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Research Article
Pulmonary Arterial Hypertension: Epidemiological, Clinical Aspects and Prognoses in the Cardiology Department and Internal Medicine of CHU Brazzaville
Solange Flore Mongo Ngamami,
Ruddy Junior Taty,
Kivie Mou-moue Ngolo Letomo*,
Christian Michel Kouala Landa,
Gankama Thibault Naibe,
Jospin Karel Makani Bassoukouahou,
Rog Paterne Bakekolo,
Meo Stephane Ikama,
Fikahem Ellenga Mbolla
Issue:
Volume 8, Issue 1, April 2024
Pages:
1-6
Received:
15 December 2023
Accepted:
27 December 2023
Published:
18 January 2024
Abstract: Pulmonary Arterial Hypertension PAH is a medical condition serious and severe. In Congo, its epidemiology and its etiologies are poorly understood. This study, aimed at improving the care of patients with PAH, was interested to epidemio-clinical aspects, and prognosis of this entity. This was a retrospective, cross-sectional study carried out from the 1st January 2021 to December 31, 2022 (2 years) in Brazzaville University Hospital. Were included 148 patients, the diagnostic criteria having permit to retain a PAH were compliant to that of the PAPUCO study (PAH if PAPS ≥ 35 mmHg, severe PAH if PAPS ≥ 60 mmHg). The heart failure syndrome was present in 140 cases (94.6%), it was right exclusively in 36 cases (24.3%). The etiologies of the group, they were present in 97 cases (66%) followed group III in 24 cases (16.2%). PAH was said to be severe in 39 cases (26.3%). The evolution has been towards complications in 29 cases (19.6%), lethality in 17 cases (11.5%). Poor prognosis factors were the existence of underlying heart disease underlying (AOR =5.6; p =0.02), male sex (AOR=4.8; p=0.02); hyperkalemia (AOR= 9.4; p=0.00). High blood pressure pulmonary is an increasingly common condition encountered in clinical practice in our context.
Abstract: Pulmonary Arterial Hypertension PAH is a medical condition serious and severe. In Congo, its epidemiology and its etiologies are poorly understood. This study, aimed at improving the care of patients with PAH, was interested to epidemio-clinical aspects, and prognosis of this entity. This was a retrospective, cross-sectional study carried out from ...
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Research Article
Value of the Novel Dynamic Coronary Roadmap in Percutaneous Coronary Intervention
Ahmed Mansy,
Sameh Allam,
Mohamed Hussien,
Omar Solyman
Issue:
Volume 8, Issue 1, April 2024
Pages:
7-13
Received:
4 January 2024
Accepted:
22 January 2024
Published:
5 February 2024
Abstract: Background: An innovative technological advancement, the dynamic coronary roadmap (DCR) superimposes the coronary arteries on a fluoroscopic image in real-time while compensating for motion. Aim: to determine the value of DCR in percutaneous coronary intervention. Methods: This study was conducted on 193 patients with anginal pain, who come for Percutaneous coronary intervention (PCI) on elective basis, who found to have multiple/complex lesions suitable for PCI, and expected to have a long procedure time and large contrast volume. They divided into two groups; DCR group which included 93 patients in which PCI was done with DCR while control group included 100 patients in which PCI was done without DCR. All patients subjected to clinical assessment, full resting 12-Lead ECG, history taking, routine pre-catheter laboratory investigations and transthoracic Echocardiography. Conventional coronary angiography followed by PCI was done then we used Dynamic Roadmap system. Results: The DCR group had considerably lower levels of total air kerma and DAP than the control group (p0.001). In addition, the DCR group compared to the control group regard as fluoroscopy duration was significantly reduced in (p0.001). 100 percent of procedures were successful in both the control and DCR groups. In the control group, there were no significant variations in radiation dosage between operators 1 and 2, however operators 2 had considerably less fluoroscopy duration and contrast volume (p=0.002 and 0.023, respectively). No significant were recorded in contrast volume, radiation dose, or fluoroscopy time between operators 3 and 4 in the DCR group. Conclusion: Dynamic coronary road map significantly reduces contrast volume, Total air kerma and DAP, fluoroscopy time with 100% procedural success.
Abstract: Background: An innovative technological advancement, the dynamic coronary roadmap (DCR) superimposes the coronary arteries on a fluoroscopic image in real-time while compensating for motion. Aim: to determine the value of DCR in percutaneous coronary intervention. Methods: This study was conducted on 193 patients with anginal pain, who come for Per...
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Review Article
Cardioembolic Cerebral Accident: Epidemiological and Paraclinical Aspects at the Brazzaville University Hospital
Solange Flore Mongo Ngamami,
Ludwine Orlane Kimbekete,
Christian Michel Kouala Landa,
Kivie Mou-moue Ngolo Letomo*,
Rog Paterne Bakekolo,
Eric Gibrel Kimbally Kaky,
Ruddy Junior Taty,
Gankama Thibault Naibe,
Jospin Karel Makani Bassoukouahou,
Macair Ossou-Nguiet,
Fikahem Ellenga Mbolla
Issue:
Volume 8, Issue 1, April 2024
Pages:
14-20
Received:
10 January 2024
Accepted:
22 January 2024
Published:
5 February 2024
Abstract: Purpose: to show the value of the Doppler echocardiogram and the Holter-ECG performed systematically during the etiological assessment of a first episode of ischemic stroke. Methods and patients: this was a prospective and descriptive study, carried out from May 1 to October 31, 2020 (six months) in the cardiology and neurology departments of the Brazzaville University Hospital Center. It included patients who had a first episode of ischemic stroke confirmed on brain scan and carried out a cardiological assessment. Results: fifty patients were included, including 26 women. The mean age was 63.9 ± 12.8 years (34 - 82 years). Transthoracic echocardiography and ECG detected emboligenic heart disease in 42 cases (84%), major heart disease in 38 cases (76%). The major emboligenic heart disease was dilated cardiomyopathy in 17 cases (34%); ischemic heart disease in 6 cases (12%), mitral stenosis in 2 cases (4%), and atrial fibrillation in 13 cases (26%). The Holter-ECG revealed permanent atrial fibrillation in 13 patients (26%), paroxysmal atrial fibrillation in 1 patient, paroxysmal atrioventricular block in one patient. Conclusion: in our work, the echocardiogram and the Holter -ECG made it possible to identify twenty-nine thromboembolic causes of stroke. These explorations are essential in the etiological assessment.
Abstract: Purpose: to show the value of the Doppler echocardiogram and the Holter-ECG performed systematically during the etiological assessment of a first episode of ischemic stroke. Methods and patients: this was a prospective and descriptive study, carried out from May 1 to October 31, 2020 (six months) in the cardiology and neurology departments of the B...
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Research Article
Mortality Predictors in Patients with Cardiovascular Involvement by COVID-19
Roberto Ramos Barbosa*,
Lucas Crespo de Barros,
Rodolfo Costa Sylvestre,
Larissa Novaes Paganini,
Pietro Dall’Orto Lima,
Lucas Martins Frizzera Borges,
Darlan Dadalt,
Glícia Chierici Baptista,
Layla Pasolini Lott,
Valentin Trevizani Neto,
Eduardo Gomes Vieira,
Amanda Alencar de Araujo,
Hemely Almeida do Nascimento,
Lucas Bandeira Lima,
Rodrigo Monico Cavedo,
Lucas Vieira Pinto,
Amanda Lessa Martins,
Emanuella Esteves Machado,
Renato Giestas Serpa,
Osmar Araujo Calil,
Luiz Fernando Machado Barbosa
Issue:
Volume 8, Issue 1, March 2024
Pages:
21-28
Received:
11 January 2024
Accepted:
25 January 2024
Published:
20 February 2024
Abstract: Introduction: SARS-CoV-2 is a new coronavirus responsible for one of the most evident diseases today, COVID-19, registering approximately 419,000 deaths until 2020. Some risk factors for infection and mortality must be assessed in clinical and research scenarios, such as the presence of cardiovascular diseases, with clinical and laboratory alterations. Objective: Our study aims to analyze the association between clinical and laboratory data and in-hospital mortality in patients with cardiovascular involvement by COVID-19 in Brazil. Method: This is a retrospective, observational, single-center cohort study. The sample consisted of patients admitted to a reference hospital from July 2020 to April 2021. We included patients over 18 years of age, hospitalized with COVID-19 infection, who developed heart involvement identified by clinical or laboratory findings. Patients who were pregnant or had negative serological tests for COVID-19 were excluded. Clinical variables such as gender, age, comorbidities, medications used during hospitalization, chest computed-tomography findings, need for intensive care unit, need for mechanical ventilation, and need for intravenous vasoactive drugs were analyzed. The laboratory variables analyzed were: troponin, NT-proBNP and D-dimer levels. The endpoint of the study was in-hospital death. Statistical analysis of the collected data was performed using Pearson's Chi-square test, Student's T test; p values < 0.05 were considered statistically significant. Results: 139 patients were included, and 30 (21.58%) patients died during hospitalization. The group that evolved to death, compared to the discharge group, was older (71 vs 65 years; p = 0.03), had more pleural effusion on chest computed-tomography (36% vs 17%; p = 0.023), had higher troponin levels (40% vs 20%; p = 0.02), more need for intensive care (83% vs 52%; p = 0.002), orotracheal intubation (83% vs 26%; p = 0.001), use of norepinephrine (76% vs 18%; p = 0.001), use of dobutamine (16% vs 4%; p = 0.023), and use of unfractioned heparin (46% vs 21%; p = 0.005). Conclusion: Advanced age was significantly associated with in-hospital death. In radiological patterns, despite the high incidence of ground-glass opacities, pleural effusion was the only finding associated with mortality. Increased troponin levels, but not NT-proBNP or D-dimer, was associated with in-hospital mortality. The need for norepinephrine and dobutamine, in addition to Intensive Care Unit admission and orotracheal Intubation, were also more frequent in the group that presented death during hospitalization, as wells as the use of unfractionated heparin rather than enoxaparin.
Abstract: Introduction: SARS-CoV-2 is a new coronavirus responsible for one of the most evident diseases today, COVID-19, registering approximately 419,000 deaths until 2020. Some risk factors for infection and mortality must be assessed in clinical and research scenarios, such as the presence of cardiovascular diseases, with clinical and laboratory alterati...
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Case Report
Early Postoperative Cardiac Rehabilitation in LVAD Patients: A Case Report
Yi-qi Cao,
Guo-qiang Zheng,
Li-min Zhong,
Ke-yi Chen,
Gang Wang,
Zhi-wei Mou*
Issue:
Volume 8, Issue 1, March 2024
Pages:
29-34
Received:
5 February 2024
Accepted:
21 February 2024
Published:
29 February 2024
Abstract: This study emphasizes the crucial role of early mobilization and proactive physical therapy for individuals undergoing left ventricular assist device (LVAD) therapy in the context of chronic or end-stage heart failure. Given the intricate medical complexities and prolonged hospitalizations inherent in this patient cohort, specialized cardiac rehabilitation (CR) strategies emerge as indispensable components in cardiovascular medicine. Detailed herein is a case study featuring a 62-year-old male patient who underwent LVAD implantation and participated in a 7-week cardiac rehabilitation program. The observed outcomes revealed substantial improvements in exercise capacity and muscle strength, assessed through standardized physical assessments. Importantly, echocardiographic evaluation demonstrated no adverse effects on left ventricular function. This case underscores the pivotal significance of early rehabilitation intervention during the postoperative phase, particularly in patients exhibiting stable vital signs and hemodynamics. The findings contribute to the refinement of tailored rehabilitation approaches for LVAD recipients, thereby fostering enhanced clinical outcomes and an elevated quality of life in this specialized patient population. The study underscores the critical importance of implementing early rehabilitation strategies in the holistic care paradigm for LVAD recipients, with potential implications for optimizing therapeutic protocols and improving long-term patient outcomes in the field of cardiovascular rehabilitation.
Abstract: This study emphasizes the crucial role of early mobilization and proactive physical therapy for individuals undergoing left ventricular assist device (LVAD) therapy in the context of chronic or end-stage heart failure. Given the intricate medical complexities and prolonged hospitalizations inherent in this patient cohort, specialized cardiac rehabi...
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Research Article
Association of Periodontitis with Ambulatory Blood Pressure, Salt Intake, and Neutrophil-Lymphocyte Ratio in High-Risk Hypertensive Patients
Tiago Pinto-Ribeiro*,
Ricardo Faria-Almeida,
Ana Monteiro,
Júlio César Matias Souza,
António Felino,
Jorge Polónia
Issue:
Volume 8, Issue 1, March 2024
Pages:
35-45
Received:
21 February 2024
Accepted:
4 March 2024
Published:
13 March 2024
Abstract: Objective: Periodontitis and cardiovascular disease are prevalent entities that often coexist, with a common pro-inflammatory pathway. The objective of this study was to evaluate the association between periodontitis and cardiovascular pro-inflammatory parameters rarely considered within risk factors. Methods: Forty-three participants aged between 38-82 years were examined. An association between mean probing depth (MPD), mean attachment loss (MAL), bleeding on probing (BOP), and periodontal inflamed surface area (PISA) was correlated with the following cardiovascular disease factors and inflammatory promoters: neutrophil-to-lymphocyte ratio (NLR), 24h ambulatory blood pressure, global cardiovascular risk, daily salt intake, night-time systolic blood pressure (nSBP), and pulse wave velocity (PWV). A two-way ANOVA and multiple comparison tests were performed using SPSS statistics software. Results: A highly significant correlation (p<0.05) was found between BOP, MPD, and MAL with high salt intake, global cardiovascular risk estimation, nSBP, and PISA. Also, significantly statistical correlation (p<0.05) was found between BOP, NLR, and PWV while PISA was only associated with NLR. Logistic regression analysis identified absolute values of nSBP, salt intake and NLR as possible independent contributors to the increase in the log odds of developing BOP. Conclusions: Several periodontal disease parameters are linked to cardiovascular risk factors such as hypertension, neutrophil-to-lymphocyte ratio, daily salt intake and night-time systolic blood pressure.
Abstract: Objective: Periodontitis and cardiovascular disease are prevalent entities that often coexist, with a common pro-inflammatory pathway. The objective of this study was to evaluate the association between periodontitis and cardiovascular pro-inflammatory parameters rarely considered within risk factors. Methods: Forty-three participants aged between ...
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Research Article
Aspects of Coronary Angiography in Diabetic Patients at the CHU Mother and Child Luxembourg in Bamako
Touré Mamadou*,
Konaté Massama,
Sako Mariam,
Sidibé Samba,
Mariko Souleymane,
Traoré Djénébou,
Sow Djénéba Sylla,
Thiam Coumba Adiaratou,
Sonfo Boubacar,
Ba Hamidou Oumar,
Menta Ichaka
Issue:
Volume 8, Issue 1, March 2024
Pages:
46-50
Received:
26 February 2024
Accepted:
9 March 2024
Published:
2 April 2024
Abstract: Introduction: Type 2 diabetes is on the increase in Africa as a result of the epidemiological transition. Cardiovascular complications, particularly ischemic complications, are common in diabetic patients. They are life-threatening. It is important to identify the angiographic appearance of the coronary arteries in diabetic patients in order to guide treatment. Objective: to identify the results of coronary angiography in diabetic patients. Patients and method: Descriptive, cross-sectional study with retrospective recruitment over a three-year period from September 2019 to August 2022. All diabetic patients who underwent coronary angiography at the CHU mother child Luxembourg in Bamako were included. Results: We enrolled 371 patients out of 985 during the study period, i.e. a hospital frequency rate of 37.66%. The mean age of the patients was 60.76 +/- 10.26 years, with extremes of 32 and 84 years. They were predominantly male, with a sex ratio of 1.45. The predominant functional signs were typical chest pain (39.4%), atypical chest pain (27.8%) and dyspnea (13.2%). The predominant risk factors were hypertension (74.7%), sedentary lifestyle (48.8%) and smoking (17.5%). The indications for coronary angiography were chronic coronary syndrome (55%) and acute coronary syndrome (45%). Coronary angiography was pathological in 78.4% of patients, with tritruncular lesions in 38% and bi-truncal lesions in 21%. Lesions were located on the common trunk in 5.4%, on the anterior interventricular in 59.8%, on the right coronary in 51.8% and on the circumflex in 47.4%. Conclusion: Ischemic heart disease is common in diabetic patients with tri- and bi-truncular lesions.
Abstract: Introduction: Type 2 diabetes is on the increase in Africa as a result of the epidemiological transition. Cardiovascular complications, particularly ischemic complications, are common in diabetic patients. They are life-threatening. It is important to identify the angiographic appearance of the coronary arteries in diabetic patients in order to gui...
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