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IPAC, Investigations in Pregnancy Associated Cardiomyopathy

IPAC is an NHLBI-funded study of the role of immune activation and myocardial recovery in peripartum cardiomyopathy (PPCM). This study will enroll 100 women at 30 centers, all newly diagnosed with PPCM and less than 2 months post partum. IPAC will continue enrollment through August 2011 and will complete all follow up by September 2012.

The pathogenesis of myocardial dysfunction in PPCM is postulated to be an inflammatory myocarditis initiated by the resetting of maternal immunity in the peripartum period. Previous investigations in single centers have been limited in study number due to the rarity of the disorder. The IPAC study will examine in a larger multicenter series whether an abnormal maternal immune reaction (either of the cellular immune response or auto-antibodies) leads to the myocardial injury and dysfunction evident in PPCM. Subjects will have cellular and humoral immune function assayed in the peripheral circulation at several time points during the first year postpartum and investigators will explore whether these immune "biomarkers" predict subsequent recovery. A subset of participants will also have cardiac magnetic resonance imaging (cMR) to look for evidence of myocardial inflammation or injury and determine if these findings correlate with the degree of immune activation.

Through the IPAC study, the PCN investigators will explore the pathogenesis of PPCM, and examine the role of both biomarkers and cMR to predict subsequent myocardial recovery. The study will be observational as the medical treatment will remain standard heart failure therapy. The hope of the PCN investigators is that the results of IPAC will facilitate future evaluation of novel therapies for this disorder.