The ESC Textbook of Cardiovascular Medicine (3 edn)
32.27 Peripartum cardiomyopathy
Get access
-
Published:July 2018
-
This version:November 2019
Abstract
Pregnancy-related heart disease is increasing worldwide and peripartum cardiomyopathy (PPCM) is an important contributor to early (<42 days postpartum) and late (up to 1 year postpartum) maternal death. PPCM is a potentially life-threatening condition presenting with heart failure secondary to left ventricular dysfunction towards the end of pregnancy, or in the months following delivery, where no other cause of heart failure is identified. It is a diagnosis of exclusion. Incidence and prognosis varies according to geography and is likely due to multiple factors including also inherited or acquired cardiomyopathy-associated mutations. It seems that PPCM also shares common pathological pathways. For example, a ‘multiple-hit’ model including systemic angiogenic imbalance that derives from the oxidative stress-cathepsin D-16 kDa prolactin cascade and additional antiangiogenic factors plays a key role in the development of PPCM in experimental models and in humans suggests that a therapeutic approach involving blockade of this pathway with bromocriptine may be a novel disease-specific approach. Despite ongoing research, numerous uncertainties regarding the incidence, pathophysiology, treatment, and prognosis of PPCM patients remain, indicating the need for further investigation. The ongoing global registry on PPCM, under the umbrella of the EuroObservational research programme, has provided novel information.
Sign in
Get help with access
Personal account
- Sign in with email/username & password
- Get email alerts
- Save searches
- Purchase content
- Activate your purchase/trial code
- Add your ORCID iD
Get help with access
Institutional access
Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:
IP based access
Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.
Sign in through your institution
Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic.
If your institution is not listed or you cannot sign in to your institution’s website, please contact your librarian or administrator.
Sign in with a library card
Enter your library card number to sign in. If you cannot sign in, please contact your librarian.
Society Members
Society member access to a journal is achieved in one of the following ways:
Sign in through society site
Many societies offer single sign-on between the society website and Oxford Academic. If you see ‘Sign in through society site’ in the sign in pane within a journal:
If you do not have a society account or have forgotten your username or password, please contact your society.
Sign in using a personal account
Some societies use Oxford Academic personal accounts to provide access to their members. See below.
Personal account
A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.
Some societies use Oxford Academic personal accounts to provide access to their members.
Viewing your signed in accounts
Click the account icon in the top right to:
Signed in but can't access content
Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.
Institutional account management
For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.