Peripartum cardiomyopathy in Europe: new insights from the UK Charle Viljoen 1,2 , Julian Hoevelmann 1,3 , and Karen Sliwa 1,2 * 1 Cape Heart Institute, Faculty of Health Sciences, University of Cape Town, 4th Floor, Chris Barnard Building, Anzio Road, Observatory, 7925 Cape Town, South Africa; 2 Division of Cardiology, Department of Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa; and 3 Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany This editorial refers to ‘A 20-year population study of peripartum cardiomyopathy’, by A.M. Jackson et al., https://doi.org/ 10.1093/eurheartj/ehad626. Peripartum cardiomyopathy (PPCM) is an idiopathic form of dilated cardiomyopathy, characterized by a reduced left ventricular ejection fraction (LVEF) of <45%, which manifests towards the end of the third trimester of pregnancy or within the frst months after delivery. 1 Over the past two decades, extensive research has been done to improve our understanding of PPCM. 2 The aetiology of the disease is believed to involve multiple factors. Recent research endorses a ‘two-hit’ theory, where the ‘frst hit’ signifes a pre-existing predisposition, and the ‘se- cond hit’ denotes an imbalanced hormonal environment during the peripartum period ultimately leading to cardiomyopathy. 2,3 The clinical Graphical Abstract Proteomics and metabolomics Better predictors of long-term outcome More data on neonatal outcome Safety of subsequent pregnancies Better understanding of genetic involvement More research on epidemiology Improvements in drug therapy Safety of discontinuing drug therapy in women with LV recovery Unmet needs in PPCM research LV recovery Unmet research domains in peripartum cardiomyopathy. The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology. * Corresponding author. Tel: +27 21 4066457, Fax: +27 21 4478789, Email: karen.sliwa-hahnle@uct.ac.za © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com European Heart Journal (2023) 00, 1–4 https://doi.org/10.1093/eurheartj/ehad724 EDITORIAL Heart failure and cardiomyopathies Downloaded from https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehad724/7332052 by guest on 31 October 2023