Etiology and pathophysiology

Abstract Peripartum cardiomyopathy (PPCM) is a life-threatening cardiomyopathy characterized by left ventricular (LV) systolic dysfunction late in pregnancy, during delivery, or in the first postpartum months, in women with no previously known heart disease. Today it is assumed that multiple pathomechanisms may induce the disease, including genetic and environmental factors. There is evidence that these factors may merge on common pathomechanistic pathways such as unbalanced oxidative stress and the cleavage of the nursing hormone prolactin (PRL) into an angiostatic 16 kDa-PRL fragment with subsequent vascular impairment and heart failure. Recent research on specific and common pathomechanisms discovered disease-specific biomarkers and therapies. The current knowledge on etiology and pathomechanisms of PPCM is summarized in the present chapter.