AIMS Peripartum cardiomyopathy (PPCM) establishes late in pregnancy or in the first postpartum months. Many patients recover well within the first year, but long-term outcome studies on morbidity and mortality are rare. Here, we present 5-year follow-up data of a German PPCM cohort. METHODS AND RESULTS Five-year follow-up data were available for 66 PPCM patients (mean age 34 ± 5 years) with a mean left ventricular ejection fraction (LVEF) of 26 ± 9% at diagnosis. Ninety-eight percent initially received standard heart failure therapy (beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and/or mineralocorticoid receptor antagonists), and 86% were additionally treated with dopamine D2 receptor agonists (mainly bromocriptine) and anticoagulation. After 1 year, mean LVEF had improved to 50 ± 11% (n = 48) and further increased to 54 ± 7% at 5-year follow-up with 72% of patients having achieved full cardiac recovery (LVEF >50%). At 5-year follow-up, only three patients (5%) displayed no recovery, of whom one had died. However, 20% had arterial hypertension and 17% arrhythmias, including paroxysmal supraventricular tachycardia, ventricular tachycardia, or ventricular fibrillation. Moreover, 70% were still on at least one heart failure drug. Subsequent pregnancy occurred in 16 patients with two abortions and 14 uneventful pregnancies. Mean LVEF was 55 ± 7% at 5-year follow-up in these patients. CONCLUSION Our PPCM collective treated with standard therapy for heart failure, dopamine D2 receptor agonists, and anticoagulation displays a high and stable long-term recovery rate with low mortality at 5-year follow-up. However, long-term use of cardiovascular medication, persisting or de novo hypertension and arrhythmias were frequent.

中文翻译：

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采用当代治疗方法对围产期心肌病患者进行长期随访：低死亡率，高心脏恢复率，但有明显的心血管合并症。

AIMS围产期心肌病（PPCM）在怀孕后期或产后头几个月建立。许多患者在第一年内恢复良好，但是关于发病率和死亡率的长期结果研究却很少。在这里，我们介绍了德国PPCM队列的5年随访数据。方法和结果对66名PPCM患者（平均年龄34±5岁）进行了五年随访，诊断时其平均左心室射血分数（LVEF）为26±9％。最初有98％的患者接受了标准的心力衰竭治疗（β受体阻滞剂，血管紧张素转化酶抑制剂/血管紧张素受体阻滞剂和/或盐皮质激素受体拮抗剂），另有86％的患者接受了多巴胺D2受体激动剂（主要是溴隐亭）和抗凝治疗。一年后 平均LVEF已改善至50±11％（n = 48），并在5年随访中进一步增加至54±7％，其中72％的患者已实现完全心脏恢复（LVEF> 50％）。在5年的随访中，只有3例患者（5％）没有恢复，其中1例死亡。但是，有20％的人患有动脉高压，而有17％的心律不齐，包括阵发性室上性心动过速，室性心动过速或室颤。此外，仍有70％的人仍在服用至少一种心力衰竭药物。随后的妊娠发生在16例患者中，其中有2例流产和14例正常妊娠。这些患者在5年随访中的平均LVEF为55±7％。结论我们的PPCM集体接受了针对心力衰竭的标准疗法，多巴胺D2受体激动剂，抗凝显示出高且稳定的长期恢复率，并且在5年的随访中死亡率较低。但是，长期使用心血管药物，持续存在或从头出现高血压和心律不齐的情况很常见。