Resumen
La Miocardiopatía Periparto (MCPP) es una complicación grave del embarazo y el puerperio, de elevada morbimortalidad. Su diagnóstico es de vital relevancia, debido a los índices de mortalidad materna en la provincia de La Rioja. Su verdadera prevalencia e incidencia en nuestro país se desconoce; probablemente a consecuencia de subdiagnosticos. La incidencia más alta en las poblaciones estudiadas se en cuenta registrada en Haití, donde se estima 1 caso cada 299 nacidos vivos, le siguen Sudáfrica 1 caso cada 1000 nacidos vivos y la más baja en EEUU con 1 caso cada 4000 nacidos vivos (1). Constituida por pacientes previamente sanas, sin patología cardiaca preexistente, y en edad reproductiva. En este artículo describiremos el síndrome, sus causas, fisiopatogenia y presentaremos dos casos que fueron diagnosticados y abordados terapéuticamente en la Unidad de Terapia Intensiva Obstétrica (UTIO).
Citas
<p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">BIBLIOGRAFÍA</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">1- Mielniczuk LM, Williams K, Davis DR, et al. Frequency of peripartum cardiomyopathy. Am J Cardiol 2006; 97:17651-.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">2-Demakis JG, Rahimtoola SH. Sutton GC, et al. Natural course of peripartum cardiomyopathy. </span><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: #000A;" lang="es">Circulation. 1971; 44:1053-1061.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: #000A;" lang="es">3-Una definición modificada para miocardiopatía Periparto y pronostico en ecocardiografía. </span><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">Hibbard, Judith U. MD; Lindheimer, Marshall MD; Lang, Roberto M. MD.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">4-Lampert MB, Lang RM. Peripartum cardiomyopathy. Am Heart J 1995; 130:860-870.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">5-Oakley C. Peripartum cardiomyopathy, other heart muscle disorders and pericardial diseases. Heart Disease in Pregnancy, Second Edition. Blackwell Publishing 2007; 186-203.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">6-Kametas NA, McAuliffe F, Krampl E, et al: Maternal cardiac function in twin pregnancy. Obstet Gynecol 2003; 102:806-815.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">7-Gleisher N, and Elkayam U. Peripartum cardiomyopath, an autoimnun manifestation of allograft rejection? Autoinmunity Reviews 2009; 8:384-387.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">8-Sundstrom JB, Fett JD, Carraway RD, Ansari AA. Is peripartum cardiomyopathy an organ-specific autoinmune disease? Autoinmun Rev 2002; 1:73-7.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">9-Bultmann BD, Klingel K, Nabauer M, Wallwiener D, Kandolf R. High prevalence of viral genomes and inflamation in peripartum cardiomyopathy. Am J Obstet Gynecol 2005; 193:363-5.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">10-Hilfiker-Kleiner D, Kaminski K, Podewski E et al. A cathepsin D-cleaved 16 kDA form of prolactin mediates postpartum cardiomyopathy. Cell 2007;128:589-600. (doi: 10.1016/j.cell.2006.12.036).</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">11-Scheme depicting examples of STAT3-dependent cell-to-cell communication between cardiomyocytes, endothelial cells, CPC, and fibroblasts, as well as infiltrated immune cells. Some STAT3-regulated mediators, by which this cellular network interacts, are illustrated at the top. Various functions of the respective cell tyoe that are modulated by STAT3 witihn this network are listed at the bottom.</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">12-Opposing roles of Akt and STAT3 in the protection of the maternal heart from peripartum stress. Melanie Ricke-Hoch, Insa bultmann, Britta Stapel, Gianluigi Condorelli, Ursula Rinas, Karen Sliwa, Michaela Scherr, Denise Hilfiker-Kleiner. First publishe online: 21 January 2014</span></p> <p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 115%; font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;" lang="EN-US">13-Cabergoline as an adjunct for early left ventricular recovery in peripartum cardiomyopathy Br J Cardiol 2011; 18:243-245 doi: 10.5837/bjc.2011.008.</span></p>
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