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खुला एक्सेस

अमूर्त

Long-Term Effect of Bromocriptine on Left Ventricle Systolic Function Recovery in Peripartum Cardiomyopathy: A Prospective Longitudinal Study

Fatou Aw1, Simon Antoine Sarr1, Joseph Salvador Mingou1, Rim Khaled1, Malick Kane1, Ndoye Gueye1, Marguerite Téning Diouf6, Désiré Alain Affangla2, Youssou Diouf 1, Mohamed Leye2, Khadimu Rassoul Diop1, Serigne Mor BEYE5, Aliou Alassane Ngaïdé4, Dioum Momar3, Malik Bodian1, Momo Banda Ndiaye1, Alassane Mbaye1, Adama Kane1, Maboury Diao1, Adama Faye7, Adama Kane6

Introduction: The treatment of peripartum cardiomyopathy follows the main principles of the treatment of heart failure with reduced ejection fraction. To date, the adoption of bromocriptine as a legitimate option in the PPCM treatement is widely variable across the world. The main objective of this work was to evaluate the efficacy of bromocriptine in improving left ventricular function in addition to conventional treatment of peripartum cardiomyopathy. Methodology:This was a longitudinal, prospective quasi-experimental study conducted in patients followed at the cardiology clinic of Aristide Le Dantec Hospital for peripartum cardiomyopathy from January 1, 2017 to January 01, 2021, with a total duration of 48 months. We made a consecutive and exhaustive recruitment of all patients admitted during the study period. This study received the approval of the ethics committee of the Cheikh Anta Diop University of Dakar. A Kaplan Meier survival curve was produced to compare the evolution of LVEF in patients on Bromocriptine versus patients on conventional treatment. Results: During the recruitment period, 540 patients were hospitalized, including 320 women. Taking into account the inclusion criteria, 55 patients were selected. The rate of hospitalization in the cardiology department for peripartum cardiomyopathy was 5.8%. The average age was 30.5 ± 6.7 years with extremes of 18 years and 42 years. Left ventricular systolic dysfunction was found in all our patients with an average systolic ejection fraction calculated by Simpson biplane of 27.9% ± 8.69%. Eleven (11) patients were in addition to treatment for heart failure with bromocriptine versus 44 with treatment for heart failure alone. After 6 months of follow-up, left ventricular systolic function in patients on bromocriptine had increased from 28.45% to 53.6%; Whereas that of the standard treatment group had increased from 28.27% to 42.1% (p=0.007). Patients on Bromocriptine recovered twice as quickly at 6 months and had better survival (p=0.036) compared to those on conventional treatment for heart failure only. Conclusion: Peripartum cardiomyopathy is a severe heart condition that worsens maternal mortality in sub-Saharan Africa. Bromocriptine improves the short-term and long-term prognosis of these patients. Large cohort clinical trials should be conducted in sub-Saharan Africa to better prove its effectiveness where this condition is more common.