Recovery of Myocardial Function in Peripartum Cardiomyopathy: Insights from Global Longitudinal Strain and Myocardial Work Analysis

By
Federica Ilardi
Federica Carusone
Dario D’Alconzo
Rachele Manzo
Alessia Palmentieri
Ciro Battaglia
Dalila Nappa
Giuseppe Giugliano
Raffaella Lombardi
Santo Dellegrottaglie
Viviana Narciso
Roberta Paolillo
Luca Bardi
Francesco S. Loffredo
Daniele Masarone
Enrica Pezzullo
Francesca Lanni
Donato Gerardi
Eugenio Stabile
Angelicarosa Cascone
Nouha Azaza
Giovanni Peretto
Giuseppe Bifulco
Attilio Di Spiezio Sardo
Gabriele Saccone
Alaide Chieffo
Cinzia Perrino
Giovanni Esposito
August 26, 2026

Frontiers In Cardiovascular Medicine

Overview

This study investigates myocardial recovery in women with peripartum cardiomyopathy (PPCM) using global longitudinal strain (GLS) and myocardial work (MW) indices. Findings indicate that while some women experience recovery of left ventricular ejection fraction (LVEF), subtle myocardial impairments persist.

Background

Peripartum cardiomyopathy (PPCM) is a rare but serious condition that can lead to heart failure during or after pregnancy. Approximately 50% of women recover their LVEF, but many may still experience residual myocardial dysfunction.

Data Highlights

Group	LVEF	GLS	GWE
Group A (<50% LVEF)	Impaired	Significantly poorer	Not applicable
Group B (≥50% LVEF)	Recovered	Lower than controls (18.0 ± 3.1% vs. 21.8 ± 1.7%, p < 0.001)	Lower than controls (92.6 ± 6.0 vs. 95.9 ± 2.0%, p = 0.023)
Group C (Controls)	Normal	Normal	Normal

Key Findings

72.7% of women with PPCM showed LV recovery.
Groups A and B had greater LV diameters and volumes compared to controls (p < 0.001).
Group A exhibited significantly poorer GLS and MW parameters (p < 0.001 for all).
Group B had lower GLS and GWE compared to controls despite LVEF recovery (p < 0.001 and p = 0.023, respectively).
GLS and MW indices may reveal myocardial impairment not detected by conventional measures.

Clinical Implications

The study presents GLS and MW indices as measures of myocardial performance in PPCM patients.

Conclusion

The findings indicate that GLS and MW indices may detect residual myocardial dysfunction in PPCM.

Recovery of Myocardial Function in Peripartum Cardiomyopathy: Insights from Global Longitudinal Strain and Myocardial Work Analysis