Dr. Fett??

[emrichardson04]

I recently learned the female body secretes a hormone that helps prevent heart disease..... unless a woman smokes.... then that depletes the hormone. Well, I wonder.... I have to admit I used to smoke... I smoked throughout my entire pregnancy..... unfortunately.... I slacked off but never could completely give it up.... I wonder if there is a record of the women in the study.... how many of which may have smoked during their pregnancies??? Does that make sense? I hope so.

[JAMESFETT]

Hormones are very important. In PPCM the hormone, prolactin, involved in providing breast milk, may be important in the development of PPCM (excess may increase risk to develop PPCM). Also, the hormone, relaxin, which in pregnancy helps the heart work harder) may be important in the development of PPCM (deficiency may increase the risk to develop PPCM). In the article you refer to, by reading the fine print, and methodology/results of study, you should be able to learn how many smoked.

JDF

[heartfulloflove]

Um...this is interesting. Periodically, I get soaring prolactin levels. In fact, they did blood work on me once and were convinced I had a prolactin-secreting tumor because the levels were staggering. A re-test showed that they had fallen dramatically, but later testing showed another elevation. No one has an answer on this, I just periodically go anovulatory and get these elevations. Now I guess my cardiologist ruled out PPCM for me because he said in PPCM first the pumping decreases then the heart enlarges because it's weakened. In my case, my ejection fraction was preserved and my enlargement was not at end diastole but end systole. But something obviously went on and this is sort of curious.

[JAMESFETT]

There are reports in the medical literature associating very small prolactin-secreting tumors in the pituitary gland of the brain associated with a dilated cardiomyopathy in humans. In our recent Lancet journal article we cite the animal mouse model for PPCM in which prolactin levels are intimately involved in the development of cardiomyopathy. It's a very complex relationship, but the complex molecular physiology is where advances are being made in research on PPCM--and where suggestions for new treatments are originating.

JDF

[heartfulloflove]

I recently learned the female body secretes a hormone that helps prevent heart disease..... unless a woman smokes.... then that depletes the hormone. Well, I wonder.... I have to admit I used to smoke... I smoked throughout my entire pregnancy..... unfortunately.... I slacked off but never could completely give it up.... I wonder if there is a record of the women in the study.... how many of which may have smoked during their pregnancies??? Does that make sense? I hope so.

I think they're talking about coronary artery disease.

If it makes you feel any better, I smoked during the first two months of my first pregnancy before finally quitting cold turkey because the cut-down method didn't work at all. Nothing happened to my heart. I never touched another cigarette again (three years woo hoo!) but it was my second pregnancy that my heart enlarged out of normal limits. Go figure! :rolleyes:

[heartfulloflove]

There are reports in the medical literature associating very small prolactin-secreting tumors in the pituitary gland of the brain associated with a dilated cardiomyopathy in humans. In our recent Lancet journal article we cite the animal mouse model for PPCM in which prolactin levels are intimately involved in the development of cardiomyopathy. It's a very complex relationship, but the complex molecular physiology is where advances are being made in research on PPCM--and where suggestions for new treatments are originating.

JDF

Hmm. I wonder if this means I'm at risk? Of course this new info on top of my CMV concerns makes me think I probably shouldn't overthink it because I could quickly and easily drive myself nuts. I do sort of question my wacky prolactin levels though, in terms of why. I had a brain MRI about 4 years ago after my first insanely high level came back and there was no pituitary tumor.

[emrichardson04]

Dr. Fett,

I didn't read this in any article or online.... this is going to sound funny but I took a hazardous waste course this week and my teacher got off subject somehow and mentioned that..... I passed the course by the way... Woo Hoo!!!! and Tomorrow will be 9 months free of cigarettes for me! Woo hoo again!!!! But if you could post a link to the article you were referring to I'd really find that information interesting.... thanks.

[JAMESFETT]

If you go to home page on this site and click on "news" there is an attached copy of our Lancet article [Sliwa, Fett, Elkayam. Peripartum cardiomyopathy. Lancet 2006 (Aug 19);368:687-93.]

JDF

[JAMESFETT]

P.S. Good for you, stopping smoking!!! You can find the article about relaxin in [Ansari AA, Fett JD, Carraway RE, et al. Autoimmune mechanisms as the basis for human periprtum cardiomyopathy. Clinical reviews in Allergy and Immunology 2002;23:301-24.]

JDF

[JAMESFETT]

PPS: In our series of 99 PPCM patients (Haiti), approximately 15 percent used tobacco in any form. That is almost identical to the use of tobacco in 80 control healthy patients. I haven't seen any US studies that identify the number who smoked. We know, however, that smoking can have adverse effects on placental blood flow and birth weights. You are strong to have finally stopped.

JDF

[SerenaWelsh]

Elizabeth,

I just wanted to add that if you'd like to conduct your own informal study, you could post a poll under "general" asking how many women smoked before being diagnosed.

Certainly, you're not going to get research quality info this way, but it's great for satisfying the "I wonders..."