title: Right ventricular systolic dysfunction and remodelling in Nigerians with peripartum cardiomyopathy: a longitudinal study.
abstract: BACKGROUND
  The literature on right ventricular systolic dysfunction (RVSD) in peripartum cardiomyopathy (PPCM) patients is scanty, and it appears that RV reverse remodelling in PPCM has not been previously described. This study thus aimed to assess RVSD and remodelling in a cohort of PPCM patients in Kano, Nigeria.
  
  
  METHODS
  A longitudinal study carried out in 3 referral hospitals in Kano, Nigeria. Consecutive PPCM patients who had satisfied the inclusion criteria were recruited and followed up for 12 months. RVSD was defined as the presence of either tricuspid annular plane systolic excursion (TAPSE) <16 mm or peak systolic wave (S') tissue Doppler velocity of RV free wall <10 cm/s. For the purpose of this study, recovery of RV systolic function was defined as an improvement of reduced TAPSE to ≥ 16 mm or S' to ≥ 10 cm/s, without falling to reduced levels again, during follow-up.
  
  
  RESULTS
  A total of 45 patients were recruited over 6 months with a mean age of 26.6 ± 7.0 years. RV systolic function recovery occurred in a total of 8 patients (8/45; 17.8%), of whom 6 (75.0%) recovered in 6 months after diagnosis. The prevalence of RVSD fell from 71.1% at baseline to 36.4% at 6 months (p = 0.007) and 18.8% at 1 year (p = 0.0008 vs baseline; p = 0.41 vs 6 month). Patients with RVSD had higher serum creatinine, and TAPSE accounted for 19.2% (p = 0.008) of the variability of serum creatinine at 6 months. Although 83.3% of the deceased had RVSD, it didn't predict mortality in the regression models (p > 0.05).
  
  
  CONCLUSIONS
  RVSD and reverse remodelling were common in Nigerians with PPCM, in whom the first 6 months after diagnosis seem to be critical for RV recovery and survival.
authors.affiliation: Department of Medicine, Bayero University and Aminu Kano Teaching Hospital, 3 New Hospital Road, Kano, Nigeria. kkaraye@yahoo.co.uk.|Department of Public Health and Clinical Medicine, Umea University, SE-901 87, Umea, Sweden. kkaraye@yahoo.co.uk.
authors.forename: Kamilu Musa
authors.initials: KM
authors.lastname: Karaye
authors.affiliation: Department of Public Health and Clinical Medicine, Umea University, SE-901 87, Umea, Sweden. krister.lindmark@vll.se.|Department of Cardiology, Umea Heart Centre, SE-901 87, Umea, Sweden. krister.lindmark@vll.se.
authors.forename: Krister
authors.initials: K
authors.lastname: Lindmark
authors.affiliation: Department of Public Health and Clinical Medicine, Umea University, SE-901 87, Umea, Sweden. michael.henein@umu.se.|Department of Cardiology, Umea Heart Centre, SE-901 87, Umea, Sweden. michael.henein@umu.se.
authors.forename: Michael
authors.initials: M
authors.lastname: Henein
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008137:Longitudinal Studies; D009549:Nigeria; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011644:Puerperal Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013599:Systole; D014261:Tricuspid Valve / Q000000981:diagnostic imaging; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000453:epidemiology*; D020257:Ventricular Remodeling; D055815:Young Adult
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