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Background: Nigeria has the highest incidence of peripartum cardiomyopathy (PPCM) in the world. However, data on PPCM-related outcomes are limited.Objectives: The purpose of this study was to examine the clinical profile, myocardial remodeling, and survival of patients with PPCM in Nigeria.Methods: This study consecutively recruited 244 PPCM patients (median 7 months postpartum) at 14 sites in Nigeria and applied structured follow-up for a median of 17 months (interquartile range: 14 to 20 months). Left ventricular reverse remodeling (LVRR) was defined as the composite of left ventricular (LV) end-diastolic dimension <33 mm/m2 and absolute increase in left ventricular ejection fraction (LVEF) ≥10%. LV full recovery was defined as LVEF ≥55%.Results: Overall, 45 (18.7%) patients died during follow-up. Maternal age <20 years (hazard ratio [HR]: 2.40; 95% confidence interval (CI): 1.27 to 4.54), hypotension (HR: 1.87; 95% CI: 1.02 to 3.43), tachycardia (HR: 2.38; 95% CI: 1.05 to 5.43), and LVEF <25% at baseline (HR: 2.11; 95% CI: 1.12 to 3.95) independently predicted mortality. Obesity (HR: 0.16; 95% CI: 0.04 to 0.55) and regular use of beta-blockers at 6-month follow-up (HR: 0.20; 95% CI: 0.09 to 0.41) were independently associated with reduced risk for mortality. In total, 48 patients (24.1%) achieved LVRR and 45 (22.6%) achieved LV full recovery. LVEF <25% at baseline (HR: 0.66; 95% CI: 0.47 to 0.92) and regular use of beta-blockers at 6-month follow-up (HR: 1.62; 95% CI: 1.17 to 2.25) independently determined the risk for LV full recovery. Progressive reverse remodeling of all cardiac chambers was observed. In total, 18 patients (7.4%) were hospitalized during the study.Conclusions: This is the largest study of PPCM in Africa. Consistent with late presentations, the mortality rate was high, whereas frequencies of LVRR and LV full recovery were low. Several variables predicted poor outcomes, and regular use of beta-blockers correlated with late survival and LV functional recovery. [ABSTRACT FROM AUTHOR]

Background: The relationship between Tei Index (TI) and left ventricular (LV) geometric patterns has not been previously well described. The present study therefore set out to describe the nature of this relationship if any, and to also assess whether a relationship exists between the geometric patterns and LV ejection fraction (LVEF) so as to establish a basis for comparison.Methods: The study was carried out in the echocardiography laboratory of Aminu Kano Teaching Hospital (AKTH) in Kano, North-Western Nigeria. The study was cross-sectional in design. Hypertensive subjects referred for echocardiography to AKTH were serially recruited from October 2008 to September 2009. TI was defined as the sum of isovolumic contraction and relaxation times divided by the ejection time, and values of LV TI < 0.40 were considered normal, while higher values were considered abnormal. Four patterns of LV geometry (normal, concentric remodelling, concentric LV hypertrophy and eccentric LV hypertrophy) were determined from the LV mass index and LV relative wall thickness as previously described. Binary logistic regression models and Pearson's Correlation (r) Coefficient were used to analyse the associations between TI or LVEF and a number of variables.Results: A total of 142 subjects were recruited into the study. The prevalence of abnormal TI (26.8%; 38 persons) in the total population was lower than that of reduced LV ejection fraction (< 50%) (38.0%; 54 persons) (p = 0.335). There was no association between any LV geometric pattern and abnormal TI. However, there was significant relationship between the geometric patterns and low LVEF (< 50%); tested in a binary logistic regression model. HR was a significant predictor of TI with regression coefficient of -0.218, 95% confidence interval (CI) of -0.005 - < -0.001 and p-value of 0.011. Similarly, HR was the only variable that significantly predicted abnormal TI in a binary logistic regression model with an odds ratio of 1.058 (95% CI = 1.002-1.118; p = 0.044), and also the only variable that correlated with TI significantly (r = -0.212; p-value = 0.014).Conclusion: This study has found that LV geometric patterns and LVEF were not associated with TI in hypertensives, but there was strong association between LV geometric patterns and LVEF. TI was found to be dependent on HR. [ABSTRACT FROM AUTHOR]