The relationship between ventricular arrhythmias and pathological cardiac remodeling in peripartum cardiomyopathy.

Abstract

Background. Peripartum cardiomyopathy (PPCM) is a rare yet serious condition affecting women during late pregnancy or the postpartum period, often leading to complications such as ventricular arrhythmias and pathological cardiac remodeling. This study aims to analyze the relationship between the frequency and severity of ventricular arrhythmias and the extent of pathological cardiac remodeling in patients with PPCM, highlighting the clinical implications for disease management and prognosis.

Materials and methods. A total of 104 patients with PPCM, treated at the Republican Specialized Scientific and Practical Medical Center of Cardiology from 1997 to 2022, were included in this study. Patients were categorized into two groups based on their left ventricular ejection fraction (LVEF): group I (LVEF <35%) and group II (LVEF 36-45%). Diagnostic criteria followed the European Society of Cardiology guidelines for PPCM. All patients underwent electrocardiography (ECG), echocardiography, 24-hour Holter monitoring, and clinical assessments to evaluate cardiac function and arrhythmias. Statistical analysis was performed using descriptive and inferential methods.

Results. The average age of patients was 30.15±2.9 years. Most cases (76%) were diagnosed in the postpartum period, with 49% detected within three months after delivery. Ventricular arrhythmias, particularly high-grade arrhythmias (Lown classes III, IVA, IVB), were significantly more frequent in group I. Severe pathological remodeling of the heart, including increased left ventricular end-diastolic and end-systolic dimensions, was 10% more prevalent in group I compared to group II. Additionally, hypotension and severe sinus tachycardia were more commonly observed in group I patients, further indicating the association between advanced cardiac dysfunction and arrhythmias.

Conclusion. The findings suggest a strong association between ventricular arrhythmias and pathological cardiac remodeling in PPCM patients, particularly those with LVEF <35%. These results underscore the importance of early identification and tailored therapeutic strategies to manage arrhythmias and prevent adverse outcomes in this vulnerable population.