Heart Care Info - Heart Disease Prevention & Treatment

Letter by Baruteau et al Regarding Article,“Peripartum Cardiomyopathy as a Part of Familial Dilated Cardiomyopathy”

AE Baruteau, E Donal... - Circulation, 2011 - Am Heart Assoc We have read with great interest the article by van Spaendonck-Zwarts et al, which strongly suggests that a subset of peripartum cardiomyopathy (PPCM) is part of the spectrum of familial dilated cardiomyopathy. 1 Entering PPCM in the field of familial dilated ...

We have read with great interest the article by van Spaendonck-Zwarts et al, which strongly suggests that a subset of peripartum cardiomyopathy (PPCM) is part of the spectrum of familial dilated cardiomyopathy.1 Entering PPCM in the field of familial dilated cardiomyopathy strongly modifies thinking on PPCM pathogenesis and management. We respectfully disagree in accepting the authors' interpretations of study findings. To our mind, they underestimate the clinical implication of their results and recommend overly restrictive indications for familial echocardiographic screening, which led us to write this letter.

In the first systematic approach examining the familiality and genetics of PPCM, they found that cardiological screening of first-degree relatives of 3 PPCM patients who did not show full recovery revealed unknown dilated cardiomyopathy in all 3 families. Unfortunately, they decided not to perform such a familial screening in the 7 PPCM patients who experienced a complete normalization of left ventricular size and function. They also recommend “presymptomatic cardiological screening for covert dilated cardiomyopathy in first-degree family members of PPCM patients without recovery of left ventricular function and dimensions.”1

Familial occurrence of PPCM was suggested in the literature by 6 previous anecdotal cases reporting a total of 8 kinships with more than 1 member affected by PPCM.1,–,3 Catastrophic outcomes were reported in 5 of these 6 publications with no recovery, death or heart transplantation for intractable heart failure in PPCM patients.