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European Journal of Heart Failure 2008 10(9):861-868; doi:10.1016/j.ejheart.2008.07.005
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© 2008 European Society of Cardiology

Reversal of IFN-{gamma}, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy

Olaf Forstera,1, Denise Hilfiker-Kleinerc,1, Aftab A. Ansarib, J. Bruce Sundstromb, Elena Libhabera, Winnie Tshania, Anthony Beckera, Anthony Yipa, Gunnar Kleinc and Karen Sliwaa,*

a Soweto Cardiovascular Research Unit, Department of Cardiology, Chris Hani Baragwanath Hospital, University of the Witwatersrand Johannesburg, South Africa
b Department of Pathology and Laboratory Medicine, Emory University School of Medicine Atlanta, USA
c Department of Cardiology and Angiology Medical School Hannover Germany

* Corresponding author. Department of Cardiology, Chris Hani Baragwanath Hospital, P.O. Bertsham 2013, Johannesburg, South Africa. Tel.: +27 11 938 1016; fax: +27 11 938 8945. E-mail address: sliwa-hahnlek{at}mdh-africa.org (K. sliwa).


  Abstract

Aim: Peripartum cardiomyopathy (PPCM) is characterized by acute onset of heart failure of unknown aetiology. We aimed to identify mechanisms involved in initiation and progression of the disease.

Methods and results: Serum markers related to cardiac function, apoptosis, oxidative stress, remodelling, inflammation and the nursing hormone prolactin were analyzed in PPCM patients and healthy controls. The kinetics of these markers were compared between patients who improved cardiac function (IMP) and those patients who did not improve (NIMP), over 6 months follow-up. All patients received ACE-inhibitors, beta-blockers and diuretics. Baseline levels of TGF-beta-1 were significantly lower, MMP-9 and VEGF were not different; all other markers were significantly higher in PPCM compared with controls. Only baseline NT-proBNP levels were higher in NIMP compared with IMP. After 6 months, NT-proBNP, oxLDL and IFN-{gamma} were significantly lower in IMP and the decrease in oxLDL, IFN-{gamma} and prolactin was significant in IMP but not in NIMP. Significant correlations were observed between the kinetics of NT-proBNP, oxLDL, prolactin and IFN-{gamma} in PPCM patients.

Conclusion: Baseline NT-proBNP and the failure to decrease oxLDL, IFN-{gamma} and prolactin are associated with poor outcome in PPCM, suggesting a potential role of these factors in the pathophysiology of PPCM and for risk stratification of PPCM patients.

Key Words: Peripartum cardiomyopathy • Africa • Predictors of outcome • Inflammatory markers • Prolactin

Received February 28, 2008; Revised May 8, 2008; Accepted July 1, 2008

1 The first two authors have contributed equally.


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