{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:32:34Z","timestamp":1782916354651,"version":"3.54.5"},"reference-count":91,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006338","name":"Vlaamse Interuniversitaire Raad","doi-asserted-by":"publisher","award":["CD2017TEA439A104"],"award-info":[{"award-number":["CD2017TEA439A104"]}],"id":[{"id":"10.13039\/501100006338","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["FIC R01ES019841"],"award-info":[{"award-number":["FIC R01ES019841"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Blood and\/or urine levels of 27 heavy metals were determined by ICPMS in 41 patients with dilated cardiomyopathy (DCM) and 29 presumably healthy subjects from the Katanga Copperbelt (KC), in the Democratic Republic of Congo (DRC). After adjusting for age, gender, education level, and renal function, DCM probability was almost maximal for blood concentrations above 0.75 and 150 \u00b5g\/dL for arsenic and copper, respectively. Urinary concentrations above 1 for chromium, 20 for copper, 600 for zinc, 30 for selenium, 2 for cadmium, 0.2 for antimony, 0.5 for thallium, and 0.05 for uranium, all in \u03bcg\/g of creatinine, were also associated with increased DCM probability. Concurrent and multiple exposures to heavy metals, well beyond permissible levels, are associated with increased probability for DCM. Study findings warrant screening for metal toxicity in case of DCM and prompt public health measures to reduce exposures in the KC, DRC.<\/jats:p>","DOI":"10.3390\/ijerph18094956","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T11:10:27Z","timestamp":1620299427000},"page":"4956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Concurrent Heavy Metal Exposures and Idiopathic Dilated Cardiomyopathy: A Case-Control Study from the Katanga Mining Area of the Democratic Republic of Congo"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8414-4447","authenticated-orcid":false,"given":"Didier","family":"Malamba-Lez","sequence":"first","affiliation":[{"name":"Unit of Training and Research in Cardiology, Department of Internal Medicine, University of Lubumbashi, Lubumbashi 07610, Democratic Republic of the Congo"},{"name":"Doctoral School for Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e9sire","family":"Tshala-Katumbay","sequence":"additional","affiliation":[{"name":"Department of Neurology and School of Public Health, Oregon Health &amp; Science University, Portland, OR 97007, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Bito","sequence":"additional","affiliation":[{"name":"Doctoral School for Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0031-526X","authenticated-orcid":false,"given":"Jean-Michel","family":"Rigo","sequence":"additional","affiliation":[{"name":"Doctoral School for Medicine and Life Sciences, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0143-3452","authenticated-orcid":false,"given":"Richie","family":"Kipenge Kyandabike","sequence":"additional","affiliation":[{"name":"Unit of Training and Research in Cardiology, Department of Internal Medicine, University of Lubumbashi, Lubumbashi 07610, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ngoy Yolola","sequence":"additional","affiliation":[{"name":"Unit of Training and Research in Cardiology, Department of Internal Medicine, University of Lubumbashi, Lubumbashi 07610, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Katchunga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Official University of Bukavu, Bukavu 11102, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Koba-Bora","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Service of Neurology, University of Lubumbashi, Lubumbashi 07610, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dophra","family":"Ngoy-Nkulu","sequence":"additional","affiliation":[{"name":"Unit of Training and Research in Cardiology, Department of Internal Medicine, University of Lubumbashi, Lubumbashi 07610, Democratic Republic of the Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ober, J.A. 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