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Breastfeeding, Cellular Immune Activation, and Myocardial Recovery in Peripartum Cardiomyopathy

2019; Elsevier BV; Volume: 4; Issue: 3 Linguagem: Inglês

10.1016/j.jacbts.2019.01.010

2452-302X

Agnes Koczo, Amy Marino, Arun Jeyabalan, Uri Elkayam, Leslie T. Cooper, James D. Fett, Joan Briller, Eileen Hsich, Lori A. Blauwet, Charles F. McTiernan, Penelope A. Morel, Karen Hanley‐Yanez, Dennis M. McNamara, Dennis M. McNamara, James D. Fett, Jessica Pisarcik, Charles F. McTiernan, Karen Hanley‐Yanez, John Gorcsan, Erik B. Schelbert, Rami Alharethi, Kismet Rasmusson, Kim Brunisholz, Amy L. Butler, D. Budge, A.G. Kfoury, Benjamin D. Horne, Joe Tuinei, Heather Brown, Julie B. Damp, Allen J. Naftilan, Jill Russell, Darla Freehardt, Eileen Hsich, Cynthia Oblak, Greg Ewald, Donna Whitehead, Jean Flanagan, Anne Platts, Uri Elkayam, Jorge Caro, Stephanie Mullin, Michael M. Givertz, Mary Susan Anello, Navin Rajagopalan, David R. Booth, Tiffany Sandlin, Wendy Wijesiri, Leslie T. Cooper, Lori A. Blauwet, Joann Brunner, Mary Phelps, Ruth Kempf, Kalgi Modi, Tracy Norwood, Joan Briller, Decebal Sorin Griza, G. Michael Felker, Robb D. Kociol, Patricia L. Adams, Gretchen Wells, Vinay Thohan, Deborah Wesley-Farrington, Sandra Soots, Richard Sheppard, Caroline Michel, Nathalie Lapointe, Heather Nathaniel, Angela Kealey, Marc J. Semigran, Maureen Daher, John Boehmer, David Silber, Eric Popjes, Patricia Frey, Todd Nicklas, Jeffrey D. Alexis, Lori Caufield, John W. Thornton, Mindy Gentry, V.J. Robinson, Gyanendra K. Sharma, Joan Holloway, Maria Powell, David W. Markham, Mark H. Drazner, Lynn Fernandez, Mark Zucker, David A. Baran, Martin L. Gimovsky, Natalia Hochbaum, Bharati Patel, Laura Adams, Gautam Ramani, Stephen S. Gottlieb, Shawn Robinson, Stacy D. Fisher, Joanne Marshall, Jennifer Haythe, Donna Mancini, Rachel Bijou, Maryjane Farr, Marybeth Marks, Henry Arango, Biykem Bozkurt, Mariana Bolos, Paul Mather, Sharon Rubin, Raphael Bonita, Susan Eberwine, Hal A. Skopicki, Kathleen Stergiopoulos, Ellen McCathy-Santoro, Jennifer Intravaia, Elizabeth W. Maas, Jordan Safirstein, Audrey Kleet, Nancy Martinez, Christine Corpoin, Donna Hesari, Sandra Chaparro, Laura J. Hudson, Jalal K. Ghali, Zora Injic, Ilan S. Wittstein,

Cardiac Structural Anomalies and Repair

The etiology of peripartum cardiomyopathy remains unknown. One hypothesis is that an increase in the 16-kDa form of prolactin is pathogenic and suggests that breastfeeding may worsen peripartum cardiomyopathy by increasing prolactin, while bromocriptine, which blocks prolactin release, may be therapeutic. An autoimmune etiology has also been proposed. The authors investigated the impact of breastfeeding on cellular immunity and myocardial recovery for women with peripartum cardiomyopathy in the IPAC (Investigations in Pregnancy Associated Cardiomyopathy) study. Women who breastfed had elevated prolactin, and prolactin levels correlated with elevations in CD8+ T cells. However, despite elevated prolactin and cytotoxic T cell subsets, myocardial recovery was not impaired in breastfeeding women.