Blood Test for Peripartum Cardiomyopathy Helps Reduce Mortality

Biomarkers have been discovered that can be used to develop a screening test to detect Peripartum Cardiomyopathy (PPCM), a life-threatening disorder that is the primary cause of mortality in pregnant women in developing countries.

The results of a simple blood test can lead to the immediate treatment of PPCM in new mothers and a significant reduction in mortality, as treatment is often delayed because it is difficult to know whether the women are experiencing normal symptoms of pregnancy or PPCM.

Cardiologists from the Lariboisière Hospital (Paris, France) collected plasma samples from 77 PPCM patients, 75 healthy peripartum women, 25 breast feeding mothers, and 65 nonpregnant acute heart failure (HF) patients. The samples were tested for levels of the cardiovascular N-terminal of the prohormone brain natriuretic peptide (NT-proBNP), anti-soluble fms-like tyrosine kinase-1 (sFlt-1) and angiogenic placental growth factor (PlGF) or vascular endothelial growth factor (VEGF). Samples were measured on either an Abbott Architect system (Abbott laboratories; Abbott Park, IL, USA) or a Cobas Chemistry analyzer (Roche; Basel, Switzerland).

The scientists had hypothesized that since angiogenesis and relaxin-2 pathways are altered in PPCM the biomarkers ratio of these two pathways placental growth factors/sFlt-1 and relaxin-2 could be used to discriminate PPCM among peripartum women. Their results showed that compared to the other groups, PPCM patients had significantly higher levels of NT-proBNP, lower levels of plasma relaxin-2, and that the sFlt-1/PlGF ratio and sFlt-1/VEGF ratio were statistically lower.

Alexandre Mebazaa, MD, PhD, a professor of Anesthesiology and Critical Care Medicine, and coauthor of the study, said, “For pregnant women there are two major causes of death: massive hemorrhage and PPCM, and it is a very sad situation because a time of great happiness turns to great sorrow and the new baby and the father are left alone. We have found a way to detect rather quickly whether the woman has PPCM and to treat it quickly and efficiently.”

Karen Sliwa, MD, PhD, FESC, FACC, DTM&H, a coauthor and professor from the University of Cape Town (South Africa) said, “There's an urgent need for biomarkers of PPCM since the condition can be hard to differentiate from the normal symptoms of pregnancy that include dyspnea, edema and palpitations. The next step will be to confirm our findings in a larger cohort and if they hold we could go on to develop a bed side test similar to NT-pro BNP in heart failure.” The study was presented at the World Congress on Acute Heart Failure during May 17–20, 2014, in Athens (Greece).

Related Links:
Lariboisière Hospital
Abbott laboratories
Roche