Prognostic factors of peripartum cardiomyopathy and the influence of acute kidney injury on prognosis

Zhu Jiajia; Liu Wenxian

doi:10.3760/j.issn.1673-4777.2019.11.003

Abstract：Objective To explore the risk factors of poor prognosis in patients with peripartum cardiomyopathy (PPCM) and the influence of acute kidney injury (AKI) on prognosis.Methods A total of 60 patients with PPCM admitted to Beijing Anzhen Hospital,Capital Medical University from January 2007 to June 2018 were divided into good response group (32 cases) and poor prognosis group(28 cases).General clinical data,echocardiogram and electrocardiogram findings,laboratory examination results and treatment regimens were recorded.Risk factors of poor prognosis and the influence of AKI on prognosis were analyzed.Results Compared with the good response group,the poor prognosis group had more multiparae[78.6％ (22/28) vs 43.8％ (14/32)] and NYHA heart function grade Ⅲ-Ⅳ [92.9％ (26/28) vs 71.9％ (23/32)],higher incidence of AKI[35.7％ (10/28) vs 3.1％ (1/32)],age[(32 ±6)years vs (29 ±4)years],serum creatinine level at admission[66(57,83) μmol/L vs 54(44,65) μmol/L],B-type natriuretic peptide level at admission[1436(696,2 353)ng/L vs 356(67,819) ng/L],use rate of digoxin[75.0％ (21/28) vs 28.1％ (9/32)] and left ventricular end-diastolic diameter[(53 ± 8)mm vs (43 ± 8) mm],lower left ventricular ejection fraction [(30 ± 10) ％ vs (43 ± 12) ％] and systolic pressure [(111 ± 17) mmHg vs (122 ± 16) mmHg],with statistically significant differences (all P ＜ 0.05).Logistic regression analysis showed that AKI(odds ratio =10.556,95％ confidence interval:1.177-94.654,P =0.035)and left ventricular ejection fraction ＜ 40％ (odds ratio =4.533,95％ confidence interval:1.118-18.382,P =0.034) were risk factors of poor prognosis.Conclusion PPCM patients suffering from AKI during hospitalization have poor prognosis.