Rationale and design of the African Cardiomyopathy and Myocarditis Registry Program: The IMHOTEP study
Sarah M Kraus1, Gasnat Shaboodien1, Veronica Francis1
1The Cardiac Clinic and Hatter Institute of Cardiovascular Research in Africa, Department of Medicine, University of Cape Town (UCT) and Groote Schuur Hospital, Cape Town, South Africa.
Insights
The IMHOTEP study is investigating cardiomyopathy and myocarditis in Africa. This research aims to uncover genetic causes and improve management strategies for these heart conditions in low- and middle-income countries.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Heart failure is a major cardiovascular disease in Africa, often caused by hypertension, rheumatic heart disease, and cardiomyopathy.
- Cardiomyopathies present significant challenges in low- and middle-income countries (LMICs) due to their high prevalence and poor prognosis.
- Etiology and outcomes of cardiomyopathy in Africa, particularly the roles of myocarditis and genetic factors, remain largely unknown.
Purpose of the Study:
- To describe the clinical characteristics, genetic causes, prevalence, management, and outcomes of cardiomyopathy and myocarditis in African children and adults.
- To identify barriers to evidence-based care implementation for cardiomyopathy.
- To establish a platform for clinical trials and interventions to reduce cardiomyopathy morbidity and mortality.
Main Methods:
- The African Cardiomyopathy and Myocarditis Registry Program (IMHOTEP study) is a pan-African, multi-center, hospital-based cohort study.
- It includes both prospective (incident) and retrospective (prevalent) patient cohorts.
- A standardized 3-stage diagnostic process is applied to all patients with cardiomyopathy and myocarditis.
Main Results:
- The pilot phase has recruited 750 patients across multiple centers.
- Comprehensive data on clinical features, genetic causes, prevalence, and outcomes are being collected.
- The study focuses on all forms of cardiomyopathy and myocarditis in African populations.
Conclusions:
- The IMHOTEP study will generate novel data on cardiomyopathy and myocarditis in Africa.
- Findings are expected to inform the development of effective management and prevention strategies for cardiomyopathies in LMICs.
- This research aims to improve patient outcomes and reduce the burden of heart disease in the region.
Background:
Heart failure (HF), the dominant form of cardiovascular disease in Africans, is mainly due to hypertension, rheumatic heart disease and cardiomyopathy. Cardiomyopathies pose a great challenge because of poor prognosis and high prevalence in low- and middle-income countries (LMICs). Little is known about the etiology and outcome of cardiomyopathy in Africa. Specifically, the role of myocarditis and the genetic causes of cardiomyopathy are largely unidentified in Africans.
Method:
The African Cardiomyopathy and Myocarditis Registry Program (the IMHOTEP study) is a pan-African multi-centre, hospital-based cohort study, designed with the primary aim of describing the clinical characteristics, genetic causes, prevalence, management and outcome of cardiomyopathy and myocarditis in children and adults. The secondary aim is to identify barriers to the implementation of evidence-based care and provide a platform for trials and other intervention studies to reduce morbidity and mortality in cardiomyopathy. The registry consists of a prospective cohort of newly diagnosed (i.e., incident) cases and a retrospective (i.e., prevalent) cohort of existing cases from participating centres. Patients with cardiomyopathy and myocarditis will be subjected to a standardized 3-stage diagnostic process. To date, 750 patients have been recruited into the multi-centre pilot phase of the study.
Conclusion:
The IMHOTEP study will provide comprehensive and novel data on clinical features, genetic causes, prevalence and outcome of African children and adults with all forms of cardiomyopathy and myocarditis in Africa. Based on these findings, appropriate strategies for management and prevention of the cardiomyopathies in LMICs are likely to emerge.
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