ABC | Volume 110, Nº2, February 2018

Original Article Bouabdallaoui et al Heart Transplantation for PPCM Arq Bras Cardiol. 2018; 110(2):181-187 Table 1 – General characteristics of PPCM patients PPCM patients Time from diagnosis to HT Time on waiting list Age at the time of HT LVEF (%) Inotropes IABP ECMO (P + C) VAD Cross- match 1 19 yrs 1 mth 49 30 Y N N N N 2 2 yrs 18 mths 30 15 N N N N N 3 8 yrs < 1 mth 36 25 Y N N N N 4 10 mths 1 mth 39 25 N N N N N 5 5 mths < 1 mth 35 10 Y N N Y N 6 3 mths < 1 mth 35 23 N N N N N 7 13 yrs < 1 mth 44 20 Y N N N N 8 1 mth < 1 mth 33 14 Y N N N NA 9 4 mths 1 mth 29 15 Y Y Y N N 10 4 yrs 9 mths 34 32 Y N Y Y N 11 15 yrs 2 mths 47 25 N N N N N 12 1 yr < 1 mth 27 10 N N N N NA 13 9 mths < 1 mth 37 25 Y N N N NA 14 1 yr 2 mths 39 35 Y N N N N LVEF: Left Ventricle Ejection Fraction; IABP: intra-aortic balloon counterpulsation; ECMO (P+C): Extra Corporeal Membrane Oxygenation (Peripheral + Central); VAD: Ventricular Assist Device; Y: Yes; N: No; NA: Not applicable; yr: year; m: month. Table 2 – Pre-transplant characteristics in PPCM group and control subjects Variable PPCM group (n = 14) Control group (n = 28) p Age at the time of HT, years 36.7 ± 6.5 38.4 ± 8.5 p = 0.4 Previous pregnancies 100% (n = 14) 50% (n = 14) p = 0.3 Smoker 21% (n = 3) 42.8% (n = 12) p = 0.1 Hypertension 7% (n = 1) 7% (n = 2) p = 0.7 Beta-blockers 50% (n = 7) 42.8% (n = 12) p = 0.5 ACE inhibitors 50% (n = 7) 75% (n = 21) p = 0.6 Time on waiting list, months 2.4 ± 5 3.8 ± 5 p = 0.1 LVEF (%) 22 ± 8 24 ± 14 p = 0.9 Inotropes 64% (n = 9) 28.57% (n = 8) p = 0.03 IABP 7% (n = 1) 7% (n = 2) p = 0.7 ECMO 14% (n = 2) 25% (n = 7) p = 0.5 VAD 14% (n = 2) 7% (n = 2) p = 0.4 PPCM: peripartum cardiomyopathy; LVEF: Left Ventricle Ejection Fraction; RV: Right Ventricle; IABP: intra-aortic balloon counter pulsation; ECMO (P+C): Extra Corporeal Membrane Oxygenation (Peripheral + Central); VAD: Ventricular Assist Device. (Comparisons between groups for continuous variables were performed using the Student t-test or the Mann Whitney U test as appropriate). Patients outcomes During a median follow-up of 7.7 years, 16 patients died, 3 (21.5%) in PPCM group and 13 (46.5%) in control group. Mortality was significantly lower in PPCM group (p = 0.03, Figure 1). Causes of death are shown in Table 3. Major causes of one-year mortality after HT were rejection, hemorrhagic complications and infections; major causes of long-term mortality (> 1 year) after HT were rejection, CAV, and infections. Both early and late rejection rates were similar in both groups (p = 0.5 and 0.6 respectively). PPCM patients had a similar incidence of infections including cytomegalovirus (CMV) infections compared with control population (p = 0.07). Two patients from control group died within the first year following transplantation from septic shock, none in PPCM group. One more patient in control group died from septic shock > 1 year post transplant, none in PPCM group. PPCM patients had a similar risk of CAV compared with control group (p = 0.4). Pathological study of explanted hearts did not reveal any specific lesion. 183