REBIRTH study offers hope for new mothers with heart failure
It’s not unusual for new mothers to struggle so much with fatigue that they wonder if they’ll ever feel like themselves again. But for up to one in 1,000 women, exhaustion is one symptom of a serious health problem — peripartum cardiomyopathy (PPCM), a form of heart failure. Other symptoms can include shortness of breath and swelling of the feet or ankles.
“PPCM develops during the last month of pregnancy and within five months of delivery,” explains Navin Rajagopalan, MD, a heart failure specialist with UK HealthCare’s Gill Heart & Vascular Institute. Women with PPCM have no previous history of heart failure or heart attack.
“While some women recover fairly quickly after PPCM without any medication, others may face a more challenging journey,” says Dr. Rajagopalan, who serves as the site principal investigator for a clinical drug trial aimed at improving cardiac function. “Some may only experience partial recovery, others may be told they’ll eventually need a heart transplant and, tragically, some lose their lives,”
“This is why advancing research and offering hope through new treatments is so important,” said Navin Rajagopalan, MD.
The Randomized Evaluation of Bromocriptine In Myocardial Recovery Therapy (REBIRTH) study, currently enrolling patients, is evaluating the benefits of the medication bromocriptine, a drug used to treat conditions in which there is a high level of prolactin in the blood.
“Prolactin levels are elevated around the time of childbirth, stimulating the production of milk,” Dr. Rajagopalan says. “In women with PPCM, it’s possible that this upregulation of prolactin gets disordered or broken down in a way that impacts the blood vessels and the heart. Bromocriptine inhibits the production of the hormone prolactin so the theory is that it can help treat PPCM.”
While small clinical trials using bromocriptine in Europe and South Africa have shown some efficacy, physicians hope that the large U.S. trial, which includes some 60 centers will give a definitive answer. Women eligible for the study include those with an ejection fraction of 40 percent or lower who do not plan to breastfeed.
“With our level of enrollment in the study, we are proud to be one of the leading sites,” Dr. Rajagopalan says. “The increasing rates of obesity, hypertension and chronic illnesses such as diabetes in the U.S. have contributed to a troubling rise in maternal disorders of pregnancy, including peripartum cardiomyopathy. Addressing PPCM through advanced research and treatment is crucial — not only to save maternal lives but also to reduce the need for life altering interventions such as heart transplantations.”
