Electrocardiographic predictors of peripartum cardiomyopathy

Cardiovasc J Afr. 2016 Mar-Apr;27(2):66-70. doi: 10.5830/CVJA-2015-092.

Abstract

Objective: To identify potential electrocardiographic predictors of peripartum cardiomyopathy (PPCM).

Methods: This was a case-control study carried out in three hospitals in Kano, Nigeria. Logistic regression models and a risk score were developed to determine electrocardiographic predictors of PPCM.

Results: A total of 54 PPCM and 77 controls were consecutively recruited after satisfying the inclusion criteria. After controlling for confounding variables, a rise in heart rate of one beat/minute increased the risk of PPCM by 6.4% (p = 0.001), while the presence of ST-T-wave changes increased the odds of PPCM 12.06-fold (p < 0.001). In the patients, QRS duration modestly correlated (r = 0.4; p < 0.003) with left ventricular dimensions and end-systolic volume index, and was responsible for 19.9% of the variability of the latter (R(2) = 0.199; p = 0.003). A risk score of ≥ 2, developed by scoring 1 for each of the three ECG disturbances (tachycardia, ST-T-wave abnormalities and QRS duration), had a sensitivity of 85.2%, specificity of 64.9%, negative predictive value of 86.2% and area under the curve of 83.8% (p < 0.0001) for potentially predicting PPCM.

Conclusion: In postpartum women, using the risk score could help to streamline the diagnosis of PPCM with significant accuracy, prior to confirmatory investigations.

MeSH terms

  • Adult
  • Cardiomyopathy, Dilated / diagnosis*
  • Cardiomyopathy, Dilated / physiopathology
  • Case-Control Studies
  • Electrocardiography* / methods
  • Female
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Nigeria
  • Peripartum Period / physiology
  • Postpartum Period
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis*
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Puerperal Disorders / diagnosis*
  • Puerperal Disorders / physiopathology
  • Risk