[The Effect of Bromocriptine on Clinical and Laboratory Parameters in Patients With Peripartum Cardiomyopathy].

Aim      To evaluate the effect of bromocriptine on clinical hemodynamic and functional indexes and to analyze life prognosis for patients with periportal cardiomyopathy divided into two groups: group 1, bromocriptine treatment (n=21) and group 2, standard treatment without bromocriptine (n=22). History was taken, examination and standard clinical evaluation were performed, the Clinical Condition Scale (CCS with V.Yu. Mareev, 2000, modification) was administered, and 6-min walk test (6MWT) was performed. Quality of life was determined with the Minnesota questionnaire. Standard 12-lead electrocardiography, echocardiography, and blood biochemistry with measuring C-reactive protein (CRP) and prolactin, were performed. Follow-up duration was one year.Results Heart rate was significantly decreased in group 1 (22.7%) compared to group 2 (18%); the 6-min distance was increased (61 and 50 %, respectively), the total CCS score was decreased (66 and 55 %, respectively, and the quality of life Minnesota questionnaire score was improved (from 68.4±12.4 to 26.4±12.4 and from 63.4±10.9 to 36.4±15.1, respectively). Also, left ventricular (LV) end-diastolic dimension was reduced from 66.82±7.07 to 60.67±3.79 mm (9.2 %) in group 1 and from 61.92±4.41 to 58.91±4.68 mm (5 %) in group 2, which was associated with increases in LV ejection fraction by 18.3 and 14.5 %, respectively. In both groups, CRP concentration was decreased from 8.3±4.1 to 4.3±1.2 mg/l and from 8.5±3.5 to 6.3±1.5 mg/l, respectively. The bromocriptine treatment was associated with a significant decrease in prolactin level (62 %). The LV function completely recovered in 66.6% of patients in group 1 and in 27% of patients in group 2.Conclusion      The bromocriptine treatment of periportal cardiomyopathy in combination with an optimal drug therapy was associated with an additional beneficial effect on the clinical functional status, intracardiac hemodynamics, blood concentration of CRP, and a potentiality for complete recovery of the LV function.

[Periportal cardiomyopathy. Some peculiarities of clinical picture and course of the disease].

Results of the study of special characteristics of the course of chronic heart failure (CHF) in women with periportal cardiomyopathy (PCMP) are presented. We have found that prevalence of PCMP in the structure of dilated cardiomyopathy is 9.5%. PCMP compared with idiopathic cardiomyopathy is characterized by less pronounced dilation of left cardiac chambers, relative preservation of left ventricular contractile function, more favorable course of CHF with lower frequency of destabilizations of clinical state. PCMP has developed mainly during postportal period and in women with preexisting anemia and chronic viral diseases.