| Mujeres afroamericanas tienen mayor riesgo de desarrollar cardiomiopatía periparto |
African-American Women Have a Higher Risk for Developing Peripartum Cardiomyopathy
Mindy B. Gentry, James K. Dias, Antonio Luis, Rakesh Patel, John Thornton, Guy L. Reed.
Augusta, Georgia; and Memphis, Tennessee
J Am Coll Cardiol 2010;55:654-9.
Objectives The purpose of this study was to assess whether African-American women are at increased risk of having peripartum cardiomyopathy. Background Peripartum cardiomyopathy is a heart disease of unknown cause that affects young women, often with devastating consequences. The frequency of peripartum cardiomyopathy varies markedly between African and non-African regions. Methods A case-control study was performed at a regional center that provides medical care to a racially heterogeneous population. For each case, 3 healthy control patients were randomly selected who delivered babies within the same month. Results African-American women had a 15.7-fold higher relative risk of peripartum cardiomyopathy than non-African Americans (odds ratio [OR]: 15.7, 95% confidence interval [CI]: 3.5 to 70.6). Other significant univariate risk factors were hypertension (OR: 10.8, 95% CI: 2.6 to 44.4), being unmarried (OR: 4.2, 95% CI: 1.4 to 12.3), and having had _2 previous pregnancies (OR: 2.9, 95% CI: 1.1 to 7.4). African-American ethnicity remained a significant risk factor for peripartum cardiomyopathy when other risk factors were considered in multivariable (OR: 31.5, 95% CI: 3.6 to 277.6) and stratified analyses (OR: 12.9 to 29.1, p _ 0.001). Although the frequency of peripartum cardiomyopathy (185 of 100,000 deliveries) at this center was higher than in previous U.S. reports, it was comparable to the frequency in countries with more women of African descent (100 to 980 of 100,000). Analysis of other U.S. studies confirmed that the frequency of peripartum cardiomyopathy was significantly higher among African-American women. Conclusions African-American women have significantly higher odds of having peripartum cardiomyopathy that could not be explained by several other factors. Further research will be necessary to determine the potential environmental and/or genetic factors associated with African descent that confer this risk. © 2010 by the American College of Cardiology Foundation.
|
| Combinación de anestesia epidural y bloqueo de nervio periférico guiado con ultrasonido para revisión de herida en una paciente con cardiomiopatía periparto. Reporte de caso |
Combined epidural anesthesia and ultrasound guided peripheral nerve block for wound revision in a patient with peripartum cardiomyopathy -A case report-.
Gong TK, Kim SS.
Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea.
Korean J Anesthesiol. 2010 Nov;59(5):353-8. Epub 2010 Nov 25.
Abstract
Peripartum cardiomyopathy (PPCM) is a rare complication that occurs between the late stage of pregnancy and six months after delivery. PPCM presents as symptoms of left ventricular dysfunction and it can be fatal unless treated promptly. Furthermore, anesthesia and surgery in such patients is a large challenge to anesthesiologists. First and foremost, the maintenance of stable hemodynamics is a major concern. We report a case of combined lumbar epidural anesthesia and both ilioinguinal and iliohypogastric nerve block under ultrasound guided for a wound revision in a 37-year-old woman diagnosed with PPCM after an emergency cesarean section.
|
| Uso exitoso de levosimendan en una paciente con cardiomiopatía periparto |
Successful use of levosimendan in a patient with peripartum cardiomyopathy.
Benlolo S, Lefoll C, Katchatouryan V, Payen D, Mebazaa A.
Department of Anesthesiology and Critical Care Medicine, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Institut Fédératif de Recherche 06, Paris, France.
Anesth Analg. 2004 Mar;98(3):822-4
Abstract
This case represents the first reported use of levosimendan, a calcium-sensitizing drug with additional vasodilation properties, for treatment of a woman with peripartum cardiomyopathy. Levosimendan induced a steady decline of increased pulmonary capillary wedge pressure, followed by a definitive increase in cardiac stroke volume. The patient recovered from this serious episode of heart failure, and she ultimately regained left ventricular function. IMPLICATIONS: Acute heart failure is a life-threatening event that only rarely occurs during childbirth. We report a case of a woman who experienced cardiovascular collapse during vaginal delivery. We determined that she met current diagnostic criteria for peripartum cardiomyopathy, and we successfully treated her with levosimendan, a calcium-sensitizing drug with additional vasodilation properties.
|
|
No hay comentarios:
Publicar un comentario