Factors Associated With Isolated Right Heart Failure in Women

Background—Small observational studies have found that isolated right heart failure (IRHF) is prevalent among women of sub-Saharan Africa. Further, several risk factors for the development of IRHF have been identified. However, no similar studies have been conducted in Kenya. Objective—We hypothesized that specific environmental exposures and comorbidities were associated with IRHF in women of western Kenya. Methods—We conducted a case-control study at a referral hospital in western Kenya. Cases were defined as women at least 35 years old with IRHF. Control subjects were similarly aged volunteers without IRHF. Exclusion criteria in both groups included history of tobacco use, tuberculosis, or thromboembolic disease. Participants underwent echocardiography, spirometry, 6min walk test, rest/exercise oximetry, respiratory health interviews, and human immunodeficiency virus (HIV) testing. Home visits were performed to evaluate kitchen ventilation, fuel use, and cook smoke exposure time, all surrogate measures of indoor air pollution (IAP). A total of 31 cases and 65 control subjects were enrolled. Surrogate measures of indoor air pollution were not associated with IRHF. However, lower forced expiratory volume at 1 s percent predicted (adjusted odds ratio [AOR]: 2.02, 95% confidence interval [CI]: 1.27 to 3.20; p = 0.004), HIV positivity (AOR: 40.4, 95% CI: 3.7 to 441; p < 0.01), and self-report of exposure to occupational dust © 2014 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/). Correspondence: C. B. Sherman ([email protected]). The authors report no relationships that could be construed as a conflict of interest. This paper appeared in abstract form at the American Thoracic Society International Conference, May 2012. HHS Public Access Author manuscript Glob Heart. Author manuscript; available in PMC 2015 April 22. Published in final edited form as: Glob Heart. 2014 June ; 9(2): 249–254. doi:10.1016/j.gheart.2014.04.003. A uhor M anscript