# Clinical Characteristics and Outcomes of 1894 Women with Peripartum Cardiomyopathy Treated with and Without Levosimendan in Germany

## TL;DR

This study examines the clinical outcomes of 1894 women with peripartum cardiomyopathy in Germany, comparing those treated with and without levosimendan.

## Contribution

The study provides real-world evidence on the use of levosimendan in treating peripartum cardiomyopathy in Germany.

## Key findings

- PPCM has a prevalence of 0.01% in Germany.
- Levosimendan was used in 3.60% of patients, mostly postpartum.
- Levosimendan treatment was associated with higher complication rates and transfusion needs.

## Abstract

Background: Peripartum cardiomyopathy (PPCM) is a rare form of heart failure occurring during the last month of pregnancy or within five months postpartum. While levosimendan is considered beneficial in heart failure and cardiogenic shock, evidence supporting its use in PPCM is limited. This study investigated the prevalence of PPCM in Germany and evaluated outcomes associated with levosimendan use. Methods: Using national data from the German Statistical Office, all pregnant women diagnosed with PPCM and hospitalized between 2009 and 2022 were included. Patients were categorized into groups based on levosimendan treatment. Demographics, treatment modalities, peripartum complications, and transfusion rates were analyzed. Results: The prevalence of PPCM in Germany is 0.01%; 3.60% of patients received levosimendan, mostly after childbirth (61.76%). Peripartum complications and the use of mechanical circulatory support devices were significantly higher in the levosimendan group (p < 0.0001). Women in the levosimendan group suffered significantly more often from intrapartum bleeding and increased rates of blood transfusion compared to women in the non-levosimendan group. Conclusions: PPCM is a rare disease in Germany with a prevalence of 0.01%. Despite higher complication rates in women with levosimendan treatment, further studies are necessary to help determine the role and timing of levosimendan in the treatment of women with PPCM.