Background Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demonstrated improvement in left ventricular recovery and clinical outcome. We sought to determine the effect of adding Bromocriptine to standard heart failure therapy on the improvement and recovery of left ventricular function and cardiovascular mortality of these patients. Inclusion Criteria. Studies were included if they satisfied the following criteria:1) Randomized Controlled Trials; 2) Pregnant patients who fulfilled the criteria for diagnosis of peripartum cardiomyopathy and 3) Reported data on improvement in left ventricular ejection fraction and clinical outcomes. Methods. Using PUBMED, Clinical Key, Science Direct, Scopus, and Cochrane databases, a search for eligible studies was conducted from June to December 31, 2018. The quality of each study was evaluated using the Cochrane Risk of Bias Tool. The primary outcome of interest is on the effect of Bromocriptine on the improvement of left ventricular function and clinical outcomes among these patients. Review Manager 5.3 was utilized to perform analysis of random effects for continuous outcomes. Results. We identified 2 randomized controlled trials of 116 pregnant patients diagnosed with peripartum cardiomyopathy, showing that among those who received Bromocriptine on top of standard heart failure therapy, there is a significant improvement in the left ventricular ejection fraction at 6 months [mean difference 15.14 (95% CI, 6.53 to 23.75) p <0.05] compared to standard heart failure therapy alone. It was also observed that those who received Bromocriptine had better clinical outcomes. Conclusion. The addition of Bromocriptine on top of standard heart failure therapy significantly improved the left ventricular ejection fraction of patients with peripartum cardiomyopathy at 6-months post-partum. This novel therapy may be considered to improve the management of these patients.
Published in | Cardiology and Cardiovascular Research (Volume 4, Issue 2) |
DOI | 10.11648/j.ccr.20200402.14 |
Page(s) | 52-58 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Bromocriptine, Peripartum Cardiomyopathy, PPCM
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APA Style
Danielle Louis Villanueva, Lauren Kay Evangelista, Cristina Espanillo-Villanueva, John Anonuevo. (2020). Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials. Cardiology and Cardiovascular Research, 4(2), 52-58. https://doi.org/10.11648/j.ccr.20200402.14
ACS Style
Danielle Louis Villanueva; Lauren Kay Evangelista; Cristina Espanillo-Villanueva; John Anonuevo. Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials. Cardiol. Cardiovasc. Res. 2020, 4(2), 52-58. doi: 10.11648/j.ccr.20200402.14
AMA Style
Danielle Louis Villanueva, Lauren Kay Evangelista, Cristina Espanillo-Villanueva, John Anonuevo. Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials. Cardiol Cardiovasc Res. 2020;4(2):52-58. doi: 10.11648/j.ccr.20200402.14
@article{10.11648/j.ccr.20200402.14, author = {Danielle Louis Villanueva and Lauren Kay Evangelista and Cristina Espanillo-Villanueva and John Anonuevo}, title = {Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials}, journal = {Cardiology and Cardiovascular Research}, volume = {4}, number = {2}, pages = {52-58}, doi = {10.11648/j.ccr.20200402.14}, url = {https://doi.org/10.11648/j.ccr.20200402.14}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20200402.14}, abstract = {Background Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demonstrated improvement in left ventricular recovery and clinical outcome. We sought to determine the effect of adding Bromocriptine to standard heart failure therapy on the improvement and recovery of left ventricular function and cardiovascular mortality of these patients. Inclusion Criteria. Studies were included if they satisfied the following criteria:1) Randomized Controlled Trials; 2) Pregnant patients who fulfilled the criteria for diagnosis of peripartum cardiomyopathy and 3) Reported data on improvement in left ventricular ejection fraction and clinical outcomes. Methods. Using PUBMED, Clinical Key, Science Direct, Scopus, and Cochrane databases, a search for eligible studies was conducted from June to December 31, 2018. The quality of each study was evaluated using the Cochrane Risk of Bias Tool. The primary outcome of interest is on the effect of Bromocriptine on the improvement of left ventricular function and clinical outcomes among these patients. Review Manager 5.3 was utilized to perform analysis of random effects for continuous outcomes. Results. We identified 2 randomized controlled trials of 116 pregnant patients diagnosed with peripartum cardiomyopathy, showing that among those who received Bromocriptine on top of standard heart failure therapy, there is a significant improvement in the left ventricular ejection fraction at 6 months [mean difference 15.14 (95% CI, 6.53 to 23.75) p Conclusion. The addition of Bromocriptine on top of standard heart failure therapy significantly improved the left ventricular ejection fraction of patients with peripartum cardiomyopathy at 6-months post-partum. This novel therapy may be considered to improve the management of these patients.}, year = {2020} }
TY - JOUR T1 - Use of Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials AU - Danielle Louis Villanueva AU - Lauren Kay Evangelista AU - Cristina Espanillo-Villanueva AU - John Anonuevo Y1 - 2020/04/21 PY - 2020 N1 - https://doi.org/10.11648/j.ccr.20200402.14 DO - 10.11648/j.ccr.20200402.14 T2 - Cardiology and Cardiovascular Research JF - Cardiology and Cardiovascular Research JO - Cardiology and Cardiovascular Research SP - 52 EP - 58 PB - Science Publishing Group SN - 2578-8914 UR - https://doi.org/10.11648/j.ccr.20200402.14 AB - Background Peripartum cardiomyopathy is a rare, pregnancy associated cause of left ventricular heart failure in previously healthy women. It remains an important cause of cardiac-related maternal morbidity and mortality worldwide. Half of the patients will recover left ventricular function after 6 months. However, in the remainder of patients who do not recover cardiac function, they will require advanced heart failure therapies. Bromocriptine, a dopamine agonist which inhibits prolactin release, has demonstrated improvement in left ventricular recovery and clinical outcome. We sought to determine the effect of adding Bromocriptine to standard heart failure therapy on the improvement and recovery of left ventricular function and cardiovascular mortality of these patients. Inclusion Criteria. Studies were included if they satisfied the following criteria:1) Randomized Controlled Trials; 2) Pregnant patients who fulfilled the criteria for diagnosis of peripartum cardiomyopathy and 3) Reported data on improvement in left ventricular ejection fraction and clinical outcomes. Methods. Using PUBMED, Clinical Key, Science Direct, Scopus, and Cochrane databases, a search for eligible studies was conducted from June to December 31, 2018. The quality of each study was evaluated using the Cochrane Risk of Bias Tool. The primary outcome of interest is on the effect of Bromocriptine on the improvement of left ventricular function and clinical outcomes among these patients. Review Manager 5.3 was utilized to perform analysis of random effects for continuous outcomes. Results. We identified 2 randomized controlled trials of 116 pregnant patients diagnosed with peripartum cardiomyopathy, showing that among those who received Bromocriptine on top of standard heart failure therapy, there is a significant improvement in the left ventricular ejection fraction at 6 months [mean difference 15.14 (95% CI, 6.53 to 23.75) p Conclusion. The addition of Bromocriptine on top of standard heart failure therapy significantly improved the left ventricular ejection fraction of patients with peripartum cardiomyopathy at 6-months post-partum. This novel therapy may be considered to improve the management of these patients. VL - 4 IS - 2 ER -