5 / 74
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 5, September/October 2014
AFRICA
199
From the Editor's Desk
This issue contains useful information on patterns of disease
presentation in Africa. Grimaldi and colleagues (page 204)
document the pattern of structural heart disease causing heart
failure in patients presenting to a tertiary hospital in Kampala.
Many were young and suffered from rheumatic heart disease
(RHD) and congenital heart disease (CHD). One suspects
this was a highly selected group as the patients were identified
during NGO missions, presumably aimed at identifying suitable
candidates for surgery. Nonetheless the article reflects the
importance of RHD as a cause of disability and death in
the young in Uganda, as in many other parts of Africa,
and emphasises the need for efforts to improve primary and
secondary prevention of this eminently preventable disease.
Another aspect of the heart failure spectrum is presented by
Ogah and colleagues (page 217). A registry of patients admitted
to hospital with acute heart failure and followed for six months
showed a pattern of disease different from that found in high-
income countries. Patients were younger, the aetiology of the
heart failure was most commonly hypertensive heart disease,
and an ischaemic aetiology was uncommon. In another article
investigating hypertensive heart disease, Ojji and colleagues (page
233) report that brain natriuretic peptide is useful in evaluating
cardiac remodelling in African patients with hypertension.
Thrombolysis for acute ischaemic stroke is, I suspect, used
much less frequently in Africa than in many other parts of the
world because of resource constraints. It is helpful to learn from
von Klemperer and co-workers (page 224) that predictors for the
serious complication of intracranial haemorrhage, developed
elsewhere, apply in an African setting, although it is important
to recognise that the demographics of the population of Cape
Town differ considerably from the rest of Africa.
PJ Commerford
Editor-in-Chief