Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine
Management of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocrip...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/476903 |
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| author | Piercarlo Ballo Irene Betti Giuseppe Mangialavori Leandro Chiodi Gherardo Rapisardi Alfredo Zuppiroli |
| author_facet | Piercarlo Ballo Irene Betti Giuseppe Mangialavori Leandro Chiodi Gherardo Rapisardi Alfredo Zuppiroli |
| author_sort | Piercarlo Ballo |
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| description | Management of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD) is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II), moderate LV systolic dysfunction (ejection fraction 35%), and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I). At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction. |
| format | Article |
| id | doaj-art-540d08bbc5414a64bfde3ec119df4c98 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-540d08bbc5414a64bfde3ec119df4c982025-02-03T07:23:51ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/476903476903Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of BromocriptinePiercarlo Ballo0Irene Betti1Giuseppe Mangialavori2Leandro Chiodi3Gherardo Rapisardi4Alfredo Zuppiroli5Department of Cardiology, S. Maria Annunziata Hospital, Via dell’Antella 58, 50012 Florence, ItalyDepartment of Cardiology, S. Maria Annunziata Hospital, Via dell’Antella 58, 50012 Florence, ItalyDepartment of Cardiology, S. Maria Annunziata Hospital, Via dell’Antella 58, 50012 Florence, ItalyDepartment of Cardiology, S. Maria Annunziata Hospital, Via dell’Antella 58, 50012 Florence, ItalyDepartment of Pediatrics, S. Maria Annunziata Hospital, 50012 Florence, ItalyDepartment of Cardiology, Local Health Unit, 50135 Florence, ItalyManagement of patients with peripartum cardiomyopathy (PPCM) is still a major clinical problem, as only half of them or slightly more show complete recovery of left ventricular (LV) function despite conventional evidence-based treatment for heart failure. Recent observations suggested that bromocriptine might favor recovery of LV systolic function in patients with PPCM. However, no evidence exists regarding its effect on LV diastolic dysfunction, which is commonly observed in these patients. Tissue Doppler (TD) is an echocardiographic technique that provides unique information on LV diastolic performance. We report the case of a 37-year-old white woman with heart failure (NYHA class II), moderate LV systolic dysfunction (ejection fraction 35%), and severe LV diastolic dysfunction secondary to PPCM, who showed no improvement after 2 weeks of treatment with ramipril, bisoprolol, and furosemide. At 6-week followup after addition of bromocriptine, despite persistence of LV systolic dysfunction, normalization of LV diastolic function was shown by TD, together with improvement in functional status (NYHA I). At 18-month followup, the improvement in LV diastolic function was maintained, and normalization of systolic function was observed. This paper might support the clinical utility of bromocriptine in patients with PPCM by suggesting a potential benefit on LV diastolic dysfunction.http://dx.doi.org/10.1155/2012/476903 |
| spellingShingle | Piercarlo Ballo Irene Betti Giuseppe Mangialavori Leandro Chiodi Gherardo Rapisardi Alfredo Zuppiroli Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine Case Reports in Medicine |
| title | Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine |
| title_full | Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine |
| title_fullStr | Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine |
| title_full_unstemmed | Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine |
| title_short | Peripartum Cardiomyopathy Presenting with Predominant Left Ventricular Diastolic Dysfunction: Efficacy of Bromocriptine |
| title_sort | peripartum cardiomyopathy presenting with predominant left ventricular diastolic dysfunction efficacy of bromocriptine |
| url | http://dx.doi.org/10.1155/2012/476903 |
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