understanding peripartum cardiomyopathy (PPCM)

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understanding peripartum cardiomyopathy (PPCM)

Postby alviarin » Mon Jun 18, 2012 10:23 pm

"Peripartum cardiomyopathy (PPCM) is an often fatal disease that affects pregnant women who are near delivery, and it occurs more frequently in women with pre-eclampsia and/or multiple gestation. The aetiology of PPCM, and why it is associated with pre-eclampsia, remain unknown. Here we show that PPCM is associated with a systemic angiogenic imbalance, accentuated by pre-eclampsia."
"...plasma samples from women with PPCM contained abnormally high levels of sFLT1."


http://www.nature.com/nature/journal/v4 ... 11040.html

"The study has harnessed significant causal evidence and arrived at a powerful argument that PPCM is a two-hit disease, with the first hit being the antiangiogenic environment of late pregnancy and the second hit being something as yet undiscovered that leaves women susceptible to cardiac damage, possibly an infection or genetic predisposition."

http://www.bidmc.org/News/InResearch/20 ... _PPCM.aspx

This study isn't about pre-eclampsia per se, but since pre-eclampsia is mentioned and we have had some posters who have suffered from PPCM I thought it would be good to share.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
alviarin
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Re: understanding peripartum cardiomyopathy (PPCM)

Postby caryn » Tue Jun 19, 2012 04:32 pm

Ha! I was just talking to the Experts about this study. It looks to me like we might have a reason to think sFlt might be causing cardiac damage in preeclamptics, rather than pregnancy unmasking preexisting risk. Or something.

I don't understand the molecular mechanisms here well at all but no one does. One thing: *all* pregnant women have high sFlt at term, which is why it's hard to design a diagnostic test, and not all pregnant women develop cardiac damage.

Will keep poking at it.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
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DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: understanding peripartum cardiomyopathy (PPCM)

Postby alviarin » Tue Jun 19, 2012 05:36 pm

PPCM very well could be a "two-hit" process. Underlying genetic pre-disposition, whether a mutation on chromosone 12 http://intermountainhealthcare.org/hospitals/imed/about/news/Pages/home.aspx?NewsID=814 or a deficiency in PGC1-alpha like the knockout mice in the above study making some women overly sensitive to high sFLT1 levels. Which are even more elevated during pre-e pregnancies.

I still wonder if some of the long-term cardiovascular risks associated with pre-e could also be linked to hypothyroidism. Since sFLT1 also mucks with your thyroid gland and even subclinical hypothyroidism has been linked to increase in cardiovascular risk factors including high LDL cholesterol, high triglycerides, impaired myocardial contractility, diastolic dysfunction, and atherosclerosis.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
alviarin
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Posts: 1592
Joined: Tue Apr 18, 2006 12:56 pm
Location: Texas

Re: understanding peripartum cardiomyopathy (PPCM)

Postby caryn » Tue Jun 19, 2012 11:13 pm

I was thinking about placentas that turn off production of whatever they'd like, including inducing thyroid issues. :)

This will be interesting to watch.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
User avatar
caryn
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Posts: 10099
Joined: Fri Jun 25, 2004 06:36 am


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