Subclinical myocardial dysfunction in patients with complete recovery from peripartum cardiomyopathy: a long-term clinical strain-echocardiographic study

Purpose The aim of this study was to assess long-term left ventricular (LV) systolic function using 3D speckle tracking echocardiography in patients with complete LV recovery following peripartum cardiomyopathy (PPCM). Methods A total of 20 PPCM patients who exhibited LV recovery (ejection fraction >= 50%) in the follow-up period and 20 age-matched, healthy women were included in the study. Standard 2D echocardiographic examinations were performed. Global longitudinal strain and global circumferential strain were analyzed. Results Age, weight, body surface area, smoking, heart rate, and systolic and diastolic blood pressure were similar in both groups. Echocardiographic examination showed no significant difference between both groups. Only the global longitudinal strain (18.1 +/- 2.7 vs 20.16 +/- 1.7, p = 0.02) and global circumferential strain (22.1 +/- 2.9 vs 24.4 +/- 1.19, p = 0.01) were significantly lower in PPCM patients. The lowest values for longitudinal strain belonged to the basal and mid regions of anterior, anteroseptal and lateral walls in the PPCM patients. Conclusion Subclinical myocardial damage may persist in PPCM patients with full LV systolic recovery. 3D Speckle Tracking strain analysis is a useful method for detecting subtle myocardial dysfunction.