Aims and Rationale of a National Registry Integrating Clinical, Echocardiographic, and Multi-Omics Profiling to Promote Precision Medicine in Peripartum Cardiomyopathy.

Background. Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening condition typically presenting as heart failure with reduced ejection fraction in the last month of pregnancy or in the first five months following delivery in women without other known causes of heart failure. PPCM incidence and prevalence are highly variable in different populations and geographical areas. The etiology of PPCM is likely multifactorial, with genetic predisposition, autoimmune conditions, nutritional deficiencies, hormonal and metabolic changes, myocardial inflammation, enhanced oxidative stress, vascular dysfunction, and angiogenic imbalance all listed as possible contributing factors. Objectives. The complexity and multifactorial nature of PPCM can be explored by large-scale "omics" investigations, and their integration has the potential to identify key drivers and pathways that have the largest contribution to the disease. The scarcity of relevant knowledge and experience with most rare diseases raises the unique need for cooperation and networking. Methods and results. In the context of PPCM, we hypothesize that the creation of prospective patient registries could represent an answer to this criticality. Therefore, we created a multicenter national registry of PPCM in different geographical areas in Italy. Conclusions. We expect that the integration of clinical, imaging and omics-based data might provide novel insights into PPCM pathophysiology and allow in the future early detection, risk assessment, and patient-specific therapeutic interventions, thereby offering new perspectives in precision medicine.