https://doi.org/10.4081/cardio.2024.31
Epidemiology of peripartum cardiomyopathy in Africa
Published: June 28, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Peripartum cardiomyopathy (PPCM) is a disease that primarily affects Black African women. The history of peripartum cardiac failure in Africa dates to the 1960s, before the availability of echocardiography. With the availability of echocardiography in the late 1970s, studies on well-characterized PPCM began to be reported. To date, there is no population-based PPCM study in Africa. However, hospital-based studies have reported incidence rates as high as 1:100 deliveries in Nigeria and representing up to 52% of all cardiomyopathies. For reasons that are not yet very clear, there are obvious wide disparities in incidence and prevalence within and between African Countries. Likewise, prevalence of suggested risk factors for the disease such as increased age, gravidity or parity, twin pregnancy, obesity, poor socioeconomic status/malnutrition and selenium deficiency vary widely between studies. However, the disease seems to be more common among the poor rural population. Clinical outcomes are much worse in Africa than in Western Europe and North America. Mortality rates as high as 24.2% at 6 months and 47.4% at 1 year of followup had been recorded in Kano, Nigeria, 48.3% over 4 years in Burkina Faso, 11.6% over 6 months in Zimbabwe and 13.0% over 6 months in South Africa. It is hoped that the ongoing peripartum cardiomyopathy in Nigeria (PEACE Registry) and the worldwide EURObservational Research Programme on PPCM will soon shed more light on the epidemiology of PPCM in Africa. The present article aimed to review the epidemiology of the disease in Africa, where the disease is relatively more common.
Sliwa K, Hilfiker-Kleiner D, Petrie MC, Mebazaa A, Pieske B, Buchmann E, et al. Heart Failure Association of the European Society of Cardiology Working Group on Peripartum Cardiomyopathy. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail 2010;12:767-78
DOI: https://doi.org/10.1093/eurjhf/hfq120
Gouley BA, McMillan TM, Bellet S. Idiopathic myocardial degeneration associated with pregnancy and especially the puerperium. Am J Med Sci 1937;19:185-99.
DOI: https://doi.org/10.1097/00000441-193708000-00005
Sliwa K, Mebazaa A, Hilfiker-Kleiner D, Petrie MC, Maggioni AP, Laroche C, Regitz-Zagrosek V, et al. Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM. Eur J Heart Fail 2017;19:1131-41.
DOI: https://doi.org/10.1002/ejhf.780
Karaye KM, Mohammed IY, Ogah OS, Okeahialam BN. Rationale and design for the Peripartum Cardiomyopathy in Nigeria (PEACE) Registry. Int Cardiovasc Forum J 2017;12:12-7.
DOI: https://doi.org/10.17987/icfj.v12i0.462
Seftel H, Susser M. Maternity and myocardial failure in African women. Br Heart J 1961;23;43-52.
DOI: https://doi.org/10.1136/hrt.23.1.43
Brockington IF. Postpartum hypertensive heart failure. Am J Cardiol 1971;27:650-8.
DOI: https://doi.org/10.1016/0002-9149(71)90231-1
Davidson NM, Trevitt L, Parry EH. Perpartum cardiac failure. An explanation the observed geographic distribution in Nigeria. Bull World Health Organ 1974;51:203-8.
Davidson NM, Parry EH. Peri-partum cardiac failure. Q J Med 1978;47:431-61.
Sanderson JE, Adesanya CO, Anjorin FI, Parry EHO. Postpartum cardiac failure-heart failure due to volume overload? Am Heart J 1979;97:613-21.
DOI: https://doi.org/10.1016/0002-8703(79)90189-3
Lee S, Cho GJ, Park GU, Kim LY, Lee TS, Kim DY, et al. Incidence, risk factors, and clinical characteristics of peripartum cardiomyopathy in South Korea. Circ Heart Fail 2018;11:e004134.
DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.117.004134
Wu VC, Chen TH, Yeh JK, Wu M, Lu CH, Chen SW, et al. Clinical outcomes of peripartum cardiomyopathy: a 15-year nationwide population-based study in Asia. Medicine (Baltimore) 2017;96:e8374.
DOI: https://doi.org/10.1097/MD.0000000000008374
Ersbøll AS, Johansen M, Damm P, Rasmussen S, Vejlstrup NG, Gustafsson F. Peripartum cardiomyopathy in Denmark: a retrospective, population-based study of incidence, management and outcome. Eur J Heart Fail 2017;19:1712-20.
DOI: https://doi.org/10.1002/ejhf.882
Mielniczuk LM, Williams K, Davis DR, Tang AS, Lemery R, Green MS, et al. Frequency of peripartum cardiomyopathy. Am J Cardiol 2006;97:1765-8.
DOI: https://doi.org/10.1016/j.amjcard.2006.01.039
Kamiya CA, Kitakaze M, Ishibashi-Ueda H, Nakatani S, Murohara T, Tomoike H, Ikeda T. Different characteristics of peripartum cardiomyopathy between patients complicated with and without hypertensive disorders. Results from the Japanese Nationwide survey of peripartum cardiomyopathy. Circ J 2011;75:1975-81.
DOI: https://doi.org/10.1253/circj.CJ-10-1214
Desai D, Moodley J, Naidoo D. Peripartum cardiomyopathy: experiences at King Edward VIII Hospital, Durban, South Africa and a review of the literature. Trop Doct 1995;25:118-23.
DOI: https://doi.org/10.1177/004947559502500310
Isezuo SA, Abubakar SA. Epidemiologic profile of peripartum cardiomyopathy in a tertiary care hospital. Ethn Dis 2007;17:228-333.
Yaméogo NV, Samadoulougou AK, Kagambèga LJ, Kologo KJ, Millogo GRC, Thiam A, et al. Maternal and fetal prognosis of subsequent pregnancy in black African women with peripartum cardiomyopathy. BMC Cardiovasc Disord 2018;18:119.
DOI: https://doi.org/10.1186/s12872-018-0856-7
Karaye KM, Sa’idu H, Habib AG. Peripartum and other cardiomyopathies in a Nigerian adult population. Int J Cardiol 2011;147:342-3.
DOI: https://doi.org/10.1016/j.ijcard.2011.01.004
Karaye KM, Henein MY. Peripartum cardiomyopathy: a review article. Int J Cardiol 2013;164:33-8.
DOI: https://doi.org/10.1016/j.ijcard.2011.11.069
Blauwet LA, Libhaber E, Forster O, Tibazarwa K, Mebazaa A, Hilfiker-Kleiner D, et al. Predictors of outcome in 176 South African patients with peripartum cardiomyopathy. Heart 2013;99:308-13.
DOI: https://doi.org/10.1136/heartjnl-2012-302760
Karaye KM, Lindmark K, Henein MY. One-year survival in Nigerians with peripartum cardiomyopathy. Heart Views 2016;17:55-61.
DOI: https://doi.org/10.4103/1995-705X.185114
Sliwa K, Forster O, Libhaber E, Fett JD, Sundstrom JB, Hilfiker-Kleiner D, et al. Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J 2006;27:441-6.
Karaye KM, Yahaya IA, Lindmark K, Henein MY. Serum selenium and ceruloplasmin in nigerians with peripartum cardiomyopathy. Int J Mol Sci 2015;16:7644-54
DOI: https://doi.org/10.3390/ijms16047644
Gambahaya ET, Hakim J, Kao D, Munyandu N, Matenga J. Peripartum cardiomyopathy among cardiovascular patients referred for echocardiography at Parirenyatwa Teaching Hospital, Harare, Zimbabwe. Cardiovasc J Afr 2017;28:8-13.
DOI: https://doi.org/10.5830/CVJA-2016-043
Elkayam U, Akhter MW, Singh H, Khan S, Bitar F, Hameed A, et al. Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation 2005;111:2050-5.
DOI: https://doi.org/10.1161/01.CIR.0000162478.36652.7E
Gentry MB, Dias JK, Luis A, Petel R, Thornton J, Reed GL. African-American women have a higher risk for developing peripartum cardiomyopathy. J Am Coll Cardiol 2010;55:654-9.
DOI: https://doi.org/10.1016/j.jacc.2009.09.043
Sheppard R, Hsich E, Damp J, Elkayam U, Kealey A, Ramani G, et al. GNB3 C825T polymorphism and myocardial recovery in peripartum cardiomyopathy: results of the multicenter investigations of pregnancy-associated cardiomyopathy study. Circ Heart Fail 2016;9:e002683.
DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.115.002683
Levine RJ, Maynard SE, Qian C, Lim KH, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med 2004;350:672-83.
DOI: https://doi.org/10.1056/NEJMoa031884
Mebazaa A, Seronde MF, Gayat E, Tibazarwa K, Anumba DOC, Akrout N, et al. Imbalanced angiogenesis in peripartum cardiomyopathy - diagnostic value of placenta growth factor. Circ J 2017;81:1654-61.
DOI: https://doi.org/10.1253/circj.CJ-16-1193
Bello N, Rendon IS, Arany Z. The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis. J Am Coll Cardiol 2013;62:1715-23.
DOI: https://doi.org/10.1016/j.jacc.2013.08.717
Nakimuli A, Chazara O, Byamugisha J, Elliott AM, Kaleebu P, Mirembe F, Moffett A. Pregnancy, parturition and preeclampsia in women of African ancestry. Am J Obstet Gynecol 2014;210:510-20.
DOI: https://doi.org/10.1016/j.ajog.2013.10.879
Elkayam U. Clinical characteristics of peripartum cardiomyopathy in the United States: diagnosis, prognosis and management. J Am Coll Cardiol 2011;58:659-70.
DOI: https://doi.org/10.1016/j.jacc.2011.03.047
Karaye KM, Habib AG. Pattern of left ventricular geometry in hypertension: a study of a hypertensive population in Nigeria. Sahel Med J 2009;12:148-54.
DOI: https://doi.org/10.4103/1118-8561.145651
Fett JD, Christie LG, Carraway RD, Murphy JG. Five-year prospective study of the incidence and prognosis of peripartum cardiomyopathy at a single institution. Mayo Proceed 2005;80:1602-6.
DOI: https://doi.org/10.4065/80.12.1602
Sliwa K, Forster O, Libhaber E, Fett JD, Sundstrom JB, Hilfiker-Kleiner D, et al. Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J 2006;27:441-6.
DOI: https://doi.org/10.1093/eurheartj/ehi481
Okamoto H, Takenaka T, Saitoh Y. Is hypertensive disorder a unique risk factor for peripartum cardiomyopathy and pregnancy-associated cardiomyopathy? Circ J 2011;75:1827-8.
DOI: https://doi.org/10.1253/circj.CJ-11-0632
Ntusi NBA, Badri M, Gumedze F, Sliwa K, Mayosi BM. Pregnancy-associated heart failure: a comparison of clinical presentation and outcome between hypertensive heart failure of pregnancy and idiopathic peripartum cardiomyopathy. PLoS ONE 2015;10:e0133466.
DOI: https://doi.org/10.1371/journal.pone.0133466
Kao DP, Hsich E, Lindenfeld J. Characteristics, adverse events, and racial differences among delivering mothers with peripartum cardiomyopathy. JACC Heart Fail 2013;1:409-16.
DOI: https://doi.org/10.1016/j.jchf.2013.04.011
McNamara DM, Elkayam U, Alharethi R, Damp J, Hsich E, Ewald G, et al. clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC study (investigations of pregnancy-associated cardiomyopathy). J Am Coll Cardiol 2015;66:905-14.
DOI: https://doi.org/10.1016/j.jacc.2015.06.1309
Gluhovschi G, Gluhovschi A, Petrica L, Anastasiu D, Gluhovschi C, Velciov S. Pregnancy-induced hypertension - a particular pathogenic model. Similarities with other forms of arterial hypertension. Rom J Intern Med 2012;50:71-81.
Karaye KM, Sani MU. The impact of income on the echocardiographic pattern of heart diseases in Kano, Nigeria. Niger J Med 2008;17:350-5.
DOI: https://doi.org/10.4314/njm.v17i3.37409
Fillmore SJ, Parry EH. The evolution of peripartal heart failure in Zaria. Circulation 1977;56:1058-61.
DOI: https://doi.org/10.1161/01.CIR.56.6.1058
Danbauchi SS. Echocardiographic features of peripartum cardiac failure: the Zaria syndrome. Tropical Doctor 2002;32:24-7.
DOI: https://doi.org/10.1177/004947550203200112
Okeke T, Ugwu E, Ezenyeaku C, Ikeako L, Okezie O. Postpartum practices of parturient women in Enugu, South East Nigeria. Ann Med Health Sci Res 2013;3:47-50.
DOI: https://doi.org/10.4103/2141-9248.109486
Tato Rocha RE, Cardenas Viedma E, Herrero Huerta E. Selenio: implicaciones fisiopatologicas y clınicas. Ann Med Intern 1994;2:457-63.
Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human body: relationship with different diseases. Sci Total Environ 2000;249:347-71.
DOI: https://doi.org/10.1016/S0048-9697(99)00526-4
Cenac A, Simonoff M, Moretto P, Djibo A. A low plasma selenium is a risk factor for peripartum cardiomyopathy. A comparative study in Sahelian Africa. Int J Cardiol 1992;36:57-9.
DOI: https://doi.org/10.1016/0167-5273(92)90108-F
Keshan Disease Research Group of the Chinese Academy of Medical Sciences, Beijing. Epidemiologic studies on the etiologic relationship of selenium and Keshan disease. Chin Med J (Engl.) 1979;92:477-82.
Fett JD, Ansari AA, Sundstrom JB, Combs GF. Peripartum cardiomyopathy: a selenium disconnection and an autoimmune connection. Int J Cardiol 2002;86:311-6.
DOI: https://doi.org/10.1016/S0167-5273(02)00359-5
Hilfiker-Kleiner D, Haghikia A, Berliner D, Vogel-Claussen J, Schwab J, Franke A, et al. Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur Heart J 2017;38:2671-9.
DOI: https://doi.org/10.1093/eurheartj/ehx355
Whitehead SJ, Berg CJ, Chang J. Pregnancy-related mortality due to cardiomyopathy: United States, 1991–1997. Obstet Gynecol 2003; 102: 1326 –1331.
DOI: https://doi.org/10.1016/j.obstetgynecol.2003.08.009
Merlo M, Pyxaras SA, Pinamonti B, et al. Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment. J Am Coll Cardiol 2011;57:1468-76.
DOI: https://doi.org/10.1016/j.jacc.2010.11.030
Karaye KM, Lindmark K, Henein MY. Electrocardiographic predictors of peripartum cardiomyopathy. Cardiovasc J Afr 2016;27:66-70
DOI: https://doi.org/10.5830/CVJA-2015-092
Karaye KM. Right ventricular systolic function in peripartum and dilated cardiomyopathies. Eur J Echocardiogr 2011;12:372-4.
DOI: https://doi.org/10.1093/ejechocard/jer024
Karaye KM, Lindmark K, Henein MY. Right ventricular systolic dysfunction and remodelling in Nigerians with peripartum cardiomyopathy: a longitudinal study. BMC Cardiovasc Disord 2016;16:27.
DOI: https://doi.org/10.1186/s12872-016-0204-8
Karaye KM, Lindmark K, Henein, MY. Prevalence and predictors of right ventricular diastolic dysfunction in peripartum cardiomyopathy. J Echocardiogr 2017;15:135-40.
DOI: https://doi.org/10.1007/s12574-017-0333-9
Blauwet LA, Delgado-Montero A, Ryo K, Marek JJ, Alharethi R, Mather PJ, et al. Right ventricular function in peripartum cardiomyopathy at presentation is associated with subsequent left ventricular recovery and clinical outcomes. Circ Heart Fail 2016;9:e002756.
DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.115.002756
How to Cite
Karaye, K. M., Habib, A. G., & Sliwa, K. (2024). Epidemiology of peripartum cardiomyopathy in Africa. Global Cardiology, 2(2). https://doi.org/10.4081/cardio.2024.31
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