Acute kidney injury predicts poor left ventricular function for patients with peripartum cardiomyopathy

急性肾损伤预示着围产期心肌病患者左心室功能不良。

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Abstract

BACKGROUND: The aim of this study was to explore the risk factors associated with a poor left ventricular (LV) function among patients with peripartum cardiomyopathy (PPCM) and to determine the influence of acute kidney injury (AKI) on the LV function of the patients. METHODS: Sixty patients with PPCM were recruited between January 2007 and June 2018, among which 11 had AKI. The participants were divided into two groups, the recovery group (32 cases) and the nonrecovery group (28 cases), with their clinical features, echocardiography and electrocardiogram findings, laboratory results, and treatments compared between groups. We further determined the risk factors associated with nonrecovery and the influence posed by AKI on the LV function of the patients. RESULTS: Compared with the patients in the recovery group, those in the nonrecovery group had higher proportions of multiparity [78.6% (22/28) vs. 43.8% (14/32)], function class III- IV heart failure [92.9% (26/28) vs. 71.9% (23/32)], and a higher incidence of AKI [35.7% (10/28) vs. 3.1% (1/32)]. Logistic regression analysis showed that having AKI [odds ratio (OR): 10.556; 95% confidence interval (CI) 1.177-94.654; P = 0.035] and left ventricular ejection fraction (LVEF) < 40% [OR: 4.533; 95% CI 1.118-18.382; P = 0.034] were independently associated with nonrecovery of PPCM. CONCLUSIONS: The prognosis of patients with PPCM and AKI during hospitalization was poor compared to those without AKI; therefore, clinicians should pay more attention to this phenomenon.

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