Clinical Features and Outcomes of Peripartum Cardiomyopathy in Nigeria

Karaye, Kamilu M; Saidu, Hadiza; Balarabe, Sulaiman A.; Ishaq, Naser A.; Adamu, Umar; Mohammed, Idris Y.; Oboirien, Isa; Umuerri, Ejiroghene Martha; Mankwe, Abaram Chesa; Shidali, Vincent; Njoku, Paschal; Dodiyi‐Manuel, Sotonye; Olunuga, Taiwo; Josephs, Veronica; Mbakwem, Amam; Okolie, Henry; Talle, Mohammed Abdullahi; Isa, M S; Ogah, Okechukwu S; Stewart, Simon

doi:10.1016/j.jacc.2020.09.540

Cited by 33 publications

(45 citation statements)

References 23 publications

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“…20,21 As previously observed, significant myocardial function recovery in PPCM patients occurs even when HF treatment is suboptimal. 9,16 In the present study, the proportion of specific causes of deaths due to worsening HF and sudden deaths were similar in the two groups, although the proportion of unknown causes of deaths was lower in Kano than the other study sites, perhaps due to a more meticulous data collection. The factors independently associated with reduced risk of mortality in this study included Kano residency, a unit change in age, and regular use of beta-blockers at the sixth follow-up month.…”

Section: Discussioncontrasting

confidence: 43%

“…This paper is a post hoc analysis of PEACE registry data, and the detailed study protocol has already been published but summarized below. 9,10…”

Section: Methodsmentioning

confidence: 99%

“…All authors made the decision to submit the manuscript for publication and testify to the standard of conduct of the study. This paper is a post hoc analysis of PEACE registry data, and the detailed study protocol has already been published but summarized below 9,10 …”

Section: Methodsmentioning

confidence: 99%

“…8 In the original report of the PEACE registry, we also described elevated mortality rates accompanied by low rates of recovery of LV function in Nigeria overall. 9 However, we did not specifically examine if these were driven by key regional differences.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria

et al. 2021

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AimsThe prospective, multicentre Peripartum Cardiomyopathy in Nigeria (PEACE) registry originally demonstrated a high prevalence of peripartum cardiomyopathy (PPCM) among patients originating from Kano, North-West Nigeria. In a post hoc analysis, we sought to determine if this phenomenon was characterized by a differential case profile and outcome among PPCM cases originating elsewhere. Methods and results Overall, 199 (81.6%) of a total 244 PPCM patients were recruited from three sites in Kano, compared with 45 patients (18.4%) from 11 widely dispersed centres across Nigeria. Presence and extent of ventricular myocardial remodelling during follow-up, relative to baseline status, were assessed by echocardiography. During median 17 months follow-up, Kano patients demonstrated significantly better myocardial reverse remodelling than patients from other sites. Overall, 50.6% of patients from Kano versus 28.6% from other regions were asymptomatic (P = 0.029) at study completion, with an accompanying difference in all-cause mortality (17.6% vs. 22.2% respectively, P = 0.523) not reaching statistical significance. Alternatively, 135/191 (84.9%) of Kano patients had selenium deficiency (<70 μg/L), and 46/135 (34.1%) of them received oral selenium supplementation. Critically, those that received selenium supplementation demonstrated better survival (6.5% vs. 21.2%; P = 0.025), but the supplement did not have significant impact on myocardial remodelling. Conclusions This study has shown important non-racial regional disparities in the clinical features and outcomes of PPCM patients in Nigeria, that might partly be explained by selenium supplementation.

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Section: Discussioncontrasting

confidence: 43%

“…This paper is a post hoc analysis of PEACE registry data, and the detailed study protocol has already been published but summarized below. 9,10…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria

et al. 2021

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“…Follow-up will be concluded in 2021. Many lessons will be learned from this program but also from the multi-centre Nigerian PEACE PPCM registry [ 9 ] and the large clinical service dedicated to women with PPCM in Iraq [ 10 ] .…”

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confidence: 99%

Time for cardiac care in pregnancy: beyond 42 days post-partum

Sliwa

Mocumbi

2021

gcsp

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[first paragraph of article]Avoidable deaths from pregnancy complications occur on a global scale, with the greatest burden of mortality among women in low-to-middle income countries [1]. Most countries record maternal death only up to 42 days postpartum because of the assumption that avoidable death in pregnant women occurs during pregnancy or shortly thereafter. Although limited, the available data suggest otherwise.

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Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy

Cooney

Scott

Mahowald

et al. 2022

Clinical Cardiology

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Background: Delays in diagnosis of peripartum cardiomyopathy (PPCM) are common and are associated with worse outcomes; however, few studies have addressed methods for improving early detection. Hypothesis:We hypothesized that easily accessible data (heart rate [HR] and electrocardiograms [ECGs]) could identify women with more severe PPCM and at increased risk of adverse outcomes.Methods: Clinical data, including HR and ECG, from patients diagnosed with PPCM between January 1998 and July 2016 at our institution were collected and analyzed.Linear and logistic regression were used to analyze the relationship between HR at diagnosis and the left ventricular ejection fraction (LVEF) at diagnosis. Outcomes included overall mortality, recovery status, and major adverse cardiac events.Results: Among 82 patients meeting inclusion criteria, the overall mean LVEF at diagnosis was 26 ± 11.1%. Sinus tachycardia (HR > 100) was present in a total of 50 patients (60.9%) at the time of diagnosis. In linear regression, HR significantly predicted lower LVEF (F = 30.00, p < .0001). With age-adjusted logistic regression, elevated HR at diagnosis was associated with a fivefold higher risk of overall mortality when initial HR was >110 beats per minute (adjusted odds ratio 5.35, confidence interval 1.23-23.28), p = .025). Conclusion:In this study, sinus tachycardia in women with PPCM was associated with lower LVEF at the time of diagnosis. Tachycardia in the peripartum period should raise concern for cardiomyopathy and may be an early indicator of adverse prognosis.

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Clinical Features and Outcomes of Peripartum Cardiomyopathy in Nigeria

Cited by 33 publications

References 23 publications

Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria

Disparities in clinical features and outcomes of peripartum cardiomyopathy in high versus low prevalent regions in Nigeria

Time for cardiac care in pregnancy: beyond 42 days post-partum

Heart rate as an early predictor of severe cardiomyopathy and increased mortality in peripartum cardiomyopathy

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