Risk Factors of Peripartum Cardiomyopathy and the Important Role of Prenatal Care.
\olume l. Nrnrhcr l. Febrllr
h
ttp://rfww.sciepub.co m/j
ou rn
r\
2015
allaj cdr
Amer
Car
*
,+v€
Science and Education Publishing
S..n r.
\re\ llis t.unrl
American .Iournal of Cardiovascular Disease Research
httpr/A\\\\\' scieprb contioumayAJCDR
Editor-in-Chief
U
\ ersi6 Hospitrl Ospedrli ltilnriti.ltah
Flditorial Board Nlemher
adtrfr bi a il,'irei sih College ol Ph\ siclans ard Suleo s lrftled Sla(€s
lonas.rcl_Id$n I Jni\ crlil\. Llnl.{l S1llcs
Bfgha r & no en\ Hosltal Hdrard Mcdical School. lrdleLl Sri(es
'l
Ilitoshi Ilirose
shubxi Liu
lJ!i!{sil\ olKcntuck\. L,
lcd SlaL.5
Cohrbra U"iterslfi Collegeot I'h\sicfus& Surgons Urlled Slates
TitnirP.ul
Ldsl lcurcsscc
Sl!1.ll \cr\rh
tirrrledStrles
hl.rdlllnreNiLr Llospll.rl N.( York IliildlStrLcs
k.rs De{ertes ll.iler snr france
Sof llrtnd I rri\cNi(\ llospilal. LrnilcdLlgdon
QLEcn s ILn!e.si1\ Ilelt.si Uuted Kn'gdorl
Tniiq Bhrt
Slrlen
Thozhultit S.tht
ar.hn
Hull Yodi lvldlicdl Sdiool. Lrdr.rsilr oIllL,ll. Lrnil.d Kirydom
thn..in\ 1.. srpeMa ]l.h
rinncrsit\ of Crctc. (lrNcc
Alerudra Kuloger{lti
El Hadi Othmrnc Tahr
Se nneNt,s
U,rrersih
Hlnrgtu1
Riss]r(rspiirlcl I Jtri\ crsil\ l loipiltil oI ( opcllugc!. Ddxnartri
Dtlu.rd. A.eU ro-Rodrigo
1]$lrit!Lchic oIBr.L.l!D
.
Knr! /\bdul^z17
Sa!d1
lInr.6ili
SrLirl
Ar.bia
Mcdicil I JIn.rsir\ Solr. Flnl!.nr
lrnne.sln .l Ne\ llnel.lid nnialia
Ni@l{ King
Dcllir Ln!\cNil,.Aunftlil
liiire.sln ot N{. it{ia ad'.d.
John Rollcl
QllnHo$nil oi Shrdon!
L'iildridltlc l:(lcral
T.luar
Lrlit.r!t\
Ilfiresir
dc lvlinrs CdNis.
Clrila
DnLil
ol lvl.d'cal S.'.nccs Irar
ILn!ebn\ olM.dr..Ll S.ien.es L!,,
lru Lurilcriih olm.dic|l seicnccs 1.!n
''Vrslellecsa di lllnle.s,n .lB..in Ronrx ia
irnir Ali{itrl Rc{uah rtul Lducd rion 1]ojnlal. I urlic\
Tehrrn
Giilcin Brkan
I MSeclreror
Snez
f!slMosco\ St.t. Medi.rl
C.n.l 1l'ivdsih
F4rI
i r,nr
e.sitr lh\sir
ShiSath\! SaiMcnicrl Collcq. & Rcicudr lriLulr. lfldi.
Revierrers
ShiI
KuDiirYiis.nirhin
]l{htn0ud Abdelgbi.:
Zhiheng He
Moltuxn!
d Mo st.fx Ans.
i
Rih.n
d
i
Hassar IaD\0urit'rrgbrbrb
Ni\ nr Shr r.\ \
American Journal of Cardiovascular Disease Researah
http://www.sciepub.com/ajcdr/contnnt/3/1
CONTENTS
Volume 3, Number 1, February 2015
Comparative Study of Hypothyroidism with Cardiometabolic Risk
Risk Factors ofPeripartum Cardiomyopathy and the Important Role ofprenatal Care
HNdnt Sasnafa Ptunesrdr. Aug stine Pu tonowati, Toni ilustdh.tan i Aptun i
j
"Requiriog Intravenous Nitroglycerin" Should be considered a lligh Risk I'eature in patients
with Non-ST Elevation Nlyocardial lnfarction and Unstable Angina
........s
Alusegmsherin, Mehssd Fa1anlo, Oladapo lgandan, et al.
sci€nce & EdLration
Poblishins
Risk Factors of Peripartum Cardiomyopathy and the
Important Role of Prenatal Care
Haryani Sasnaya Pramesryari', Angustinc Purnornownfi, Toni Nlustabsnni
Aprllni
D.paihrenl olCardiolog/ aird Vascular Medicine, Padjadjaran Unive.siry, Jalan Eijknan 18, Bandung 40161, hdonesja
*Coresponding author: hawa.isasnraya@gmail co
Re ce
tre d
Jdn arr
1
3, )0
1
5
:
uevje.l
Jd nuary)
2 3, 20
1
5:
A.ce?ted Janlary 27, 20 ! 5
-{bstratt Pcripadum cardiomyopxthy (PPC\,]) is orre oldilited cardiomyopathy of unkro'ln causc l-fie aim of
dris study is to detenire the isk factors ard tle irporlance of prcDatal care (PNC) This is a descriprive and
analylical study with C|i Square test ofPPCM cases collecGd Aon nedical records Janmry l, 2011 througtr
Decenber ,11, 2013 ir tle Dr llasan Sadikin Central ce er3i llospital as the topreferal hosprtd of West Java
P.ovincc We collected 57 PPCNI cases (18.7%) of 305 prcgndr worne or 6 montbs postpamrm with
cardroaascular problems. Distibutrcn of PPCM cases decr*sed significantly b- 0.002) nom 20i I (27 parienrs),
2012 (16 patielts). and 2013 (l,l patients)- wilh average rsc 30.3 (17.9) years, cesarein delivery (43.870)- perlaginal
(17.5%), lbrceps (15%)- and vacuun-extaclor (3.8o/") Regular pHaral care was 84 20olo Lo\\er solroelunurnc
patients were 63.2%, thercturc the issue of wellare can lead to vuherab;liry to PPCM. Conlinncd diagnosis Ltsing
echography nade dmng postpaturn uas 52.63%:ud dilcptutum was 47.5%. Preeclanpsia was 43.80% (p=0 007)
troslly NYIL\ finctional class IV (86.30%). Echocitrdiography was pedonrcd on 57 paticnts hale a\ er age elecnon
ftactlon 14.8%o- global hypoktuetic;n 98.27% palienls. 39.6% wiih allcddiac clambe( dilalalioq left arium andleft
vertdcle dilalion in 34 48%, ard 2 5 86% wilh len ! enhioular dilatation Tle hospital hsed prevxlcncc was I 8.68%.
wirh fte mdonty (8420%) was NYtlA lirnctional class lV lfie significant risk faclors wcrc age ove.l0 ye s.
nulliparous. low socioeconomic. and preeclarnpsia. This study is probably the trsl report mcntbning a |igh
prcvalcncc of PPCI\4 rn lndonesia. This rcport provides an awareness ofPPCM during PNC to prevent t|e rnorbidiry
and tnofaiity. PPCM disorder rcquircs rcgular and caletul PNC by laking mto accotrnt cxisting risk lactors is rhc
ley rl ar ,s requu (J ffJ i,L,r \c Fld in e\ eri heairh ce r(
Keywords: peripurun car.Jb
t
pathy, risk|ilctor, prcftltal carc, prcgnd t vanan
Cite This ,{rticle:
Hawani Sasnaya Prercswari, Augustirc Punomowati, and Toni Mustahsani Apnmi"Risk FactoA of Pcr\rarlun CardiorJryopalhy and the hnponint Rolc of Prcratal Care.- ,1,?e.i.dn Jatlrnul aj
(arclto|asctlor Disedse tlcredr.l?- vol. 3, no. I (2015)r 5-8. doi: 10.12691/aicdr 3 I 2.
l.Introduction
Pe.iparlum Cardiomyopathy (PPCM) is one ofthc mxin
foms ofdilated cardiomyopathy with an unknoM causc
Its prevalence in rhe Urited Srares I ollhe 2500-4000 livc
delileries, higher in Soutb Anica (l nt 1000 lift-birtht
dd inHaiti (1tu 300 lile bitht l,2l
Ihc latcst definition of PPCM by the tlean Failure
Association of the ESC Wo*ing Group in 2010, is
.lraracter;zed by jdiopalhic cardionyopathy hcat failule
iecotrdary to left ventricular systolic dysftnc{ion that
occurs at the end ofpregnancy or a few montfis alier bilth.
of PPCM is dono by elinriraring other
diagoses. Echocardiography Senerally showed left
Diagnosis
l entricular dilatation accompanicd Lry hypokinetic and low
:jecrion fraciion lnay less than,157o [].3,4.51.
PPCM has various risk lactors. but some studies
lrggest the r;sk faclors that okcn arises is the age,
:nultiparity, tlrin pregmncy. chonic hyp€'tension, severe
:reeclanpsia. eclampsia and Africar race. [ 4.6]
:nolog), ofPPCM is rot known for certair, holve\er ore
theory olien mcntioned is the excesslve prolactin homone
accompanied by high oxidative stress h pregnant womeD
that cd cause danrage to rnyocardial cells. [1.7.8] Cardiac
tuDctioD cd retuD to noflnal jn 2l-41% olpatients wrth
carly dcte.tion- irteNention and heatnent [],6.91.
PPCM is a ra.e cardiornyopalhy and docuncnted
research is still very rec- therefore the pupose of this
study is conducted to study the prevalence snd nsk factors
for PPcM-patielrs ;n Dr. Hasan Sadkin Central Gcnenl
Hospital (RSHS) in Bandung.
2. Methods
This resexrch was conductcd ir the Depatrnent of
Cardiology and Vasculd Mcdicine of RSHS. Ba dung.
All PPCM cases wcrc separated fron cases {ith
cardiovascul:r complicltion nr prcgnant lvonan and file
monrh. iRer delr\er) qrrh dragnosr. .I c i" p e!iou.
nisiory ol te3ll-healthy Domx!- syDrptoDrs ald slErs of
heaf fti1ure appeared during prcSnancy tlat tad been
proled using echogr.phy having caldiotryopalhy. leti
heart lirilure. dilatation of all cardiac cha rbers These
,1
nieri.d .l.,nnl
of Catdiora\.r ldr 1)^^.ate llescdtLh
criteia have been found during last nonth of pregnanct
or edli€r p.eseniation End 5 nronths riier deliver-v. The
method used *as a rctrospective dcscriptivc review. md
aralytical in thc fom ofdata on the Dredical records fiom
I Janudy 2011 io :l December 2013. This study has
ltpproled bv the hospital edncal cotnnitte€. The data raere
statistically ,nalyzed usirg SPSS 19 and chi-square
sisnificece test. P value smallo than 0 05 considcrcd
signincdt
The tnne ofdiagnosis ofpostpartun PPCM is 52 63%.
antepartum '17.36% (p:0 502) are shown ir Fjgure 2
Clinic.l cheactcistics varied. with moslly hearl lailure
(81.20% NYHA tunctioral class tV, a d 15.80% NYIIA
tunciional class Ill), wiih a sigrificant diference (p
h
ttp://rfww.sciepub.co m/j
ou rn
r\
2015
allaj cdr
Amer
Car
*
,+v€
Science and Education Publishing
S..n r.
\re\ llis t.unrl
American .Iournal of Cardiovascular Disease Research
httpr/A\\\\\' scieprb contioumayAJCDR
Editor-in-Chief
U
\ ersi6 Hospitrl Ospedrli ltilnriti.ltah
Flditorial Board Nlemher
adtrfr bi a il,'irei sih College ol Ph\ siclans ard Suleo s lrftled Sla(€s
lonas.rcl_Id$n I Jni\ crlil\. Llnl.{l S1llcs
Bfgha r & no en\ Hosltal Hdrard Mcdical School. lrdleLl Sri(es
'l
Ilitoshi Ilirose
shubxi Liu
lJ!i!{sil\ olKcntuck\. L,
lcd SlaL.5
Cohrbra U"iterslfi Collegeot I'h\sicfus& Surgons Urlled Slates
TitnirP.ul
Ldsl lcurcsscc
Sl!1.ll \cr\rh
tirrrledStrles
hl.rdlllnreNiLr Llospll.rl N.( York IliildlStrLcs
k.rs De{ertes ll.iler snr france
Sof llrtnd I rri\cNi(\ llospilal. LrnilcdLlgdon
QLEcn s ILn!e.si1\ Ilelt.si Uuted Kn'gdorl
Tniiq Bhrt
Slrlen
Thozhultit S.tht
ar.hn
Hull Yodi lvldlicdl Sdiool. Lrdr.rsilr oIllL,ll. Lrnil.d Kirydom
thn..in\ 1.. srpeMa ]l.h
rinncrsit\ of Crctc. (lrNcc
Alerudra Kuloger{lti
El Hadi Othmrnc Tahr
Se nneNt,s
U,rrersih
Hlnrgtu1
Riss]r(rspiirlcl I Jtri\ crsil\ l loipiltil oI ( opcllugc!. Ddxnartri
Dtlu.rd. A.eU ro-Rodrigo
1]$lrit!Lchic oIBr.L.l!D
.
Knr! /\bdul^z17
Sa!d1
lInr.6ili
SrLirl
Ar.bia
Mcdicil I JIn.rsir\ Solr. Flnl!.nr
lrnne.sln .l Ne\ llnel.lid nnialia
Ni@l{ King
Dcllir Ln!\cNil,.Aunftlil
liiire.sln ot N{. it{ia ad'.d.
John Rollcl
QllnHo$nil oi Shrdon!
L'iildridltlc l:(lcral
T.luar
Lrlit.r!t\
Ilfiresir
dc lvlinrs CdNis.
Clrila
DnLil
ol lvl.d'cal S.'.nccs Irar
ILn!ebn\ olM.dr..Ll S.ien.es L!,,
lru Lurilcriih olm.dic|l seicnccs 1.!n
''Vrslellecsa di lllnle.s,n .lB..in Ronrx ia
irnir Ali{itrl Rc{uah rtul Lducd rion 1]ojnlal. I urlic\
Tehrrn
Giilcin Brkan
I MSeclreror
Snez
f!slMosco\ St.t. Medi.rl
C.n.l 1l'ivdsih
F4rI
i r,nr
e.sitr lh\sir
ShiSath\! SaiMcnicrl Collcq. & Rcicudr lriLulr. lfldi.
Revierrers
ShiI
KuDiirYiis.nirhin
]l{htn0ud Abdelgbi.:
Zhiheng He
Moltuxn!
d Mo st.fx Ans.
i
Rih.n
d
i
Hassar IaD\0urit'rrgbrbrb
Ni\ nr Shr r.\ \
American Journal of Cardiovascular Disease Researah
http://www.sciepub.com/ajcdr/contnnt/3/1
CONTENTS
Volume 3, Number 1, February 2015
Comparative Study of Hypothyroidism with Cardiometabolic Risk
Risk Factors ofPeripartum Cardiomyopathy and the Important Role ofprenatal Care
HNdnt Sasnafa Ptunesrdr. Aug stine Pu tonowati, Toni ilustdh.tan i Aptun i
j
"Requiriog Intravenous Nitroglycerin" Should be considered a lligh Risk I'eature in patients
with Non-ST Elevation Nlyocardial lnfarction and Unstable Angina
........s
Alusegmsherin, Mehssd Fa1anlo, Oladapo lgandan, et al.
sci€nce & EdLration
Poblishins
Risk Factors of Peripartum Cardiomyopathy and the
Important Role of Prenatal Care
Haryani Sasnaya Pramesryari', Angustinc Purnornownfi, Toni Nlustabsnni
Aprllni
D.paihrenl olCardiolog/ aird Vascular Medicine, Padjadjaran Unive.siry, Jalan Eijknan 18, Bandung 40161, hdonesja
*Coresponding author: hawa.isasnraya@gmail co
Re ce
tre d
Jdn arr
1
3, )0
1
5
:
uevje.l
Jd nuary)
2 3, 20
1
5:
A.ce?ted Janlary 27, 20 ! 5
-{bstratt Pcripadum cardiomyopxthy (PPC\,]) is orre oldilited cardiomyopathy of unkro'ln causc l-fie aim of
dris study is to detenire the isk factors ard tle irporlance of prcDatal care (PNC) This is a descriprive and
analylical study with C|i Square test ofPPCM cases collecGd Aon nedical records Janmry l, 2011 througtr
Decenber ,11, 2013 ir tle Dr llasan Sadikin Central ce er3i llospital as the topreferal hosprtd of West Java
P.ovincc We collected 57 PPCNI cases (18.7%) of 305 prcgndr worne or 6 montbs postpamrm with
cardroaascular problems. Distibutrcn of PPCM cases decr*sed significantly b- 0.002) nom 20i I (27 parienrs),
2012 (16 patielts). and 2013 (l,l patients)- wilh average rsc 30.3 (17.9) years, cesarein delivery (43.870)- perlaginal
(17.5%), lbrceps (15%)- and vacuun-extaclor (3.8o/") Regular pHaral care was 84 20olo Lo\\er solroelunurnc
patients were 63.2%, thercturc the issue of wellare can lead to vuherab;liry to PPCM. Conlinncd diagnosis Ltsing
echography nade dmng postpaturn uas 52.63%:ud dilcptutum was 47.5%. Preeclanpsia was 43.80% (p=0 007)
troslly NYIL\ finctional class IV (86.30%). Echocitrdiography was pedonrcd on 57 paticnts hale a\ er age elecnon
ftactlon 14.8%o- global hypoktuetic;n 98.27% palienls. 39.6% wiih allcddiac clambe( dilalalioq left arium andleft
vertdcle dilalion in 34 48%, ard 2 5 86% wilh len ! enhioular dilatation Tle hospital hsed prevxlcncc was I 8.68%.
wirh fte mdonty (8420%) was NYtlA lirnctional class lV lfie significant risk faclors wcrc age ove.l0 ye s.
nulliparous. low socioeconomic. and preeclarnpsia. This study is probably the trsl report mcntbning a |igh
prcvalcncc of PPCI\4 rn lndonesia. This rcport provides an awareness ofPPCM during PNC to prevent t|e rnorbidiry
and tnofaiity. PPCM disorder rcquircs rcgular and caletul PNC by laking mto accotrnt cxisting risk lactors is rhc
ley rl ar ,s requu (J ffJ i,L,r \c Fld in e\ eri heairh ce r(
Keywords: peripurun car.Jb
t
pathy, risk|ilctor, prcftltal carc, prcgnd t vanan
Cite This ,{rticle:
Hawani Sasnaya Prercswari, Augustirc Punomowati, and Toni Mustahsani Apnmi"Risk FactoA of Pcr\rarlun CardiorJryopalhy and the hnponint Rolc of Prcratal Care.- ,1,?e.i.dn Jatlrnul aj
(arclto|asctlor Disedse tlcredr.l?- vol. 3, no. I (2015)r 5-8. doi: 10.12691/aicdr 3 I 2.
l.Introduction
Pe.iparlum Cardiomyopathy (PPCM) is one ofthc mxin
foms ofdilated cardiomyopathy with an unknoM causc
Its prevalence in rhe Urited Srares I ollhe 2500-4000 livc
delileries, higher in Soutb Anica (l nt 1000 lift-birtht
dd inHaiti (1tu 300 lile bitht l,2l
Ihc latcst definition of PPCM by the tlean Failure
Association of the ESC Wo*ing Group in 2010, is
.lraracter;zed by jdiopalhic cardionyopathy hcat failule
iecotrdary to left ventricular systolic dysftnc{ion that
occurs at the end ofpregnancy or a few montfis alier bilth.
of PPCM is dono by elinriraring other
diagoses. Echocardiography Senerally showed left
Diagnosis
l entricular dilatation accompanicd Lry hypokinetic and low
:jecrion fraciion lnay less than,157o [].3,4.51.
PPCM has various risk lactors. but some studies
lrggest the r;sk faclors that okcn arises is the age,
:nultiparity, tlrin pregmncy. chonic hyp€'tension, severe
:reeclanpsia. eclampsia and Africar race. [ 4.6]
:nolog), ofPPCM is rot known for certair, holve\er ore
theory olien mcntioned is the excesslve prolactin homone
accompanied by high oxidative stress h pregnant womeD
that cd cause danrage to rnyocardial cells. [1.7.8] Cardiac
tuDctioD cd retuD to noflnal jn 2l-41% olpatients wrth
carly dcte.tion- irteNention and heatnent [],6.91.
PPCM is a ra.e cardiornyopalhy and docuncnted
research is still very rec- therefore the pupose of this
study is conducted to study the prevalence snd nsk factors
for PPcM-patielrs ;n Dr. Hasan Sadkin Central Gcnenl
Hospital (RSHS) in Bandung.
2. Methods
This resexrch was conductcd ir the Depatrnent of
Cardiology and Vasculd Mcdicine of RSHS. Ba dung.
All PPCM cases wcrc separated fron cases {ith
cardiovascul:r complicltion nr prcgnant lvonan and file
monrh. iRer delr\er) qrrh dragnosr. .I c i" p e!iou.
nisiory ol te3ll-healthy Domx!- syDrptoDrs ald slErs of
heaf fti1ure appeared during prcSnancy tlat tad been
proled using echogr.phy having caldiotryopalhy. leti
heart lirilure. dilatation of all cardiac cha rbers These
,1
nieri.d .l.,nnl
of Catdiora\.r ldr 1)^^.ate llescdtLh
criteia have been found during last nonth of pregnanct
or edli€r p.eseniation End 5 nronths riier deliver-v. The
method used *as a rctrospective dcscriptivc review. md
aralytical in thc fom ofdata on the Dredical records fiom
I Janudy 2011 io :l December 2013. This study has
ltpproled bv the hospital edncal cotnnitte€. The data raere
statistically ,nalyzed usirg SPSS 19 and chi-square
sisnificece test. P value smallo than 0 05 considcrcd
signincdt
The tnne ofdiagnosis ofpostpartun PPCM is 52 63%.
antepartum '17.36% (p:0 502) are shown ir Fjgure 2
Clinic.l cheactcistics varied. with moslly hearl lailure
(81.20% NYHA tunctioral class tV, a d 15.80% NYIIA
tunciional class Ill), wiih a sigrificant diference (p