Novel Score to Predict LV Recovery in Peripartum Cardiomyopathy

Quick Takes

  • Prediction of LV recovery among individuals with peripartum cardiomyopathy has been challenging.
  • This clinical prediction tool can be used to predict LV recovery at 6 months (C-statistic, 0.79; 95% CI, 0.74-0.83).

Study Questions:

Can a clinical tool to predict left ventricular (LV) recovery at 6 months among individuals with peripartum cardiomyopathy (PPCM) be established?


Data from the European Society of Cardiology (ESC) EURObservational Research Programme (EORP) registry were collected from 2012–2018 in 51 countries. The PPCM registry included 752 women meeting diagnostic criteria for PPCM. LV recovery was defined as ejection fraction (EF) ≥50% at 6 months. Statistical modeling used data from the registry participants and then an integer score was created.


Of 465 individuals with an echocardiogram performed at 6 months, 46.5% recovered. The variables included were: 1) baseline LVEF, 2) baseline LV end-diastolic diameter, 3) human development index (related to the country’s development status), 4) duration of symptoms, 5) QRS duration, and 6) pre-eclampsia. The C-statistic of this model was 0.79 (95% confidence interval [CI], 0.74-0.83).


The ESC EORP PPCM Recovery Score can be applied to predict LV recovery at 6 months in individuals with PPCM.


PPCM is a devastating diagnosis and associated with highly variable outcomes, from full recovery to heart transplantation or death. Previously, the most reliable predictor of recovery was the baseline EF. In this study, a clinical prediction tool using six variables is established. In this cohort, patients are more likely to recovery if they had a higher baseline EF, smaller LV diameter, narrow QRS, shorter duration of symptoms, pre-eclampsia, and live in a country with higher social and economic development. While several of these individual variables have previously been associated with LV recovery, this is the first clinical tool that combines them into a model that predicts recovery.

One important caveat to remember is that although many patients recover within 6 months, delayed recovery also occurs. When making clinical decisions such as timing of implantable cardioverter-defibrillator placement, the use of this tool should be considered helpful but not definitive. Overall, this is an exciting addition to the field of cardio-obstetrics.

Clinical Topics: Heart Failure and Cardiomyopathies

Keywords: Cardiomyopathies, Peripartum Period

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