[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-319501-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-319501-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","pathophysiology-and-risk-factors-of-peripartum-cardiomyopathy","Pathophysiology and risk factors of peripartum cardiomyopathy","","Peripartum cardiomyopathy (PPCM) is a potentially fatal idiopathic heart failure with variable prevalence across countries and ethnic groups. The cause remains unclear, while environmental and genetic factors, together with pregnancy-associated conditions such as pre-eclampsia, may contribute. Animal studies suggest impaired vascular and metabolic functions as central mechanisms. Pregnancy hormones drive rapid cardiovascular hemodynamic, structural and metabolic adaptations. The peripartum period can disrupt cardiovascular homeostasis through profound hormonal fluctuations, predisposing to secondary perturbations, warranting new therapies.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/pathophysiology-and-risk-factors-of-peripartum-cardiomyopathy/319501/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/pathophysiology-and-risk-factors-of-peripartum-cardiomyopathy/319501.png","ImageObject",300,407,{"name":42,"@type":43},"River Wang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-20",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How is peripartum cardiomyopathy (PPCM) defined and diagnosed?","Question",{"text":63,"@type":64},"PPCM is idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction during the peripartum phase, after excluding other causes. Diagnosis generally relies on ruling out differential diagnoses such as pre-existing dilated cardiomyopathy, familial cardiomyopathy, myocarditis, Takotsubo cardiomyopathy, and valvular heart disease.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What are the typical outcomes after PPCM diagnosis?",{"text":68,"@type":64},"Outcomes vary widely. Myocardial recovery with LVEF > 50% was reported in 46% of patients 6 months after diagnosis, while persistent severe LV dysfunction or death occurred in 28%. Registry data further support this variability.",{"name":70,"@type":61,"acceptedAnswer":71},"Which factors are described as risk factors and drivers of PPCM?",{"text":72,"@type":64},"Risk factors include genetic variants seen in other cardiomyopathies, low socioeconomic status, pre-eclampsia, and a history of cancer. Proposed mechanisms include dysregulated metabolic pathways and an angiogenic imbalance, potentially related to aberrant hormonal signaling during pregnancy.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},319501,1790090165,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.  \n2Department of Medicine, Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.  \n3Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.  \n4Department of Cardiovascular Complications in Pregnancy and in Oncologic Therapies, Comprehensive Cancer Center, Philipps University Marburg, Marburg, Germany.  \n5Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.  \n6Department of Medicine & Cardiology, Cape Heart Institute, Faculty of Heath Sciences, University of Cape Town, Cape Town, South Africa.✉[e-mail:](e-mail: m.hoes@umcg.nl)[ m.hoes@umcg.nl](e-mail: m.hoes@umcg.nl)  \n[https://doi.org/10.1038/](https://doi.org/10.1038/)[ ](https://doi.org/10.1038/)[s41569-021-00664-8](s41569-021-00664-8)  \nReviews  \nPathophysiology and risk factors of peripartum cardiomyopathy   \nMartijn F. Hoes1 ✉, Zoltan Arany2, Johann Bauersachs3, Denise Hilfiker-Kleiner4, Mark C. Petrie5, Karen Sliwa6 and Peter van der Meer1  \nAbstract | Peripartum cardiomyopathy (PPCM) is a potentially fatal form of idiopathic heart failure with variable prevalence across different countries and ethnic groups. The cause of PPCM is unclear, but environmental and genetic factors and pregnancy-associated conditions such as pre-eclampsia can contribute to the development of PPCM. Furthermore, animal studies have shown that impaired vascular and metabolic function might be central to the development of PPCM. A better understanding of the pathogenic mechanisms involved in the development of PPCM is necessary to establish new therapies that can improve the outcomes of patients with PPCM. Pregnancy hormones tightly regulate a plethora of maternal adaptive responses, including haemodynamic, structural and metabolic changes in the cardiovascular system. In patients with PPCM, the peripartum period is associated with profound and rapid hormonal fluctuations that result in a brief period of disrupted cardiovascular (metabolic) homeostasis prone to secondary perturbations. In this Review, we discuss the latest studies on the potential pathophysiological mechanisms of and risk factors for PPCM, with a focus on maternal cardiovascular changes associated with pregnancy. We provide an updated framework to further our understanding of PPCM pathogenesis, which might lead to an improvement in disease definition.  \nPeripartum cardiomyopathy (PPCM) is a form of heart failure that is associated with pregnancy1 ,2 . PPCMis defined as idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular (LV) systolic dysfunction in the peripartum phase (which encompasses the period leading up to the end of the pregnancy, the time of delivery and the months after delivery), in which no other cause of heart failure is found1,3–5. Diagnosis generally follows the exclusion of other similar conditions; differential diagnoses include pre-existing dilated cardiomyopathy (DCM), familial cardiomyopathy, myocarditis, Takotsubo cardiomyopathy and valvular heart disease1,2,5,6. PPCM outcomes are highly variable as evidenced by registry data from the ESC EURObservational Research Programme (EORP)4. Myocardial recovery (that is, LV ejection fraction (LVEF)>50%) was observed in 46% of patients 6 months after diagnosis of PPCM but persistent severe LV dysfunction or death occurred in 28%4. Patients with PPCM often have hypertension and heart palpitations and might have a long-term elevated risk of sudden death, arrhythmia and other cardiovascular complications7. A need for long-term drug therapy is common in this patient cohort,  \neven among those with fully recovered LV function7,8.  \nPPCM incidence seems to vary markedly depending on geographical region but inconsistent disease  \ndefinitions between different regions have precludeda direct comparison of studies. Countries wi","cbCaihU2SXspiiTC","https://ap.wps.com/l/cbCaihU2SXspiiTC","pdf",2190343,"English","# Abstract\n# Peripartum cardiomyopathy: definition, diagnosis, and outcomes\n# Incidence by country and potential trends\n# Pathophysiology and the multiple-hit model\n# Key points","[{\"question\":\"How is peripartum cardiomyopathy (PPCM) defined and diagnosed?\",\"answer\":\"PPCM is idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction during the peripartum phase, after excluding other causes. Diagnosis generally relies on ruling out differential diagnoses such as pre-existing dilated cardiomyopathy, familial cardiomyopathy, myocarditis, Takotsubo cardiomyopathy, and valvular heart disease.\"},{\"question\":\"What are the typical outcomes after PPCM diagnosis?\",\"answer\":\"Outcomes vary widely. Myocardial recovery with LVEF \\u003e 50% was reported in 46% of patients 6 months after diagnosis, while persistent severe LV dysfunction or death occurred in 28%. Registry data further support this variability.\"},{\"question\":\"Which factors are described as risk factors and drivers of PPCM?\",\"answer\":\"Risk factors include genetic variants seen in other cardiomyopathies, low socioeconomic status, pre-eclampsia, and a history of cancer. Proposed mechanisms include dysregulated metabolic pathways and an angiogenic imbalance, potentially related to aberrant hormonal signaling during pregnancy.\"}]","Pathophysiology and risk factors of peripartum cardiomyopathy | PDF",1789944589,28]