{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:06:25Z","timestamp":1786370785165,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure in late pregnancy and early postpartum, and biomarkers for risk stratification are lacking. Soluble fms-like tyrosine kinase-1 (sFlt-1), implicated in PPCM and pre-eclampsia, may be associated with PPCM and may have potential diagnostic relevance. This study aimed to evaluate the association between circulating sFlt-1 levels and PPCM and to provide an exploratory assessment of the diagnostic performance of sFlt-1 overall and according to pre-eclampsia status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Europe PMC, and ScienceDirect from inception to 15th February 2026 for studies reporting sFlt-1 in PPCM cases and pregnant or postpartum controls. Given the rarity of PPCM and the limited number of eligible studies, this review was designed as an exploratory meta-analysis. Random-effects models pooled odds ratios (ORs) for PPCM comparing high vs. low sFlt-1 and enabled subgroup analyses by pre-eclampsia. I Diagnostic performance was summarised using pooled sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009226) met the criteria. High sFlt-1 levels were associated with increased PPCM risk [pooled OR 1.79; 95% confidence interval (CI) 1.22\u20132.64], although substantial heterogeneity was present across studies. In exploratory diagnostic analyses, performance was modest, with sensitivity 72% (95% CI 64%\u201380%), specificity 57% (95% CI 44%\u201368%), and AUC 0.71 (95% CI 0.67\u20130.75). In women with pre-eclampsia, the association with PPCM was stronger (OR 2.11; 95% CI 1.45\u20133.09) than in those without pre-eclampsia (OR 1.36; 95% CI 1.03\u20131.80), with higher sensitivity and specificity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated sFlt-1 was associated with PPCM, with exploratory analyses suggesting somewhat better diagnostic discrimination in women with pre-eclampsia. However, because all included studies measured sFlt-1 in the postpartum period, these findings should not be interpreted as evidence for antepartum screening utility. Larger prospective studies with measurements during pregnancy and serial peripartum follow-up are needed before any clinical application can be considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024535557<\/jats:ext-link>\n                      , identifier (CRD42024535557).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1825532","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:33:15Z","timestamp":1780896795000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Soluble fms-like tyrosine kinase-1 and peripartum cardiomyopathy: an exploratory meta-analysis of association and diagnostic performance"],"prefix":"10.3389","volume":"13","author":[{"given":"Triwedya Indra","family":"Dewi","sequence":"first","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Kamarullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawani Sasmaya","family":"Prameswari","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaerul","family":"Achmad","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruswana","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delvac","family":"Oceandy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, The University of Manchester, Manchester Academic Health Science Centre","place":["Manchester, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firman Fuad","family":"Wirakusumah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3787","DOI":"10.1093\/eurheartj\/ehaa455","article-title":"Clinical presentation, management, and 6-month outcomes in women with peripartum cardiomyopathy: an ESC EORP registry","volume":"41","author":"Sliwa","year":"2020","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1002\/ejhf.1493","article-title":"Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the heart failure association of the European Society of Cardiology study group on peripartum 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