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Clinical Presentation and Outcomes of Peri-Partum Cardiomyopathy in the Middle-East: A Report from Seven Arab Countries

30 Pages Posted: 14 Apr 2020

See all articles by Amar Salam

Amar Salam

Qatar University - QU Health

Mohamed Badie Ahmed

Qatar University - QU Health

Kadhim Sulaiman

Royal Hospital (Oman) - Department of Cardiology

Rajvir Singh

Hamad General Hospital - Biostatistics Section

Mohamed Alhashemi

Hamad Medical Corporation - Adult Cardiology

Alison S. Carr

Qatar University - QU Health

Alawi A. Alsheikh-Ali

Mohammed Bin Rashid University of Medicine and Health Sciences - College of Medicine

Khalid F. Alhabib

King Saud University - College of Medicine

Ibrahim Al-Zakwani

Sultan Qaboos University - Department of Pharmacology & Clinical Pharmacy

Prashanth Panduraga

Royal Hospital (Oman) - Department of Cardiology

Nidal Asaad

Hamad Medical Corporation - Adult Cardiology

Abdulla Shehab

UAE University - College of Medicine and Health Sciences

Wael AlMahmeed

Cleveland Clinic

Jassim Al Suwaidi

Hamad Medical Corporation - Adult Cardiology

Gulf CARE Investigators

More...

Abstract

Background: Published data on the clinical presentation of peripartum cardiomyopathy (PPCM) are very limited particularly from the Middle East. The aim of this study was to examine the clinical presentation, management and outcomes of patients with PPCM using data from a large multicentre heart failure (HF) registry from the Middle-East.

Methods: From February to November, 2012, a total of 5005 consecutive patients with HF were enrolled from 47 hospitals in 7 Middle East countries. From this cohort, patients with PPCM were identified and included in this study. Clinical features, in-hospital and 12 months outcomes were examined.

Findings: During the study period 64 patients with PPCM were enrolled with a mean age of 32.5 ±5.8 years. Family history was identified in 11 patients (17.2%) and hypertension in 7 patients (10.9%). The predominant presenting symptom was dyspnea with NYHA class VI in 51.6%, class III in 31.3% and class II in 17.2%. Basal lung crepitations and peripheral edema were the predominant signs on clinical examination (98.2% and 84.4%, respectively). Most patients received evidence-based HF therapies. Inotropic support and mechanical ventilation were required in 16% and 5% of patients, respectively. There was one in-hospital death (1.6%), and over one-year of follow-up 9 patients were re-hospitalized with HF (15%) and one patient died (1.6%).

Interpretation: A high index of suspicion of PPCM is required to make the diagnosis especially in the presence of family history of HF or cardiomyopathy. Further studies are warranted on the genetic basis of PPCM.

Trial Registration: The study was registered at clinicaltrials.gov with the number NCT01467973.

Funding Statement: Gulf CARE was an investigator-initiated study conducted under the auspices of the Gulf Heart Association and funded by Servier, Paris, France; and (for centres in Saudi Arabia) by the Saudi Heart Association [The Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (Research group number: RG -1436-013)]. The publication of this article was funded by the Qatar National Library.

Declaration of Interests: The authors report no relationships that could be construed as a conflict of interest.

Ethics Approval Statement: Study ethical approval was obtained from all concerned authorities in the recruiting centers. Informed consent was obtained from all patients.

Keywords: Cardiomyopathy, heart failure, outcomes, peripartum, registry, symptoms

Suggested Citation

Salam, Amar and Ahmed, Mohamed Badie and Sulaiman, Kadhim and Singh, Rajvir and Alhashemi, Mohamed and Carr, Alison S. and Alsheikh-Ali, Alawi A. and Alhabib, Khalid F. and Al-Zakwani, Ibrahim and Panduraga, Prashanth and Asaad, Nidal and Shehab, Abdulla and AlMahmeed, Wael and Al Suwaidi, Jassim and Investigators, Gulf CARE, Clinical Presentation and Outcomes of Peri-Partum Cardiomyopathy in the Middle-East: A Report from Seven Arab Countries (March 12, 2020). Available at SSRN: https://ssrn.com/abstract=3555205 or http://dx.doi.org/10.2139/ssrn.3555205

Amar Salam (Contact Author)

Qatar University - QU Health ( email )

Qatar

Mohamed Badie Ahmed

Qatar University - QU Health

Qatar

Kadhim Sulaiman

Royal Hospital (Oman) - Department of Cardiology

Oman

Rajvir Singh

Hamad General Hospital - Biostatistics Section

Qatar

Mohamed Alhashemi

Hamad Medical Corporation - Adult Cardiology

Qatar

Alison S. Carr

Qatar University - QU Health

Qatar

Alawi A. Alsheikh-Ali

Mohammed Bin Rashid University of Medicine and Health Sciences - College of Medicine

United Arab Emirates

Khalid F. Alhabib

King Saud University - College of Medicine

Saudi Arabia

Ibrahim Al-Zakwani

Sultan Qaboos University - Department of Pharmacology & Clinical Pharmacy

Oman

Prashanth Panduraga

Royal Hospital (Oman) - Department of Cardiology

Oman

Nidal Asaad

Hamad Medical Corporation - Adult Cardiology

Qatar

Abdulla Shehab

UAE University - College of Medicine and Health Sciences

United Arab Emirates

Wael AlMahmeed

Cleveland Clinic

9500 Euclid Ave.
Cleveland, OH 44195
United States

Jassim Al Suwaidi

Hamad Medical Corporation - Adult Cardiology

Qatar

No contact information is available for Gulf CARE Investigators

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