Cardiology Letters 2025, 34(3):165-170

Bromocriptine in the management of peripartum cardiomyopathy: a review of current evidence

Karolina Stachyra¹, Julia Krasnodębska², Mateusz Leśniewski², Michał Kluska³, Przemysław Kwiatka⁴, Marta Borecka⁴, Arkadiusz Zaremba⁵, Karolina Hanusz⁴, Maciej Wyskok⁶, Anna Bieda⁷, $Monika Szpotańska-Sikorska¹

¹ 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland

² Czerniakowski Hospital, Warsaw, Poland

³ Samodzielny Publiczny Szpital Kliniczny im. prof. W. Orłowskiego CMKP, Warsaw, Poland

⁴ National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland

⁵ Scanmed Rudolf Weigl Hospital in Blachownia, Blachownia, Poland

⁶ Academy of Silesia, Katowice, Poland and 7Masovian Bródnowski Hospital, Warsaw, Poland

Peripartum cardiomyopathy (PPCM) is a severe form of heart failure that occurs during late pregnancy or early postpartum. Bromocriptine, a dopamine agonist that inhibits prolactin secretion, has been proposed as a disease-specific therapy due to its potential role in mitigating the cardiotoxic effects of the 16-kDa prolactin fragment. A comprehensive review of observational studies and clinical trials from PubMed and Google Scholar was conducted, with a focus on original research assessing bromocriptine therapy in PPCM. Data from ClinicalTrials.gov were also analyzed to identify ongoing research efforts. Key outcomes included changes in left ventricular ejection fraction (LVEF), heart failure recovery rates, thromboembolic events, and neonatal outcomes. Bromocriptine therapy was associated with significant improvement in LVEF and RVEF across studies. While an 8-week regimen suggested a numerically greater improvement compared to a 1-week course, the difference did not reach statistical significance in any trial. Bromocriptine treatment required concurrent anticoagulation due to thromboembolic risk, though no significant increase in adverse events was observed. Neonatal outcomes remained unaffected, but the necessity to discontinue breastfeeding remains a key limitation. Overall, bromocriptine improves myocardial recovery in PPCM. However, the lack of large randomized controlled trials limits definitive conclusions regarding optimal treatment duration and safety. Further research is needed to refine patient selection criteria and address long-term implications.

Keywords: peripartum cardiomyopathy; heart failure; Bromocriptine

Published: March 1, 2025  Show citation