Taurine as an adjunct therapy for early left ventricular recovery in peripartum cardiomyopathy

Abstract

Background and Aims: The pathophysiology of peripartum cardiomyopathy is not fully understood. Despite standard medical therapy, both morbidity and mortality remain high. Restoration of inflammatory cytokine balance may hold promise for therapy. Taurine has a powerful immune-modulatory and anti-inflammatory in addition to positive inotropic effect. This study evaluates the effect of taurine infusion on clinical status, left ventricular function, circulating plasma levels of N-terminal brain natriuretic peptide and C-reactive protein in women with peripartum cardiomyopathy. Methods: Forty women with peripartum cardiomyopathy admitted postpartum to the ICU were randomly assigned to one of two groups (20 in each group): Group T received taurine infusion and Group C received normal saline infusion over 24 hours for 5 days. Both groups received standard heart failure therapy according the institutional treatment protocol. Results: In the taurine group on day 5, there was a significant reduction in LVEDD and LVESD and significant increase in LVEF. All patients had an improvement in LVEF of at least 10% and 5 patients had recovery of LVEF to ≥50% on day 5 while the other 15 patients had LVEF 45- 50%. In the control group on day 5, there was non-significant change in LVEDD, LVESD and LVEF and no patient had recovery of LVEF to ≥50% or showed improvement in LVEF more than 10%. NYHA functional class showed significant increase on day 5 in the taurine group compared to the control group. Seventeen patients (85%) in the taurine group showed improvement of the NYHA functional class at day 5. In contrast, only 2 patients (10%) in the control group showed improvement of NYHA functional class at day 5. Conclusion: Early addition of taurine infusion to standard heart failure therapy improves both; echocardiographic parameters and laboratory parameters but without clinically significant changes in women with peripartum cardiomyopathy.