title: Prevalence and predictors of right ventricular diastolic dysfunction in peripartum cardiomyopathy.
abstract: This study aimed to assess the prevalence of right ventricular diastolic dysfunction (RVDD) and its potential predictors in peripartum cardiomyopathy (PPCM) patients.
  
  
  
  This was a cross-sectional study carried out in Nigeria. RVDD was defined and graded using Doppler filling and myocardial tissue Doppler velocities obtained at tricuspid annular level.
  
  
  
  Forty-three subjects with PPCM and mean age of 26.6 ± 7.0 years were recruited over 6 months. RVDD was found in 30 (69.8 %) subjects, of whom 16 (53.3 %) had grade I, 12 (40.0 %) had grade II and 2 (6.7 %) had grade III severity. RV systolic dysfunction (RVSD), defined as RV fractional area change <35 %, was found in 88.4 %, while combined RVSD and RVDD was found in 58.1 % of patients. Subjects with RVDD had significantly higher tricuspid E/e' ratio (5.1 ± 2.8 versus 3.5 ± 1.0, p = 0.012) and prevalence of pulmonary hypertension (76.7 versus 46.2 %; p < 0.05), and lower serum selenium concentration (55.6 ± 12.1 versus 72.5 ± 12.0 µg/L, p = 0.001) than those with preserved RV diastolic function. Regression analyses showed serum selenium [odds ratio (OR) = 1.14; 95 % confidence interval (CI) = 1.0-1.3; p = 0.049] and combined RVSD and pulmonary hypertension (OR = 79.2; CI = 3.9-1593.7; p = 0.004) as the only predictors of RVDD, and serum selenium <70 µg/L increased the odds of RVDD by 6.67-fold (CI = 1.18-37.78; p = 0.032).
  
  
  
  Both RVDD and RVSD were common in PPCM patients. Selenium deficiency and combined RVSD and pulmonary hypertension seemed to be the only determinants of RVDD in this small cohort, a finding that needs verification in a larger sample of patients.
authors.affiliation: Department of Medicine, Bayero University, 4445, Kano, Nigeria. kkaraye@yahoo.co.uk.
authors.forename: K M
authors.initials: KM
authors.lastname: Karaye
authors.affiliation: Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Lindmark
authors.affiliation: Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden.
authors.forename: M Y
authors.initials: MY
authors.lastname: Henein
mesh_terms: D000328:Adult; D009202:Cardiomyopathies / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology; D009549:Nigeria / Q000453:epidemiology; D016017:Odds Ratio; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011644:Puerperal Disorders / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012044:Regression Analysis; D012307:Risk Factors; D012643:Selenium / Q000097:blood; D012720:Severity of Illness Index; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D012643:Selenium
keywords: Diastolic dysfunction; Heart failure; Nigeria; Peripartum cardiomyopathy; Right ventricular dysfunction