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Prevalence and predictors of right ventricular diastolic dysfunction in peripartum cardiomyopathy

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Abstract

Background

This study aimed to assess the prevalence of right ventricular diastolic dysfunction (RVDD) and its potential predictors in peripartum cardiomyopathy (PPCM) patients.

Methods

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.

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Department of Medicine, Bayero University, 4445, Kano, Nigeria

    K. M. Karaye

  2. Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden

    K. Lindmark & M. Y. Henein

Authors
  1. K. M. Karaye
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  2. K. Lindmark
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  3. M. Y. Henein
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Corresponding author

Correspondence to K. M. Karaye.

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Conflict of interest

Kamilu Karaye, Krister Lindmark, and Michael Henein declare that they have no conflicts of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent for inclusion in the study was obtained from all patients [9].

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Karaye, K.M., Lindmark, K. & Henein, M.Y. Prevalence and predictors of right ventricular diastolic dysfunction in peripartum cardiomyopathy. J Echocardiogr 15, 135–140 (2017). https://doi.org/10.1007/s12574-017-0333-9

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  • DOI: https://doi.org/10.1007/s12574-017-0333-9

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