RT Journal Article
SR Electronic
T1 Prolactin: a new therapeutic target in peripartum cardiomyopathy
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1352
OP 1357
DO 10.1136/hrt.2009.179218
VO 96
IS 17
A1 Hatice Yamac
A1 Insa Bultmann
A1 Karen Sliwa
A1 Denise Hilfiker-Kleiner
YR 2010
UL http://heart.bmj.com/content/96/17/1352.abstract
AB Peripartum/postpartum cardiomyopathy (PPCM) is a potentially life-threatening disease of uncertain aetiology in previously healthy women. Clinical and experimental data suggested inflammation, autoimmune processes, apoptosis and endothelial dysfunction as typical pathophysiological features of PPCM. Recent data discovered that unbalanced peri/postpartum oxidative stress linked to proteolytic cleavage of the nursing hormone prolactin into a potent anti-angiogenic, pro-apoptotic and pro-inflammatory 16-kDa subform as a potential pathomechanism for the development of PPCM. Consistent with these idea, blockade of prolactin by bromocriptine, a dopamine D2 receptor agonist, prevented the onset of disease in an experimental model of PPCM and appeared successful in small pilot trials with respect to prevention or treatment of PPCM in patients. Here we highlight the current state of knowledge on diagnosis of PPCM, provide novel insights into the pathophysiology behind the disease and outline potential consequences for the clinical management and treatment options for patients at risk for or with PPCM.