-
HAART Use and Cardiovascular Risk Among HIV Patients in Rivers State, Nigeria
Ajala Aisha Oluwabunmi,
Ofori Sandra Nnedinma,
Odia Osarentin James
Issue:
Volume 3, Issue 3, September 2019
Pages:
45-51
Received:
26 June 2019
Accepted:
24 July 2019
Published:
7 August 2019
Abstract: Cardiovascular diseases have been associated with deaths among HIV seropositive persons in low income countries. This was a cross-sectional study of cardiovascular risk among 100 HIV seropositive persons and 100 age and sex matched seropositive but HAART-naive controls in Rivers state, Nigeria. The study subjects underwent clinical examinations to determine their blood pressure and anthropometric parameters. Blood samples were taken to assess fasting blood glucose and lipid profile. Risk assessment was done using the WHO/ISH cardiovascular risk score chart. Among the subjects, 76 (76%) were on a non-PI based HAART compared with 24 (24%) on a PI-based HAART. The mean BMI and CD4 count were significantly higher among the cases than the controls (p =.0.048 and p < 0.0001 respectively). There was a statistically significant difference in the mean SBP (131.90 ± 14.33mmHg versus 127.48 ± 12.03mmHg) and DBP (83.88 ± 6.59mmHg versus 80.63 ± 6.74mmHg) between the cases and controls (p = 0.019 and 0.023 respectively). Dyslipidaemia was higher among the cases than the controls (low HDL-c was 36% vs 33%; increased TC 20% vs 7%; increased LDL-c 13% vs 4% and triglycerides 7% vs 5%. The prevalence of hypercholesterolemia and increased LDL-c was significantly higher among the cases than the controls (p = 0.007 and 0.022 respectively). The prevalence of intermediate to high CV risk score was higher among the HAART experienced HIV seropositive subjects compared to control subjects.
Abstract: Cardiovascular diseases have been associated with deaths among HIV seropositive persons in low income countries. This was a cross-sectional study of cardiovascular risk among 100 HIV seropositive persons and 100 age and sex matched seropositive but HAART-naive controls in Rivers state, Nigeria. The study subjects underwent clinical examinations to ...
Show More
-
Cardiorenal Syndrome in Acute Coronary Disease: A Current Perspective
Hedgar Berty Gutiérrez,
Yenisey Arteaga Concepción,
Cristians Auza-Santivañez
Issue:
Volume 3, Issue 3, September 2019
Pages:
52-54
Received:
26 June 2019
Accepted:
4 August 2019
Published:
3 September 2019
Abstract: Acute coronary disease is one of the leading causes of death in the world. Currently 20-30% of these patients have acute renal failure forming part of the cardiorenal syndrome. Studies show that the evaluation of renal function through the estimated glomerular filtration rate (eGFR) is related to mortality in patients with cardiovascular disease, with greater precision in eGFR Chronic Kidney Disease Epidemiology Collaboration. Therefore, it is considered an immediate, easy and useful marker for the initial evaluation of patients with acute coronary disease.
Abstract: Acute coronary disease is one of the leading causes of death in the world. Currently 20-30% of these patients have acute renal failure forming part of the cardiorenal syndrome. Studies show that the evaluation of renal function through the estimated glomerular filtration rate (eGFR) is related to mortality in patients with cardiovascular disease, w...
Show More
-
Immediate Outcome and Predictors of Percutaneous Mitral Balloon Commissurotomy: A 5 Years Experience in Cardiac Center Ethiopia
Mohammed Bedru Sebah,
Kefelegn Dejene Tadesse,
Ali Dawed Mohammed,
Fekede Agwar Debel,
Shibikom Tamirat Agonafir,
Azene Dessie Mengistu,
Jemal Haidar Ali
Issue:
Volume 3, Issue 3, September 2019
Pages:
55-61
Received:
23 July 2019
Accepted:
18 August 2019
Published:
4 September 2019
Abstract: Percutaneous mitral balloon commissurotomy (PMBC) is the treatment of choice for rheumatic mitral stenosis with favorable anatomy and prevents complications inherent to a surgical procedure, while maintaining effectiveness. In view of this, we examined the immediate outcome and its predictors of patients undergoing PMBC in our Cardiac Center and availed evidence based information for future use of the treatment in Ethiopia. A retrospective data analysis of 330 patients with symptomatic severe mitral stenosis treated with PMBC using Inoue balloon in the cardiac center Ethiopia from 2014 to 2018 were assessed for their clinical outcome for those who presented for the first time in our cardiac center, Addis Ababa. Demographic, clinical, echocardiographic and hemodynamic data of all patients with symptomatic severe mitral stenosis were collected and analyzed. Of the 330 PMBC performed during the 5 years in the center, the majority had successful procedure (97.88%) and optimal result (92.42%). Twenty four (7.2%) had complications of which 7 (2.1%) had failed procedure and 9 (2.7%) marked mitral regurgitation. Atrial fibrillation was observed in 67 (20.3%). The mean mitral valve score (MVS) was 7.3± 1.35 ranged from 4 to 13. A significant association of immediate outcome was observed with atrial fibrillation (AOR=4.41; 95% CI=1.51 to 12.89) and high mitral valve total Wilkins score (AOR=0.25; 95% CI 0.09 to 0.70). The major predictors identified for poor outcome are atrial fibrillation and MVS. Percutaneous mitral balloon commissurotomy is a safe procedure with excellent immediate results signifying that it is a treatment of choice for heterogeneous group of patients with rheumatic mitral stenosis.
Abstract: Percutaneous mitral balloon commissurotomy (PMBC) is the treatment of choice for rheumatic mitral stenosis with favorable anatomy and prevents complications inherent to a surgical procedure, while maintaining effectiveness. In view of this, we examined the immediate outcome and its predictors of patients undergoing PMBC in our Cardiac Center and av...
Show More
-
Treating the Brain But Forgetting the Heart: Mitral Valvular Disease Cabergoline Induced
Randa Tabbah,
Hamid Bayeh,
Raffy Karaminassian
Issue:
Volume 3, Issue 3, September 2019
Pages:
62-64
Received:
27 July 2019
Accepted:
19 August 2019
Published:
6 September 2019
Abstract: Drug induced valvular heart disease is a forgotten entity of valvular disease, sometimes underdiagnosed or even misdiagnosed. The majority of drugs found to induce this kind of disease have a common pharmacological action on a specific serotonin receptor-the 5HT2B receptor. The typical echocardiographic features in these cases are mild to moderate thickening and restriction of the valve with no commissural fusion nor calcification which is the main cause of valvular regurgitation. These findings are not coherent with rheumatic valvular disease We described a case of a 36years old female with a past medical history of hyperprolactinemia treated with low dose of cabergoline for 9 months, presenting for dyspnea on minimal exertion and palpitation. She consulted a cardiologist that discovered a systodiastolic loud murmur on apical area. A cardiac ultrasound was done revealing a mitral valve disease with moderate leaflet thickening and restriction with no commissural fusion nor calcification with a severe eccentric mitral regurgitation grade 3+ due to tenting and malcoaptation of the valve during diastole. Rheumatic and degenerative valve disease were ruled out. The final diagnosis was a drug induced valvular heart disease and more specifically a cabergoline induced mitral valve disease acting on the serotonin receptors 5HT2B. Patient was sent for surgery. Early diagnosis with a good physical examination and current echocardiographic follow up in patient with hyperprolactinemia with even low dose of cabergoline and short term treatment is suggested.
Abstract: Drug induced valvular heart disease is a forgotten entity of valvular disease, sometimes underdiagnosed or even misdiagnosed. The majority of drugs found to induce this kind of disease have a common pharmacological action on a specific serotonin receptor-the 5HT2B receptor. The typical echocardiographic features in these cases are mild to moderate ...
Show More
-
Dilated Cardiopathy Associated with Sickle Cell Disease in a 68 Years Old Female: An Emerging Complication in Sub-sahara Africa
Sylvie Ndongo Amougou,
Mary Anne Ngam,
Murielle Helles Lema,
Mazou Ngou Temgoua,
Aicha Yap Mefire,
Anderson Ngouo Tchiffo,
Samuel Kingue
Issue:
Volume 3, Issue 3, September 2019
Pages:
65-70
Received:
23 August 2019
Accepted:
9 September 2019
Published:
21 September 2019
Abstract: Sickle Cell Anemia (SCA) is an autosomal recessive disease caused by a point mutation in the hemoglobin beta gene found on chromosome 11p15.5 [1]. Specifically, it occurs when a single base from A to T in the codon for glutamic acid at position 6 is changed to valine of the beta globin and thus disrupts the tertiary structure and stability of the hemoglobin molecule [2]. Sickle hemoglobin is responsible for wide spectrum of disorders which vary with respect to severity of anemia, frequency of crises and duration of survival [3]. We present the case of a dilated cardiopathy in an elderly female sickle cell patient. A 68 years old female sickle cell patient with no known major cardiovascular risk factor presented with progressive onset of dyspnea. Clinical examination showed signs of left ventricular failure; an electrocardiogram showed a sinus regular rhythm, left ventricular hypertrophy with systolic overload, Q waves in the anteroseptal leads. Cardiac ultrasound showed a dilated cardiopathy with a preserved left ventricular systolic function at 57%, normal regional wall motion and normal pulmonary pressure. We concluded of heart failure due to probable chronic anemia or anischemic cardiopathy with a conserved systolic function in an elderly sickle cell patient but we were not able to confirm the main etiology without CT Coronary Angiogram or coronarography. Sickle cell anemia is a common genetic condition in sub-Saharan Africa associated with early death. This case is special because we have an elderly female presenting with heart failure on a dilated cardiopathy. This enhances the necessity of strict cardiovascular follow up of Sickle cell patient.
Abstract: Sickle Cell Anemia (SCA) is an autosomal recessive disease caused by a point mutation in the hemoglobin beta gene found on chromosome 11p15.5 [1]. Specifically, it occurs when a single base from A to T in the codon for glutamic acid at position 6 is changed to valine of the beta globin and thus disrupts the tertiary structure and stability of the h...
Show More
-
Fragmented QRS Complex as a Predictor of High Risk in Acute Coronary Syndrome
Hanan Ibrahim Radwan,
Kamal Saad Mansour,
Mohammed Mustafa Al-Daydamony,
Reema Saed Mohammed
Issue:
Volume 3, Issue 3, September 2019
Pages:
71-79
Received:
17 August 2019
Accepted:
4 September 2019
Published:
23 September 2019
Abstract: Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected to Grace score calculation, ECG to detect ischemic changes and detect presence or absent of fQRS, transthoracic echo to detect LV ejection fraction and recording in-hospital outcome. Results: Patients with fQRS have significant higher Killip class>2, higher troponin &CKMB levels, higher grace score, increased LVEDD & LVESD and significantly lower LVEF%. LVEF is significantly lower among patients with fQRS than patients with not fQRS in NSTEMI patients while there is no significant difference of LVEF % between both groups in unstable angina patients. There is significant association between fQRS and higher prevalence of NSTEMI and higher incidence of heart failure, arrhythmia and bad outcome. By multivariate analysis, NSTEMI (p =0.003) and high HR (p =0.004) and fragmented QRS (p =0.00) were the only significant predictors for bad outcome. FQRS have the ability to diagnose NSTEMI in 47.9% of cases, fQRs can truly exclude NSTEMI in 72.7% of case. Conclusion: Among patients with ACS, the presence of fQRS was associated with an increase incidence of complication, worse outcome, larger LV dimensions, and lower LVEF. The presence of fQRS in acute coronary syndrome patients could predict the presence of NSTEMI with fair diagnostic value.
Abstract: Background: To detect the potential in hospital prognostic value of fQRS complex in patients with acute coronary syndrome (ACS) & investigate whether FQRS complex can be used to distinguish patients with early NSTEMI from those with unstable angina. Methods: It included 150 patients with acute NSTEMI and unstable angina. All patients were subjected...
Show More
