{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:48:34Z","timestamp":1790963314261,"version":"4.1.0"},"reference-count":119,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Peripartum cardiomyopathy (PPCM) is a form of heart failure, often severe, that occurs in previously healthy women at the end of their pregnancy or in the first few months after delivery. In PPCM, the recovery of heart function reaches 45\u201350%. However, the all-cause mortality in long-term observation remains high, reaching 20% irrespective of recovery status. The incidence of PPCM is increasing globally; therefore, effort is required to clarify the pathophysiological background of the disease, as well as to discover specific diagnostic and prognostic biomarkers. The etiology of the disease remains unclear, including oxidative stress; inflammation; hormonal disturbances; endothelial, microcirculatory, cardiomyocyte and extracellular matrix dysfunction; fibrosis; and genetic mutations. Currently, antiangiogenic 16-kDa prolactin (PRL), cleaved from standard 23-kDa PRL in the case of unbalanced oxidative stress, is recognized as the main trigger of the disease. In addition, 16-kDa PRL causes damage to cardiomyocytes, acting via microRNA-146a secreted from endothelial cells as a cause of the NF-\u03ba\u03b2 pathway. Bromocriptine, which inhibits the secretion of PRL from the pituitary gland, is now the only specific treatment for PPCM. Many different phenotypes of the disease, as well as cases of non-responders to bromocriptine treatment, indicate other pathophysiological pathways that need further investigation. Biomarkers in PPCM are not well established. There is a deficiency in specific diagnostic biomarkers. Pro-brain-type natriuretic peptide (BNP) and N-terminal BNP are the best, however unspecific, diagnostic biomarkers of heart failure at the moment. Therefore, more efforts should be engaged in investigating more specific biomolecules of a diagnostic and prognostic manner such as 16-kDa PRL, galectin-3, myeloperoxidase, or soluble Fms-like tyrosine kinase-1\/placental growth factor ratio. In this review, we present the current state of knowledge and future directions of exploring PPCM pathophysiology, including microRNA and heat shock proteins, which may improve diagnosis, treatment monitoring, and the development of specific treatment strategies, and consequently improve patients\u2019 prognosis and outcome.<\/jats:p>","DOI":"10.3390\/biom14010103","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T11:43:53Z","timestamp":1705059833000},"page":"103","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Biomarkers in Peripartum Cardiomyopathy\u2014What We Know and What Is Still to Be Found"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-3548","authenticated-orcid":false,"given":"Karolina E.","family":"Kryczka","sequence":"first","affiliation":[{"name":"Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Demkow","sequence":"additional","affiliation":[{"name":"Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zofia","family":"Dzieli\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1093\/eurjhf\/hfq120","article-title":"Current state of knowledge on aetiology, diagnosis, management and therapy of peripartum cardiomyopathy (PPCM): A position statement from the Heart Failure Association of the European Society of Cardiology Working group on PPCM","volume":"12","author":"Sliwa","year":"2010","journal-title":"Eur. J. Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC Guidelines on the management of cardiovascular diseases during pregnancy, the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)","volume":"39","author":"Bauersachs","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_3","first-page":"311","article-title":"A modified definition for peripartum cardiomyopathy and prognosis based on echocardiography","volume":"94","author":"Hibbard","year":"1999","journal-title":"Obstet. Gynecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1093\/eurheartj\/ehad194","article-title":"ESC Scientific Document Group 2023 ESC Guidelines for the management of cardiomyopathies, Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC)","volume":"44","author":"Arbelo","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3094","DOI":"10.1093\/eurheartj\/ehab458","article-title":"Peripartum cardiomyopathy: From genetics to management","volume":"42","author":"Sliwa","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_6","doi-asserted-by":"crossref","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":"ref_7","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"18","author":"Ponikowski","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jacc.2023.04.043","article-title":"Long-Term Outcomes of Women with Peripartum Cardiomyopathy Having Subsequent Pregnancies","volume":"82","author":"Pachariyanon","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","unstructured":"(2023, October 01). WHO International Programme on Chemical Safety Biomarkers in Risk Assessment, Validity and Validation. Available online: http:\/\/www.inchem.org\/documents\/ehc\/ehc\/ehc222.htm."},{"key":"ref_10","first-page":"228","article-title":"Epidemiologic profile of peripartum cardiomyopathy in a tertiary care hospital","volume":"17","author":"Isezuo","year":"2007","journal-title":"Ethn. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.4065\/80.12.1602","article-title":"Five-year prospective study of the incidence and prognosis of peripartum cardiomyopathy at a single institution","volume":"80","author":"Fet","year":"2005","journal-title":"Mayo Clin. Proc."},{"key":"ref_12","first-page":"118","article-title":"Peripartum Cardiomyopathy: Experiences at King Edward VIII Hospital, Durban, South Africa and a Review of the Literature","volume":"25","author":"Desai","year":"1995","journal-title":"Trop. Dr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Nabbaale, J., Okello, E., Kibirige, D., Ssekitoleko, I., Isanga, J., Karungi, P., Sebatta, E., Zhu, Z.W., Nakimuli, A., and Omagino, J. (2020). Burden, predictors and short-term outcomes of peripartum cardiomyopathy in a black African cohort. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0240837"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1536\/ihj.18-729","article-title":"Worldwide Incidence of Peripartum Cardiomyopathy and Overall Maternal Mortality","volume":"60","author":"Isogai","year":"2019","journal-title":"Int. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jacc.2019.11.014","article-title":"Peripartum Cardiomyopathy","volume":"75","author":"Davis","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e001056","DOI":"10.1161\/JAHA.114.001056","article-title":"Temporal Trends in Incidence and Outcomes of Peripartum Cardiomyopathy in the United States: A Nationwide Population-Based Study","volume":"3","author":"Kolte","year":"2014","journal-title":"J. Am. Heart. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1002\/ejhf.780","article-title":"Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM","volume":"19","author":"Sliwa","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.33963\/KP.15586","article-title":"Cardiovascular magnetic resonance imaging of biventricular assist device-induced recovery from acute heart failure in peripartum cardiomyopathy","volume":"78","author":"Kryczka","year":"2020","journal-title":"Kardiol. Pol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1016\/j.echo.2019.07.018","article-title":"Global Left Ventricular Strain at Presentation is Associated with Subsequent Recovery in Patients with Peripartum Cardiomyopathy","volume":"32","author":"Sugahara","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_20","first-page":"CS62","article-title":"Ultrastructural evidence of myocardial capillary remodeling in peripartum cardiomyopathy","volume":"16","author":"Walczak","year":"2010","journal-title":"Med. Sci. Monit."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1016\/j.cell.2006.12.036","article-title":"A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy","volume":"128","author":"Kaminski","year":"2007","journal-title":"Cell"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1172\/JCI64365","article-title":"MicroRNA-146a is a Therapeutic Target and Biomarker for Peripartum Cardiomyopathy","volume":"123","author":"Halkein","year":"2013","journal-title":"J. Clin. Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1038\/nature11040","article-title":"Cardiac angiogenic imbalance leads to peripartum cardiomyopathy","volume":"485","author":"Patten","year":"2012","journal-title":"Nature"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"893","DOI":"10.3389\/fendo.2019.00893","article-title":"A Dysregulation of the Prolactin\/Vasoinhibin Axis Appears to Contribute to Preeclampsia","volume":"10","author":"Lenke","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/cvr\/cvu010","article-title":"Opposing roles of Akt and STAT3 in the protection of the maternal heart from peripartum stress","volume":"101","author":"Bultmann","year":"2014","journal-title":"Cardiovasc. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1016\/j.ajpath.2017.08.022","article-title":"Myofilament Remodeling and Function is More Impaired in Peripartum Cardiomyopathy Compared with Dilated Cardiomyopathy and Ischemic Heart Disease","volume":"187","author":"Bollen","year":"2017","journal-title":"Am. J. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1161\/HYPERTENSIONAHA.116.07371","article-title":"Suppressed Production of Soluble Fms-Like Tyrosine Kinase-1 Contributes to Myocardial Remodeling and Heart Failure","volume":"68","author":"Seno","year":"2016","journal-title":"Hypertension"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Petryka-Mazurkiewicz, J., Kryczka, K., Mazurkiewicz, \u0141., Mi\u0142osz-Wieczorek, B., \u015apiewak, M., Marczak, M., Henzel, J., Grzybowski, J., Demkow, M., and Dzieli\u0144ska, Z. (2021). Cardiovascular Magnetic Resonance in Peripartum Cardiomyopathy: Comparison with Idiopathic Dilated Cardiomyopathy. Diagnostics, 11.","DOI":"10.3390\/diagnostics11101752"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1002\/ejhf.696","article-title":"Myocardial fibrosis: Biomedical research from bench to bedside","volume":"19","author":"Winkler","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/ehf2.12553","article-title":"Outcome in German and South African peripartum cardiomyopathy cohorts associates with medical therapy and fibrosis markers","volume":"7","author":"Azibani","year":"2020","journal-title":"ESC Heart Fail."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Nikolov, A., and Popovski, N. (2022). Extracellular Matrix in Heart Disease, Focus on Circulating Collagen Type I and III Derived Peptides as Biomarkers of Myocardial Fibrosis and Their Potential in the Prognosis of Heart Failure: A Concise Review. Metabolites, 12.","DOI":"10.3390\/metabo12040297"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ejim.2006.09.014","article-title":"Propeptide of procollagen type I (PIP) and outcomes in decompensated heart failure","volume":"18","year":"2007","journal-title":"Eur. J. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Spracklen, T.F., Chakafana, G., Schwartz, P.J., Kotta, M.C., Shaboodien, G., Ntusi, N.A.B., and Sliwa, K. (2021). Genetics of Peripartum Cardiomyopathy: Current Knowledge, Future Directions and Clinical Implications. Genes, 12.","DOI":"10.3390\/genes12010103"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"820","DOI":"10.12659\/AJCR.909601","article-title":"Severe Course of Peripartum Cardiomyopathy and Subsequent Recovery in a Patient with a Novel TTN Gene-Truncating Mutation","volume":"19","author":"Kryczka","year":"2018","journal-title":"Am. J. Case Rep."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Franaszczyk, M., Chmielewski, P., Truszkowska, G., Stawinski, P., Michalak, E., Rydzanicz, M., Sobieszczanska-Malek, M., Pollak, A., Szczygie\u0142, J., and Kosinska, J. (2017). Titin Truncating Variants in Dilated Cardiomyopathy\u2014Prevalence and Genotype-Phenotype Correlations. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0169007"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1001\/jamacardio.2016.0208","article-title":"Recovery of Cardiac Function in Cardiomyopathy Caused by Titin Truncation","volume":"1","author":"Felkin","year":"2016","journal-title":"JAMA Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.jtcvs.2017.10.160","article-title":"Stretch your heart-but not too far: The role of titin mutations in dilated cardiomyopathy","volume":"156","author":"Takayama","year":"2018","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.1172\/JCI94310","article-title":"Loss-of-function mutations in co-chaperone BAG3 destabilize small HSPs and cause cardiomyopathy","volume":"127","author":"Fang","year":"2017","journal-title":"J. Clin. Investig."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1161\/CIRCGENETICS.110.959205","article-title":"Genome-wide significance and replication of the chromosome 12p11.22 locus near the PTHLH gene for peripartum cardiomyopathy","volume":"4","author":"Horne","year":"2011","journal-title":"Circ. Cardiovasc. Genet."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jaccao.2019.09.008","article-title":"Increased cancer prevalence in peripartum cardiomyopathy","volume":"1","author":"Pfeffer","year":"2019","journal-title":"JACC Cardio Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1654","DOI":"10.1253\/circj.CJ-16-1193","article-title":"Imbalanced angiogenesis in peripartum cardiomyopathydiagnostic value of placenta growth factor","volume":"81","author":"Mebazaa","year":"2017","journal-title":"Circ. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1161\/CIRCULATIONAHA.109.901496","article-title":"Evaluation of bromocriptine in the treatment of acute severe peripartum cardiomyopathy: A proof-of-concept pilot study","volume":"121","author":"Sliwa","year":"2010","journal-title":"Circulation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"100064","DOI":"10.1016\/j.jacadv.2022.100064","article-title":"The Utilization and Interpretation of Cardiac Biomarkers During Pregnancy","volume":"1","author":"Sarma","year":"2022","journal-title":"JACC Adv."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1136\/hrt.2005.071233","article-title":"Role of B-type natriuretic peptide (BNP) and NT-proBNP in clinical routine","volume":"92","author":"Weber","year":"2006","journal-title":"Heart"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.ajog.2004.12.006","article-title":"Evaluation of B-type natriuretic peptide (BNP) levels in normal and preeclamptic women","volume":"193","author":"Resnik","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1515\/JPM.2005.023","article-title":"The comparison of amino-terminal probrain natriuretic peptide levels in preeclampsia and normotensive pregnancy","volume":"33","author":"Kale","year":"2005","journal-title":"J. Perinat. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"bvab091","DOI":"10.1210\/jendso\/bvab091","article-title":"Pregnancy-specific Reference Intervals for BNP and NT-pro BNP-Changes in Natriuretic Peptides Related to Pregnancy","volume":"5","author":"Dockree","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijcard.2022.03.052","article-title":"NT-proBNP and predictors of event free survival and left ventricular systolic function recovery in peripartum cardiomyopathy","volume":"357","author":"Imran","year":"2022","journal-title":"Inter. J. Cardiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/cphy.c160033","article-title":"Overview of the Muscle Cytoskeleton","volume":"7","author":"Henderson","year":"2017","journal-title":"Compr. Physiol."},{"key":"ref_50","first-page":"236","article-title":"The Control of Cardiomyocyte Apoptosis via the Beta-Adrenergic Signaling Pathways","volume":"98","author":"Communal","year":"2005","journal-title":"Arch. Mal. Coeur. Vaiss."},{"key":"ref_51","first-page":"1875","article-title":"In peripartum cardiomyopathy plasminogen activator inhibitor-1 is a potential new biomarker with controversial roles","volume":"116","author":"Hoes","year":"2019","journal-title":"Cardiovasc. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1136\/hrt.2006.087387","article-title":"Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy","volume":"93","author":"Hu","year":"2007","journal-title":"Heart"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"15","DOI":"10.29046\/TMF.018.1.012","article-title":"Peripartum Cardiomyopathy: A Cause of Heart Failure in Young Women","volume":"18","author":"Peng","year":"2017","journal-title":"Med. Forum"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Nikuei, P., Rajaei, M., Roozbeh, N., Mohseni, F., Poordarvishi, F., Azad, M., and Haidari, S. (2020). Diagnostic accuracy of sFlt1\/PlGF ratio as a marker for preeclampsia. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-2744-2"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1161\/CIRCULATIONAHA.111.054361","article-title":"Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia","volume":"125","author":"Rana","year":"2012","journal-title":"Circulation"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"173","DOI":"10.5603\/GP.2019.0030","article-title":"The role of disordered angiogenesis tissue markers (sFlt-1; PlGF) in present day diagnosis of preeclampsia","volume":"90","author":"Kwiatkowski","year":"2019","journal-title":"Ginkol. Pol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/nrendo.2015.36","article-title":"New insights in prolactin, pathological implications","volume":"11","author":"Bernard","year":"2015","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1111\/jne.12297","article-title":"Effects of Prolactin and Lactation on A15 Dopamine Neurones in the Rostral Preoptic Area of Female Mice","volume":"27","author":"Brown","year":"2015","journal-title":"J. Neuroendocrinol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.ejheart.2008.07.005","article-title":"Reversal of IFN-gamma; oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy","volume":"10","author":"Forster","year":"2008","journal-title":"Eur. J. Heart Fail."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1002\/ejhf.586","article-title":"Current management of patients with severe acute peripartum cardiomyopathy, practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy","volume":"18","author":"Bauersachs","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"7984","DOI":"10.1158\/0008-5472.CAN-05-0631","article-title":"16-kDa Prolactin Down-Regulates Inducible Nitric Oxide Synthase Expression through Inhibition of the Signal Transducer and Activator of Transcription 1\/IFN Regulatory Factor-1 Pathway","volume":"65","author":"Lee","year":"2005","journal-title":"Cancer Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.bbagen.2005.12.020","article-title":"Galectin-3: An open-ended story","volume":"1760","author":"Dumic","year":"2006","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"885","DOI":"10.2217\/fca.12.65","article-title":"Personalizing biomarker strategies in heart failure with galectin-3","volume":"8","author":"Sherwi","year":"2012","journal-title":"Future Cardiol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/S0735-1097(16)31534-0","article-title":"Galectin-3 levels and outcomes in periprartum cardiomyopathy: Results from the multicenter IPAC Investigation","volume":"67","author":"Groh","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1161\/CIRCHEARTFAILURE.112.971168","article-title":"Genetic and pharmacological inhibition of galectin-3 prevents cardiac remodeling by interfering with myocardial fibrogenesis","volume":"6","author":"Yu","year":"2013","journal-title":"Circ. Heart Fail."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Fulda, S., Gorman, A.M., Hori, O., and Samali, A. (2010). Cellular stress responses, cell survival and cell death. Int. J. Cell Biol., 2010.","DOI":"10.1155\/2010\/214074"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S0735-1097(99)00624-5","article-title":"Peripartum cardiomyopathy, analysis of clinical outcome, left ventricular function, plasma levels of cytokines and Fas\/APO-1","volume":"35","author":"Sliwa","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1093\/eurheartj\/ehi481","article-title":"Peripartum cardiomyopathy, inflammatory markers as predictors of outcome in 100 prospectively studied patients","volume":"27","author":"Sliwa","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1515\/hsz-2015-0149","article-title":"C-reactive protein and inflammation, conformational changes affect function","volume":"396","author":"Wu","year":"2015","journal-title":"Biol. Chem."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"C771","DOI":"10.1152\/ajpcell.00532.2003","article-title":"Interleukin-6-induced JAK2\/STAT3 signaling pathway in endothelial cells is suppressed by hemodynamic flow","volume":"287","author":"Ni","year":"2004","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.yjmcc.2009.03.019","article-title":"Activation of the protective Survivor Activating Factor Enhancement (SAFE) pathway against reperfusion injury: Does it go beyond the RISK pathway?","volume":"47","author":"Lecour","year":"2009","journal-title":"J. Mol. Cell Cardiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1146\/annurev.physiol.65.092101.142249","article-title":"Stress-activated cytokines and the heart: From adaptation to maladaptation","volume":"65","author":"Mann","year":"2003","journal-title":"Annu. Rev. Physiol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S1388-9842(02)00008-9","article-title":"The addition of pentoxifylline to conventional therapy improves outcome in patients with peripartum cardiomyopathy","volume":"4","author":"Sliwa","year":"2002","journal-title":"Eur. J. Heart Fail."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/imm.12273","article-title":"Critical role of the endogenous interferon ligand-receptors in type I and type II interferons response","volume":"142","author":"Lasfar","year":"2014","journal-title":"Immunology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1038\/icb.2012.9","article-title":"The interferons and their receptors\u2014Distribution and regulation","volume":"90","author":"Weerd","year":"2012","journal-title":"Immunol. Cell Biol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/j.1600-065X.2008.00707.x","article-title":"Regulation of interferon and toll-like receptor signaling during macrophage activation by opposing feedforward and feedback inhibition mechanisms","volume":"226","author":"Hu","year":"2008","journal-title":"Immunol. Rev."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.1111\/j.1755-5922.2010.00171.x","article-title":"Plasminogen activator inhibitor-1 (PAI-1): A key factor linking fibrinolysis and age-related subclinical and clinical conditions","volume":"28","author":"Cesari","year":"2010","journal-title":"Cardiovasc. Ther."},{"key":"ref_78","first-page":"1127","article-title":"Autoantibodies against the myocardial \u03b21-adrenergic and M2-muscarinic receptors in patients with congestive heart failure","volume":"115","author":"Zhang","year":"2002","journal-title":"Chin. Med. J."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1172\/JCI114888","article-title":"Mapping of a Functional Autoimmune Epitope on the Adrenergic Receptor in Patients with Idiopathic Dilated Cardiomyopathy","volume":"86","author":"Magnusson","year":"1990","journal-title":"J. Clin. Investig."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1113\/EP088263","article-title":"The relationship between \u03b21-adrenergic and M2-muscarinic receptor autoantibodies and hypertrophic cardiomyopathy","volume":"105","author":"Duan","year":"2020","journal-title":"Exp. Physiol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1161\/CIRCULATIONAHA.106.683193","article-title":"\u03b21-Adrenergic receptor autoantibodies mediate dilated cardiomyopathy by agonistically inducing cardiomyocyte apoptosis","volume":"116","author":"Altuntas","year":"2007","journal-title":"Circulation"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.ijcard.2009.11.025","article-title":"Opposing cardiac effect of autoantibody activation of \u03b2-adrenergic and M2 muscarinic receptors in cardiac-related diseases","volume":"148","author":"Stavrakis","year":"2011","journal-title":"Int. J. Cardiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1161\/01.CIR.94.1.102","article-title":"Physiological and biochemical evidence for coordinate increases in muscarinic receptors and Gi during pacing-induced heart failure","volume":"94","author":"Vatner","year":"1996","journal-title":"Circulation"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s00395-015-0517-2","article-title":"Evidence of autoantibodies against cardiac troponin I and sarcomeric myosin in peripartum cardiomyopathy","volume":"110","author":"Haghikia","year":"2015","journal-title":"Basic Res. Cardiol."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Liu, J., Wang, Y., Chen, M., Zhao, W., Wang, X., Wang, H., Zhang, Z., Zhang, J., Xu, L., and Chen, J. (2014). The Correlation between Peripartum Cardiomyopathy and Autoantibodies against Cardiovascular Receptors. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0086770"},{"key":"ref_86","first-page":"471","article-title":"Successful Treatment of Peripartum Cardiomyopathy with Plasmapheresis","volume":"29","author":"Wang","year":"2013","journal-title":"Acta Cardiol. Sin."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.pharmthera.2005.06.023","article-title":"Myeloperoxidase and its contributory role in inflammatory vascular disease","volume":"111","author":"Lau","year":"2006","journal-title":"Pharmacol. Ther."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"41279","DOI":"10.1074\/jbc.M106958200","article-title":"Hypochlorous acid oxygenates the cysteine switch domain of pro-matrilysin (MMP-7). A mechanism for matrix metalloproteinase activation and atherosclerotic plaque rupture by myeloperoxidase","volume":"276","author":"Fu","year":"2001","journal-title":"J. Biol. Chem."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3109\/10715769809065797","article-title":"The oxidative inactivation of tissue inhibitor of metalloproteinase-1 (TIMP-1) by hypochlorous acid (HOCl) is suppressed by anti-rheumatic drugs","volume":"28","author":"Shabani","year":"1998","journal-title":"Free Radic. Res."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1373\/clinchem.2009.142257","article-title":"Use of myeloperoxidase for risk stratification in acute heart failure","volume":"56","author":"Reichlin","year":"2010","journal-title":"Clin. Chem."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Serraino, G.F., Jiritano, F., Costa, D., Ielapi, N., Napolitano, D., Mastroroberto, P., Bracale, U.M., Andreucci, M., and Serra, R. (2023). Metalloproteinases and Hypertrophic Cardiomyopathy: A Systematic Review. Biomolecules, 13.","DOI":"10.3390\/biom13040665"},{"key":"ref_92","first-page":"845","article-title":"Serum Matrix Metalloproteinases as Quantitative Biomarkers for Myocardial Fibrosis and Sudden Cardiac Death Risk Stratification in Patients with Hypertrophic Cardiomyopathy","volume":"2","author":"Avanesov","year":"2016","journal-title":"J. Card. Fail."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1161\/CIRCHEARTFAILURE.111.966200","article-title":"Circulating Matrix Metalloproteinases in Adolescents with Hypertrophic Cardiomyopathy and Ventricular Arrhythmia","volume":"5","author":"Zachariah","year":"2012","journal-title":"Circ. Heart Fail."},{"key":"ref_94","first-page":"87","article-title":"TIMP-1 promotes VEGF-induced neovascularization in the retina","volume":"16","author":"Yamada","year":"2001","journal-title":"Histol. Histopathol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.bbrc.2006.11.080","article-title":"MicroRNAs preferentially target the genes with high transcriptional regulation complexity","volume":"352","author":"Cui","year":"2007","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/nrc1840","article-title":"Oncomirs\u2014microRNAs with a role in cancer","volume":"6","author":"Slack","year":"2006","journal-title":"Nat. Rev. Cancer"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1038\/aps.2018.30","article-title":"miRNAs in cardiovascular diseases, potential biomarkers: Therapeutic targets and challenges","volume":"39","author":"Zhou","year":"2018","journal-title":"Acta Pharmacol. Sin."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.advms.2019.04.003","article-title":"microRNA expression profile in Smooth Muscle Cells isolated from thoracic aortic aneurysm samples","volume":"64","author":"Wojciechowska","year":"2019","journal-title":"Adv. Med. Sci."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1161\/ATVBAHA.114.303425","article-title":"Role of Flow-Sensitive microRNAs in Endothelial Dysfunction and Atherosclerosis. Mechanosensitive Athero-miRs","volume":"34","author":"Kumar","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/j.athoracsur.2016.03.061","article-title":"Unbiased Profile of MicroRNA Expression in Ascending Aortic Aneurysm Tissue Appoints Molecular Pathways Contributing to the Pathology","volume":"102","author":"Licholai","year":"2016","journal-title":"Ann. Thorac. Surg."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"361","DOI":"10.20452\/pamw.1093","article-title":"Role of microRNAs in endothelial cell pathophysiology","volume":"121","author":"Staszel","year":"2011","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"633013","DOI":"10.3389\/fcvm.2021.633013","article-title":"Heat Shock Proteins, Potential Modulators and Candidate Biomarkers of Peripartum Cardiomyopathy","volume":"8","author":"Chakafana","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1093\/eurheartj\/ehx355","article-title":"Bromocriptine for the treatment of peripartum cardiomyopathy: A multicentre randomized study","volume":"38","author":"Haghikia","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1164\/rccm.201707-1371OC","article-title":"Anti-sFlt-1 Therapy Preserves Lung Alveolar and Vascular Growth in Antenatal Models of Bronchopulmonary Dysplasia","volume":"197","author":"Wallace","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.omtm.2020.05.030","article-title":"Synthetic mRNA Encoding VEGF-A in Patients Undergoing Coronary Artery Bypass Grafting: Design of a Phase 2a Clinical Trial","volume":"18","author":"Anttila","year":"2020","journal-title":"Mol. Ther. Methods Clin. Dev."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"3375","DOI":"10.1002\/ehf2.13412","article-title":"Perhexiline treatment improves toxic effects of \u03b2-adrenergic receptor stimulation in experimental peripartum cardiomyopathy","volume":"8","author":"Pfeffer","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1002\/ejhf.312","article-title":"Searching for new mechanisms of myocardial fibrosis with diagnostic and\/or therapeutic potential","volume":"17","author":"Heymans","year":"2015","journal-title":"Eur. J. Heart Fail."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.jacc.2009.12.074","article-title":"Prognostic significance of myocardial fibrosis quantification by histopathology and magnetic resonance imaging in patients with severe aortic valve disease","volume":"56","author":"Azevedo","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1253\/circj.CJ-11-0568","article-title":"Prognostic impact of myocardial interstitial fibrosis in non-ischemic heart failure\u2014Comparison between preserved and reduced ejection fraction heart failure","volume":"75","author":"Aoki","year":"2011","journal-title":"Circ. J."},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Siraki, A.G. (2021). The many roles of myeloperoxidase: From inflammation and immunity to biomarkers, drug metabolism and drug discovery. Redox Biol., 46.","DOI":"10.1016\/j.redox.2021.102109"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/S0140-6736(00)02060-2","article-title":"Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations","volume":"355","author":"Troughton","year":"2000","journal-title":"Lancet"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1016\/j.jacc.2006.10.081","article-title":"Plasma brain natriuretic peptide-guided therapy to improve outcome in heart failure: The STARS-BNP Multicenter Study","volume":"49","author":"Jourdain","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jacc.2009.02.095","article-title":"N-terminal pro-B-type natriuretic peptide-guided treatment for chronic heart failure: Results from the BATTLESCARRED (NT-proBNP-Assisted Treatment to Lessen Serial Cardiac Readmissions and Death) trial","volume":"55","author":"Lainchbury","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1001\/jama.2017.10565","article-title":"Effect of natriuretic peptideguided therapy on hospitalization or cardiovascular mortality in high-risk patients with heart failure and reduced ejection fraction: A randomized clinical trial","volume":"318","author":"Felker","year":"2017","journal-title":"JAMA"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1001\/jama.2009.2","article-title":"BNP-guided vs symptom-guided heart failure therapy: The Trial of Intensified vs Standard Medical Therapy in Elderly Patients with Congestive Heart Failure (TIME-CHF) randomized trial","volume":"301","author":"Pfisterer","year":"2009","journal-title":"JAMA"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1001\/archinternmed.2010.35","article-title":"B-type natriuretic peptide-guided heart failure therapy: A meta-analysis","volume":"170","author":"Porapakkham","year":"2010","journal-title":"Arch. Intern. Med."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1093\/eurheartj\/ehu090","article-title":"Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: An individual patient meta-analysis","volume":"35","author":"Troughton","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1016\/j.jchf.2023.07.028","article-title":"Proteomic Profiling in Patients with Peripartum Cardiomyopathy: A Biomarker Study of the ESC EORP PPCM Registry","volume":"11","author":"Kodogo","year":"2023","journal-title":"JACC Heart Fail."}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/1\/103\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:45:54Z","timestamp":1760103954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/14\/1\/103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,12]]},"references-count":119,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["biom14010103"],"URL":"https:\/\/doi.org\/10.3390\/biom14010103","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,12]]}}}