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Cleaved 16 kDa prolactin has been implicated in cardiac angiogenic imbalance, prompting investigation of prolactin inhibitors. This systematic review and meta-analysis assessed how prolactin inhibition affects left ventricular function and mortality in PPCM patients. Studies in PubMed and EMBASE up to March 2022 were pooled using random-effects models for LVEF at follow-up, LV recovery, and all-cause mortality.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prolactin-inhibition-in-peripartum-cardiomyopathy-systematic-review-and-meta-analysis/319570/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prolactin-inhibition-in-peripartum-cardiomyopathy-systematic-review-and-meta-analysis/319570.png","ImageObject",300,407,{"name":92,"@type":93},"Sage","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical question does this systematic review address?","Question",{"text":112,"@type":113},"It evaluates the impact of prolactin inhibition on left ventricular (LV) function and mortality in patients with peripartum cardiomyopathy (PPCM).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which treatment approach was analyzed for prolactin inhibition?",{"text":117,"@type":113},"The review focuses on prolactin inhibition strategies, including bromocriptine, compared with standard guideline-directed medical therapy (GDMT) alone.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the overall findings regarding LV function and mortality?",{"text":121,"@type":113},"Adding bromocriptine to standard GDMT was associated with improved LVEF and higher odds of LV recovery, while no significant difference in all-cause mortality was found between groups.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},319570,1790256688,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":56,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},687197207057,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Author Manuscript Author Manuscript Author Manuscript Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Curr Probl Cardiol. Author manuscript; available in PMC 2023 February 01. |\n| --- | --- |\n\nPublished in final edited form as:  \nCurr Probl Cardiol. 2023 February ; 48(2): 101461. doi:10.1016/j.cpcardiol.2022.101461 .  \nProlactin Inhibition in Peripartum Cardiomyopathy: Systematic Review and Meta-analysis  \nAmudha Kumara, Ramya Ravib, Ranjith K. Sivakumarb, Vignesh Chidambarama, Marie G. Majellac, Shashank Sinhad, Luigi Adamoe, Emily S. Lauf, Subhi J. Al’Arefg, Aarti Asnanih, Garima Sharmae, Jawahar L. Mehtag  \na Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, ARb Department of Anesthesia and Intensive Care, Chinese university of Hong Kong, Prince of Wales hospital, Shatin, Hong Kong  \nc Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital & Research Center, Pondicherry, India  \nd Division of Cardiology, Inova Heart and Vascular Institute, Fairfax, VA  \ne Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD  \nfDivision of Cardiology, Massachusetts General Hospital, Boston, MA  \ng Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, AR  \nhBeth Israel Deaconess Medical Center, Harvard Medical School, Cardiovascular Institute, Boston, MA  \nAbstract  \nHeart failure (HF) is one of the leading causes of maternal mortality and morbidity in the United States. Peripartum cardiomyopathy (PPCM) constitutes up to 70% of all HF in pregnancy. Cardiac angiogenic imbalance caused by cleaved 16kDa prolactin has been hypothesized to contribute to the development of PPCM, fueling investigation of prolactin inhibitors for the management of PPCM. We conducted a systematic review and meta-analysis to assess the impact of prolactin inhibition on left ventricular (LV) function and mortality in patients with PPCM. We included English language articles from PubMed and EMBASE published upto March 2022. We pooled the mean difference (MD) for left ventricular ejection fraction (LVEF) at follow-up, odds ratio (OR) for LV recovery and risk ratio (RR) for all-cause mortality using random-effects meta-analysis.  \nAmong 548 studies screened, 10 studies (3 randomized control trials (RCTs), 2 retrospective and 5 prospective cohorts) were included in the systematic review. Patients in the Bromocriptine + standard guideline directed medical therapy (GDMT) group had higher LVEF%(pMD 12.56 (95% CI 5.84-19.28, I2=0%) from two cohorts and pMD 14.25 (95% CI 0.61-27.89, I2=88%)  \nDeclaration of Competing Interest: The authors declare no competing interests.  \nSupplementary materials  \nSupplementary material associated with this article can be found in the online version at doi:10.1016/j.cpcardiol.2022.101461 .  \nAuthor Manuscript Author Manuscript Author Manuscript Author Manuscript  \nKumar et al. Page 2  \nfrom two RCTs) at follow-up compared to standard GDMT alone group. Bromocriptine group also had higher odds of LV recovery (pOR 3.55 (95% CI 1.39-9.1, I2=62)) . We did not find any difference in all-cause mortality between the groups. Our analysis demonstrates that the addition of Bromocriptine to standard GDMT was associated with a significant improvement in LVEF% and greater odds of LV recovery, without significant reduction in all-cause mortality.  \nIntroduction  \nHeart failure (HF) is one of the leading causes of maternal morbidity and mortality in the United States 1. Peripartum cardiomyopathy (PPCM) accounts for nearly 70% of all HF in pregnant women.1,2 The European Society of Cardiology defines PPCM as an idiopathic cardiomyopathy that presents as HF with left ventricular (LV) systolic dysfunction in late pregnancy through postpartum period.3 Significant geographical and racial variations have been noted in the incidence of PPCM, with the lowest in Japan (1 in 20,000 live births)4 ","cbCaiukyptuViB0C","https://ap.wps.com/l/cbCaiukyptuViB0C","pdf",1136325,"English","# Abstract\n# Introduction\n# Pathophysiological Mechanisms\n# Systematic Review and Meta-analysis","[{\"question\":\"What clinical question does this systematic review address?\",\"answer\":\"It evaluates the impact of prolactin inhibition on left ventricular (LV) function and mortality in patients with peripartum cardiomyopathy (PPCM).\"},{\"question\":\"Which treatment approach was analyzed for prolactin inhibition?\",\"answer\":\"The review focuses on prolactin inhibition strategies, including bromocriptine, compared with standard guideline-directed medical therapy (GDMT) alone.\"},{\"question\":\"What were the overall findings regarding LV function and mortality?\",\"answer\":\"Adding bromocriptine to standard GDMT was associated with improved LVEF and higher odds of LV recovery, while no significant difference in all-cause mortality was found between groups.\"}]","Prolactin Inhibition in Peripartum Cardiomyopathy - Systematic Review and Meta-analysis | PDF",1789945309,48]