{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:12:43Z","timestamp":1788538363788,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peripartum cardiomyopathy (PPCM) coexisting with severe preeclampsia is uncommon and diagnostically challenging because dyspnea, pulmonary edema, and cardiac dysfunction may be attributed to either condition. Long-term outcomes after rescue mechanical support remain poorly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 28-year-old primigravida at 37 + 6 weeks presented with 2 days of worsening orthopnea, dyspnea, and cough. At 15 + 3 weeks, electrocardiography had shown complete left bundle branch block, although left ventricular ejection fraction (LVEF) was 61%. On admission, blood pressure was 159\/120 mmHg, heart rate 157 beats\/min, urine protein was positive, N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 5,660 pg\/ml, and echocardiography showed an LVEF of 26%. Severe preeclampsia and acute heart failure due to PPCM were diagnosed. Labetalol, magnesium sulfate, and furosemide were administered, followed by emergency cesarean delivery of a 2,880-g male infant (Apgar scores, 8 and 10). Persistent postoperative hemodynamic instability despite mechanical ventilation and pharmacotherapy prompted multidisciplinary initiation of venoarterial extracorporeal membrane oxygenation (VA-ECMO). She was successfully decannulated on day 4 and discharged on day 21 with an LVEF of 44%. NT-proBNP normalized by 6 months, LVEF exceeded 50% by 9 months, and at 5 years LVEF was 59% and NT-proBNP was 20.9 pg\/ml.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case provides rare 5-year documentation of sustained myocardial recovery after VA-ECMO in PPCM with severe preeclampsia. In peripartum patients with severe hypertension and respiratory symptoms, an LVEF below 45% should prompt evaluation for PPCM; timely echocardiography, multidisciplinary care, and early VA-ECMO may bridge refractory hemodynamic instability to recovery, followed by prolonged cardiac surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1952278","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:18:07Z","timestamp":1788535087000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Venoarterial extracorporeal membrane oxygenation for peripartum cardiomyopathy complicated by severe preeclampsia: a case report with 5-year follow-up"],"prefix":"10.3389","volume":"13","author":[{"given":"Haiqing","family":"Wang","sequence":"first","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"Institute of Translational Medicine, Medical College, Yangzhou University","place":["Yangzhou, China"]},{"name":"The Taixing People's Hospital","place":["Taixing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mulan","family":"Liu","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"The Yangzhou School of Clinical Medicine of Dalian Medical University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"Institute of Translational Medicine, Medical College, Yangzhou University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Fang","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"The Yangzhou Clinical Medical College of Xuzhou Medical University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhurui","family":"Chen","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"Institute of Translational Medicine, Medical College, Yangzhou University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhao","family":"Sun","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"Institute of Translational Medicine, Medical College, Yangzhou University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Lu","sequence":"additional","affiliation":[{"name":"Northern Jiangsu People's Hospital Affiliated to Yangzhou University","place":["Yangzhou, China"]},{"name":"Institute of Translational Medicine, Medical College, Yangzhou University","place":["Yangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"B1","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 cardiomyopathy","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur J Heart Fail."},{"key":"B2","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1093\/eurheartj\/ehaf784.4177","article-title":"Peripartum cardiomyopathy: an often mislabelled diagnosis","author":"Taniskidi","year":"2025"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S786","DOI":"10.1016\/j.ajog.2021.12.001","article-title":"Preeclampsia and eclampsia: the conceptual evolution of a syndrome","volume":"226","author":"Offer","year":"2022","journal-title":"Am J Obstet Gynecol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1093\/eurheartj\/ehae875","article-title":"Bromocriptine in the treatment of peripartum cardiomyopathy: is it ready for prime time?","volume":"46","author":"Elkayam","year":"2025","journal-title":"Eur Heart J."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1016\/S0140-6736(25)01451-5","article-title":"Peripartum cardiomyopathy","volume":"406","author":"Sliwa","year":"2025","journal-title":"Lancet."},{"key":"B6","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1056\/NEJMra2306667","article-title":"Peripartum cardiomyopathy","volume":"390","author":"Arany","year":"2024","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"k5287","DOI":"10.1136\/bmj.k5287","article-title":"Peripartum cardiomyopathy","volume":"364","author":"Honigberg","year":"2019","journal-title":"BMJ."},{"key":"B8","doi-asserted-by":"publisher","first-page":"3257","DOI":"10.1002\/ehf2.13463","article-title":"Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria","volume":"8","author":"Karaye","year":"2021","journal-title":"ESC Heart Fail."},{"key":"B9","doi-asserted-by":"publisher","first-page":"4","DOI":"10.15761\/JIC.1000247","article-title":"Peripartum cardiomyopathy: a review of literature on clinical status and meta-analysis of diagnosis and clinical management","author":"Aref","year":"2018","journal-title":"J integr cardiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1016\/j.jacc.2013.08.717","article-title":"The Relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis","volume":"62","author":"Bello","year":"2013","journal-title":"J Am Coll Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.1002\/ejhf.2264","article-title":"Hypertensive disorders in women with peripartum cardiomyopathy: insights from the Esc Eorp Ppcm registry","volume":"23","author":"Jackson","year":"2021","journal-title":"Eur J Heart Fail."},{"key":"B12","doi-asserted-by":"publisher","first-page":"7713590","DOI":"10.1155\/2024\/7713590","article-title":"Connecting the dots: exploring the interplay between preeclampsia and peripartum cardiomyopathy","volume":"2024","author":"Gumilar","year":"2024","journal-title":"J Pregnancy."},{"key":"B13","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1038\/s41569-021-00664-8","article-title":"Pathophysiology and risk factors of peripartum cardiomyopathy","volume":"19","author":"Hoes","year":"2022","journal-title":"Nature reviews Cardiology."},{"key":"B14","doi-asserted-by":"publisher","first-page":"eadi0077","DOI":"10.1126\/scitranslmed.adi0077","article-title":"Placental senescence pathophysiology is shared between peripartum cardiomyopathy and preeclampsia in mouse and human","volume":"16","author":"Roh","year":"2024","journal-title":"Science translational medicine."},{"key":"B15","doi-asserted-by":"publisher","first-page":"4462","DOI":"10.1093\/eurheartj\/ehaf862","article-title":"2025 Esc guidelines for the management of cardiovascular disease and pregnancy","volume":"46","author":"De Backer","year":"2025","journal-title":"Eur Heart J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1161\/CIRCULATIONAHA.115.020491","article-title":"Peripartum cardiomyopathy","volume":"133","author":"Arany","year":"2016","journal-title":"Circulation."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1002\/ccr3.2158","article-title":"Life-threatening peripartum cardiomyopathy-not expected when expecting","volume":"7","author":"Magnusson","year":"2019","journal-title":"Clinical case reports."},{"key":"B18","doi-asserted-by":"publisher","first-page":"857","DOI":"10.2147\/JMDH.S357872","article-title":"The relationship between peripartum cardiomyopathy and preeclampsia - pathogenesis, diagnosis and management","volume":"15","author":"Ku\u0107","year":"2022","journal-title":"J Multidiscip Healthc."},{"key":"B19","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ijcard.2020.03.006","article-title":"Extracorporeal membrane oxygenation in peripartum cardiomyopathy: a review of the elso registry","volume":"311","author":"Olson","year":"2020","journal-title":"Int J Cardiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3390\/life12010087","article-title":"Long-term follow-up of mechanical circulatory support in peripartum cardiomyopathy (PPCM) refractory to medical management: a multicenter study","volume":"12","author":"Khalil","year":"2022","journal-title":"Life."},{"key":"B21","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.jacc.2019.11.014","article-title":"Peripartum cardiomyopathy: JACC state-of-the-art review","volume":"75","author":"Davis","year":"2020","journal-title":"J Am Coll Cardiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1016\/S0735-1097(25)01943-6","article-title":"Comparison of clinical outcomes between peripartum cardiomyopathy and dilated cardiomyopathy: a propensity matched analysis","volume":"85","author":"Hanif","year":"2025","journal-title":"J Am Coll Cardiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1002\/ejhf.2603","article-title":"A global perspective on the management and outcomes of peripartum cardiomyopathy: a systematic review and meta-analysis","volume":"24","author":"Hoevelmann","year":"2022","journal-title":"Eur J Heart Fail."},{"key":"B24","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/S0140-6736(18)32484-X","article-title":"Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (Tred-Hf): an open-label, pilot, randomised trial","volume":"393","author":"Halliday","year":"2019","journal-title":"Lancet."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1952278\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:18:08Z","timestamp":1788535088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1952278\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":24,"alternative-id":["10.3389\/fmed.2026.1952278"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1952278","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"article-number":"1952278"}}