraction of 25% or less.

But only 18% of black patients experienced complete recovery of left ventricular function as defined by an ejection fraction of at least 50%, compared with 61% of white patients.

Mean age of the black women at diagnosis of peripartum cardiomyopathy was 26 years, compared with 30 years in white patients.

Two-thirds of black patients had gestational hypertension, as did 46% of white patients.

More than 80% of black women had PPCM symptoms after delivery, compared with half of white women.

Black patients also had a significantly greater mean left ventricular end diastolic diameter, both at the time of diagnosis and at last follow-up, an average of roughly 2 years later.

The combined end point of death or cardiac transplantation occurred in 31% of black patients, a significantly higher rate than was seen in white patients, Dr. Goland reported.

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