Epidemiology and Etiology of Cardiomyopathy in Africa

Abstract

Background— Cardiomyopathy, an often irreversible form of heart muscle disease that is associated with a dismal outcome, is endemic in Africa. The primary objective of this review was to summarize the current state of knowledge on the epidemiology and etiology of cardiomyopathy in people living in Africa and to identify new avenues for research. Methods and Results— We searched MEDLINE (January 1, 1966, through February 12, 2005) and reference lists of articles for relevant references. Unlike other parts of the world in which cardiomyopathy is rare, dilated cardiomyopathy is a major cause of heart failure throughout Africa. Similarly, peripartum cardiomyopathy is ubiquitous on the continent, with an incidence ranging from 1 in 100 to 1 in 1000 deliveries. There is an apparent marked regional variation in the pathogenesis of dilated cardiomyopathy and peripartum cardiomyopathy, underlining the heterogeneity of causative factors in these conditions. By contrast, endomyocardial fibrosis is restricted to the tropical regions of East, Central, and West Africa. Although the pathogenesis of endomyocardial fibrosis is not fully understood, it seems that the conditioning factors are geography and diet, the triggering factor may be an as yet unidentified infective agent, and the perpetuating factor is eosinophilia. Although epidemiological studies are lacking, hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy seem to have characteristics similar to those of other populations elsewhere in the world. Conclusions— There is a need for large-scale epidemiological studies of the incidence, prevalence, determinants, and outcome of cardiomyopathy in Africa to inform strategies for the treatment and prevention of heart muscle disease on the continent.

Myocardial Infarction; New Onset Heart Failure After Mi. Its Frequency and Factors Contributing It

“…19 Rapidly changing lifestyles in the developing nations has been increasing the incidence of IHD at a tremendous rate. So the rate of new onset HF and its epidemiology 13 is expected to rise in parallel over here. Moreover there can still be a significant difference in clinical practices and facilities available for management of post MI patients, like use of SK instead of tPA, very less number of primary PCIs, prolonged times from onset of MI and presentation to hospital.…”

“…[9][10][11][12] In the developing nations where valvular heart disease was once the commonest cause for heart failure, a rapid surge in IHD incidence is expected to change the epidemiology of HF as well. 13 Although HF is common in patients suffering from various ischemic syndrome, its occurrence acutely after an episode of MI has not been extensively studied even in the west, especially in terms of the factors contributing it after such an event.…”

Miocardiopatía periparto: Caso clínico

“…Los reportes acerca de la incidencia de MCPP varían de acuerdo a la situación geográfica, con cifras que van desde 1:5.000 en EEUU, 1:1000 en Sudáfrica hasta 1:300 en Haití y 1:100 en Nigeria, siendo en estos últimos donde más estudios sobre MCPP se han realizado 1 . Entre las razones que podrían explicar la diferencia entre las incidencias se encuentra la aplicación de diferentes criterios diagnósticos, la poca exclusión de otras enfermedades y las diferencias culturales, como la ingesta de sal durante el embarazo y el período puerperal 2 .…”

“…1 Se caracteriza por disfunción sistólica del ventrí-culo izquierdo (VI) y posterior aparición de síntomas de falla cardíaca, los cuales pueden ocurrir durante el último mes de gestación y los primeros cinco meses postparto. 2 Su etiología no está del todo aclarada, pero se plantean diferentes teorías.…”

The burden of cardiovascular disease in Sub-Saharan Africa

“…Occasionally the disease is familial with specifi c candidate genes recently identifi ed. (21) There may be a whole spectrum of causes of DCM, including genetic etiology, toxins, and vitamin or micronutrient defi ciency, such as selenium defi ciency. Dilated cardiomyopathy is often seen as a late complication of HIV infection.…”