Nutritional status and plasma trace elements in peripartum cardiomyopathy. A comparative study in Niger

Peripartum cardiomyopathy is a frequent condition of unknown origin in Sahelian West Africa.

To identify the nutritional and trace-elements status, plasma concentrations of albumin, pre-albumin (trans-thyretin), retinol binding protein, copper, selenium and zinc were assayed in 35 African women living in a Sahelian area, hospitalized in the Hôpital national, Niamey (Republic of Niger) with peripartum cardiac failure due to peripartum cardiomyopathy.

Plasma albumin was assayed by an automatic method; pre-albumin and retinol binding protein by radial immunodiffusion (Mancini's method); and plasma copper, selenium and zinc by neutron activation and particle-induced X-ray emission. The results were compared with those for a control group of African women living under the same conditions but without peripartum cardiac failure.

Plasma albumin and pre-albumin were lower in patients with peripartum cardiomyopathy than they were in controls (P < 0.001). For retinol binding protein, the difference was not statistically significant. The plasma concentrations of selenium and zinc were lower in patients than they were in controls (48 +/- 25 versus 77 +/- 16 ng/ml and 0.90 +/- 0.21 versus 1.17 +/- 0.25 micrograms/ml, respectively, P < 0.001) whereas that of copper was higher (2.03 +/- 0.37 versus 1.23 +/- 0.20 micrograms/ml, P < 0.001). The mean zinc: copper ratio was lower in patients than it was in controls (0.44 versus 0.95).

Such differences may be aetiological factors or biological consequences of the peripartum cardiac failure due to cardiomyopathy. Nutritional abnormalities may play a role in the pathophysiology of the disease.