Aims The aim of this study was to describe the incidence, clinical characteristics and risk factors of peripartum cardiomyopathy (PPCM) in Nigeria. Methods and Results The study was conducted in 22 hospitals in Nigeria, and PPCM patients were consecutively recruited between June 2017 and March 2018. To determine factors associated with PPCM, the patients were compared with apparently healthy women who recently delivered, as controls. Four hundred six patients were compared with 99 controls. The incidence and disease burden (based on the rate of consecutive recruitment of subjects) varied widely between the six geographical zones of Nigeria. From the North–West zone, 72.3% of the patients was recruited, where an incidence as high as 1 per 96 live births was obtained in a centre, while the disease was uncommon (7.6% of all recruited patients) in the South. Majority of the patients (76.6%) and controls (74.8%) (p = 0.694) were of Hausa–Fulani ethnic group. Atrial fibrillation, intracardiac thrombus, stroke, and right ventricular systolic dysfunction were found in 1.7%, 6.4%, 2.2%, and 54.9% of the patients, respectively. Lack of formal education (odds ratio [OR] 3.08, 95% confidence interval [1.71, 5.53]; P < 0.001), unemployment (OR: 3.28 [2.05, 5.24]; P < 0.001), underweight (OR: 13.43 [4.17, 43.21]; P < 0.001) and history of pre‐eclampsia (OR: 9.01 [2.18, 37.75]; P = 0.002) emerged as independent PPCM risk factors using regression models. Customary hot baths (OR: 1.24 [0.80, 1.93]; P = 0.344), pap enriched with dried lake salt (OR: 1.20 [0.74, 1.94]; P = 0.451), and Hausa–Fulani ethnicity (OR: 1.11 [0.67, 1.84]; P = 0.698) did not achieve significance as PPCM risk factors. Conclusions In Nigeria, the burden of PPCM was greatest in the North–West zone, which has the highest known incidence. PPCM was predicted by sociodemographic factors and pre‐eclampsia, which should be considered in its control at population level. Postpartum customary birth practices and Hausa–Fulani ethnicity were not associated with PPCM in Nigeria.
Background: Diabetes mellitus (DM) is a risk factor for left ventricular (LV) dysfunction, and microalbuminuria is frequently associated with DM. This study aimed to compare LV function among normotensive type 2 diabetes (T2DM) patients with normoalbuminuria, those with microalbuminuria, and healthy controls. Methods: This was a cross-sectional study conducted at the diabetes and cardiology clinics of the
To compare left ventricular (LV) geometry patterns among normotensive type 2 diabetics (NT2DM) with normoalbuminuria, NT2DM with microalbuminuria and healthy controls. A cross-sectional study conducted at the medical outpatient department of a Teaching Hospital from January 2013 to March 2014. Sixty-three normoalbuminuric NT2DM, 71 microalbuminuric NT2DM and fifty-nine healthy controls were recruited. Microalbuminuria was tested for using Micral test strips (Roche, Germany). Trans-thoracic echocardiography was carried out on all subjects. Relative wall thickness (RWT), left ventricular mass index (LVMI) and LV geometry patterns were compared among the three groups. The three groups were age and sex-matched and appropriate statistical tests were used for comparisons with p<0.05. The proportions of abnormal LV geometry (33.3% vs 71.4% vs 84.5%), LVMI and RWT showed a significant stepwise increase from healthy controls through normoalbuminuric NT2DM and to microalbuminuric NT2DM (all p<0.01). Concentric remodeling (CR) was the commonest pattern among the three groups. Left ventricular mass index and RWT correlated significantly with duration of DM and body mass index (all p< 0.01). Microalbuminuria showed a strong direct association with abnormal LV geometry (OR 3.27, 95% CI 1.63-6.57, p<0.01) while duration of DM was found to be an independent predictor of LV geometry remodeling (OR 1.23, 95% CI 1.02-1.49, p = 0.03) among normotensive diabetics. Although CR was the commonest pattern across the three patient groups, those with microalbuminuria had the highest proportion and risk of LV remodeling. Early screening and prompt treatment of microalbuminuria in NT2DM is hereby recommended.
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