Peripartum Cardiomyopathy From a Genetic Perspective

Peripartum cardiomyopathy (PPCM) is a rare, but life-threatening condition that occurs during the peripartum period in previously healthy women. Although its etiology remains unknown, potential risk factors include hypertensive disorders during pregnancy, such as preeclampsia, advanced maternal age,...

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Bibliographic Details
Published in:Circulation Journal 2016/07/25, Vol.80(8), pp.1684-1688
Main Authors: Kamiya, Chizuko A., Yoshimatsu, Jun, Ikeda, Tomoaki
Format: Article
Language:English
Subjects:
Animals
Cardiomyopathy, Dilated - genetics
Dilated cardiomyopathy
Disease Models, Animal
Female
Genetic Predisposition to Disease
Genetics
Humans
Hypertension
Mice
Peripartum cardiomyopathy
Peripartum Period
Pregnancy
Pregnancy Complications, Cardiovascular - genetics
Risk Factors
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Summary:Peripartum cardiomyopathy (PPCM) is a rare, but life-threatening condition that occurs during the peripartum period in previously healthy women. Although its etiology remains unknown, potential risk factors include hypertensive disorders during pregnancy, such as preeclampsia, advanced maternal age, multiparity, multiple gestation, and African descent. Several cohort studies of PPCM revealed that the prevalence of these risk factors was quite similar. Clinically, approximately 40% of PPCM patients are complicated with hypertensive disorders during pregnancy. Because PPCM is a diagnosis of exclusion, heterogeneity is a common element in its pathogenesis. Recent genetic research has given us new aspects of the disease. PPCM and dilated cardiomyopathy (DCM) share genetic predisposition: 15% of PPCM patients were found to have genetic mutations that have been associated with DCM, and they showed a lower recovery rate. Other basic research using PPCM model mice suggests that predisposition genes related to both hypertensive and cardiac disorders via angiogenic imbalance may explain common elements of hypertensive disorders and PPCM. Furthermore, hypertensive disorders during pregnancy are now found to be a risk factor of not only PPCM, but also cardiomyopathy in the future. Understanding genetic variations allows us to stratify PPCM patients and to guide therapy. (Circ J 2016; 80: 1684–1688)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-16-0342