Current understanding of pathophysiological mechanisms of peripartal cardiomyopathy

Abstract

The aim of the study. To analyze literature data in order to study the pathophysiological mechanisms of development of peripartum cardiomyopathy. Research methods and materials. A review of modern Russian and foreign, mainly English-speaking, literature on the pathogenetic mechanisms of IPAH development was carried out. We took into account publications not older than 6 years, published in specialized medical journals and guidelines. Results. According to the data of modern studies devoted to the peculiarities of the development of peripartum cardiomyopathy, much attention is paid to the risk factors of the disease, in particular the age-related obstetric history, pregnancy with twins or more, and arterial hypertension. In addition, the significance of genetic predisposition, inflammatory syndrome has been proven, and the vasculo-hormonal theory is being studied. Difficult issues of the etiopathogenesis of the disease, including myocarditis, the role of the prolactin-cathepsin-prolactin 16 kDa system, and malnutrition are discussed.Conclusion. Pathophysiological mechanism of development of peripartum cardiomyopathy. appears as a complex combination of inflammatory changes in the myocardium with the participation of a cardiotoxic subfragment – prolactin 16 kDa, which causes damage and dysfunction of the endothelium under hemodynamic stress against the background of possible genetic changes, which leads to damage to cardiomyocytes and a decrease in myocardial contractility.