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Resting Heart Rate and Associated Factors in Patients with Chronic Heart Failure in Cameroon: A Cross-sectional Study in Sub-saharan Africa
Ba Hamadou,
Jérôme Boombhi,
Audrey Joyce Foka,
Sylvie Ndongo Amougou,
Liliane Mfeukeu-kuate,
Chris Nadège Nganou,
Aurel Tankeu,
Ahmadou Musa Jingi,
Alain Menanga,
Kingue Samuel
Issue:
Volume 4, Issue 1, March 2020
Pages:
1-4
Received:
25 December 2019
Accepted:
2 January 2020
Published:
17 January 2020
Abstract: Introduction: Controlled heart rate has been associated with better prognosis in patients with chronic heart failure (CHF). Radial pulse palpation is a simple and useful method to evaluate heart rate control especially in limited resources setting such as sub-Saharan Africa. However, data on heart rate control in patients with heart failure are scarce in our context. Therefore, we sought to investigate heart rate control in patients followed for chronic heart failure in Cameroon. Methodology: We conducted a cross-sectional study from January to September 2017 in three specialized cardiology centers of Cameroon. We included patients with chronic heart failure, normal sinus rhythm without recent cardiac events. Resting heart rate was measured by pulse palpation after 05 minutes of rest, three (03) times over 60 seconds. An uncontrolled heart rate was defined as HR ≥70bpm. Results: Overall, 213 patients with a mean age of 63±15 years were included. About 64.8% of patients have a heart rate above recommended targets (≥70 bpm). There was no significant association between age, gender, NYHA stage, cardiovascular risk factors or current therapies and heart rate control. Conclusion: Uncontrolled heart rate is frequent in patients with chronic heart failure in our context with more than half presenting a resting heart rate above currently recommended values.
Abstract: Introduction: Controlled heart rate has been associated with better prognosis in patients with chronic heart failure (CHF). Radial pulse palpation is a simple and useful method to evaluate heart rate control especially in limited resources setting such as sub-Saharan Africa. However, data on heart rate control in patients with heart failure are sca...
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Role of NT-pro BNP Levels as a Marker of Early and Late Recurrence in Patients Submitted to Atrial Fibrillation Ablation with Normal Ventricular Function
Fabricio Vassallo,
Lucas Luis Meigre,
Christiano Cunha,
Eduardo Serpa,
Hermes Carloni,
Aloyr Simões Junior,
Flávia Pezzin,
Karla Meira,
Alberto Nogueira Junior,
Orly Lacerda Junior,
Walter Batista Junior,
Dalton Hespanhol
Issue:
Volume 4, Issue 1, March 2020
Pages:
5-10
Received:
21 December 2019
Accepted:
7 January 2020
Published:
21 January 2020
Abstract: BACKGROUND: Levels of NT-pro BNP has diagnostic and prognostic correlation in patients with heart failure. It is also described as a possible marker of atrial myocardial disease in patients with normal ventricular function associated with atrial fibrillation (AFib). Retrospective and prospective studies have shown that their high dosage prior and few months after AF ablation may be a risk factor for recurrence. OBJECTIVE: Determine if in patients submitted to first AFib ablation the previous levels of NT-pro BNP and at 6 and 12 months after the procedure the modification in these levels by the restoring and maintenance of sinus rhythm can identify patients at higher risk of recurrence of atrial tachyarrhythmias. METHODS AND RESULTS: From June 2015 and June 2017 we sequentially began the NT-pro BNP serial dosing in patients with paroxysmal and persistent AFib with preserved ventricular function. Levels were in the previous week, 6 and 12 months after the procedure. We prospectively analyzed 73 patients submitted to first time ablation of atrial fibrillation. In pre-procedure set 33 patients had elevated concentrations. Of these 15 (45.5%) remained elevated with a 40% recurrence rate at 12-months compared to 5.5% for those which normalized the levels. On the other hand, we had 40 patients that we considered normal NT-pro BNP levels before ablation. Of these 15 (37.5%) do not had a descent of more than 50% from baseline levels had recurrence rates of 33.3% at 12 months. The remaining 25 (62.5%) who show drops > 50% of NT-pro BNP recurrence was of only 8%. Patients who had high concentrations of NT-pro BNP or who did not present a significant decrease in these levels were, respectively, 2.25 and 2.28 times more likely to present atrial arrhythmias recurrences after catheter ablation. CONCLUSION: Our data showed that serial levels of NT-pro BNP in patients with atrial fibrillation and normal ejection fraction might identify those at higher risk of recurrence after successful catheter ablation.
Abstract: BACKGROUND: Levels of NT-pro BNP has diagnostic and prognostic correlation in patients with heart failure. It is also described as a possible marker of atrial myocardial disease in patients with normal ventricular function associated with atrial fibrillation (AFib). Retrospective and prospective studies have shown that their high dosage prior and f...
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Administration of Intracoronary Streptokinase During Primary Percutaneous Coronary Intervention for Anterior Wall Myocardial Infarction with Definite Coronary Thrombosis
Haytham Fathalla Emara,
Wael Mahmoud El Kilany,
Tarek Mounir Zaki,
Ahmed Mohamed El-Missiri
Issue:
Volume 4, Issue 1, March 2020
Pages:
11-16
Received:
2 February 2020
Accepted:
14 February 2020
Published:
24 February 2020
Abstract: Background: The presence of intracoronary heavy thrombus burden during primary percutaneous coronary intervention (PCI) plays increases the incidence of occurrence no-reflow phenomenon. Intracoronary thrombolytic therapy during primary PCI may improve microvascular perfusion. The aim of this study was to assess the effect of using 250,000 U of intracoronary streptokinase during primary PCI in patients presenting with an acute anterior wall ST segment elevation myocardial infarction (STEMI) with a definite thrombus in the left anterior descending coronary artery (LAD) on clinical and angiographic outcomes. Methods: Prospective cohort study conducted on 100 patients managed by primary PCI within 12 hours of symptom onset. Patients were divided into a study group (n=50) that received intracoronary streptokinase during primary PCI, and a control group (n=50) that received no additional therapy. Post-procedural TIMI flow grade, myocardial blush grade (MBG), and corrected TIMI frame count were assessed. Admission and peak CK-MB and percentage of ST segment resolution were recorded. At 6-months follow-up, assessment for major adverse cardiovascular events (MACE) was performed. Results: There were no differences between both groups regarding baseline clinical characteristics, time to reperfusion, and risk factors for the development of coronary artery disease. Peak CK-MB was significantly higher in the control group (p = 0.004). In the study group, a larger proportion of patients had TIMI 3 flow at the end of the procedure 42 (84%) vs 29 (58%) – p = 0.026, and a larger proportion had MBG 2 and 3, 23 (46%) vs 17 (34%) and 24 (48%) vs 14 (28%), respectively – p = 0.001. Corrected TIMI frame count at the end of the procedure was significantly smaller in the study group 24.2 ± 4.97 vs 31.28 ± 6.7 frames (p<0.0001). Conclusion: Administration of intracoronary streptokinase during primary PCI in patients presenting with acute anterior STEMI with definite coronary thrombosis improves coronary perfusion by improving TIMI flow grade, MBG, and shortening corrected TIMI frame count.
Abstract: Background: The presence of intracoronary heavy thrombus burden during primary percutaneous coronary intervention (PCI) plays increases the incidence of occurrence no-reflow phenomenon. Intracoronary thrombolytic therapy during primary PCI may improve microvascular perfusion. The aim of this study was to assess the effect of using 250,000 U of intr...
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Prevalence and Risk Factors of Sexual Dysfunction in Patients with Chronic Heart Failure in Yaoundé, Cameroon
Jerome Boombhi,
Berthe Eteki,
Ba Hamadou,
Mazou Ngou Temgoua,
Donald Tchapmi,
Alain Menanga,
Samuel Kingue
Issue:
Volume 4, Issue 1, March 2020
Pages:
17-21
Received:
5 February 2020
Accepted:
25 February 2020
Published:
10 March 2020
Abstract: Heart failure is a major public health problem in sub Saharan Africa, associated with high morbidity and mortality. Sexual dysfunction contributes a lot to the burden of the disease. This complication is linked to the side effects of drugs, physical and psychological factors, and the coexistence of shared risk factors between heart failure and sexual dysfunction. Although patients with heart failure frequently report sexual disorders, few data are available in our context. This research seeks to determine the prevalence and risk factors of sexual dysfunction in patients with chronic heart failure in three reference hospitals of Cameroon. We carried out an analytical cross-sectional study over a period of four months (January to April 2018). All consenting patient with chronic heart failure aged 18 years and above were selected. Baseline socio-demographical and clinical characteristics were collected. The assessment of sexual function was made using a self-administered questionnaire. Data analysis was done using the software IBM SPSS 23.0; the level of statistical significance was set at p<5%. A total of 170 patients with chronic heart failure were recruited, the mean age was 60.46 ± 10.66 years old, with a female predominance (sex-ratio=0.78). The prevalence of sexual dysfunction was 57.7%. The main sexual disorders were: Sexual desire disorders (21.65%), vaginal lubrication disorders (20%) in women, erectile disorders in men (17.3%), orgasmic dysfunction (7.22%), arousal disorders (4.44%) and sexual satisfaction disorders (1%). The independent risks factors of sexual dysfunction were: Female gender (p=0.008), age>60 years (p=0.001), hypertension (p=0.0017), use of beta blockers (p=0.0081) and fear of heart attack (p<0,001). Sexual dysfunction is common in patients with chronic heart failure in our context. Indeed, it affects more than half of our study population (57.7%) and is influenced by many factors.
Abstract: Heart failure is a major public health problem in sub Saharan Africa, associated with high morbidity and mortality. Sexual dysfunction contributes a lot to the burden of the disease. This complication is linked to the side effects of drugs, physical and psychological factors, and the coexistence of shared risk factors between heart failure and sexu...
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Acute Coronary Syndrome and Myocardial Ischemia in Hypertrophic Cardiomyopathy
Ambreen Gul,
Ali Gohar Lodro
Issue:
Volume 4, Issue 1, March 2020
Pages:
22-26
Received:
7 November 2019
Accepted:
29 January 2020
Published:
18 March 2020
Abstract: 47 years old male smoker with no co morbidities, presented with history of chest pain in the retrosternal area for the 3 days. The Pain was described as sharp, non-exertional and intermittent. Patient did not have any family history of known cardiac disease or sudden cardiac death. A Clinical examination failed to reveal any abnormalities. An ECG revealed deep T wave inversion in the anterolateral chest leads with left ventricular hypertrophy (LVH). Bloods analysis showed normal Complete blood count, liver function and mildly increased cardiac troponins. The Patient was admitted to the CoronaryCare Unit with a diagnosis of acute coronary syndrome. Patient was initiated dual antiplatelets, fondaparinux and high intensity atorvastatin. Following this, an echocardiogram revealed severe Left ventricular hypertrophy and reduced LV (left ventricular) cavity dimensions. Good LV systolic function with grade 3 diastolic dysfunction was noted. Coronary angiogram showed a normal right and left coronary system. Patient was diagnosed with hypertrophic cardiomyopathy. Cardiac MRI Showed severe Left ventricular hypertrophy with interventricular septum thickness 3.7 cm with rest of the walls hypertrophied. There was evidence of severe fibrosis of the septum, anterior and lateral wall. On the basis of severe left ventricular hypertrophy (especially septal thickness >3.5 cm) and myocardial fibrosis, Patient was started on beta blockers and ICD was inserted for primary prevention of arrhythmias.
Abstract: 47 years old male smoker with no co morbidities, presented with history of chest pain in the retrosternal area for the 3 days. The Pain was described as sharp, non-exertional and intermittent. Patient did not have any family history of known cardiac disease or sudden cardiac death. A Clinical examination failed to reveal any abnormalities. An ECG r...
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