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AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S26
Quality of life in patients with chronic heart failure in Brazzaville (Republic of the Congo)
Bertrand Fikahem Ellenga Mbolla*, Bijou Moualengué
#
, Solange Flore Mongo Ngamami
#
, Christian Kouala Landa
#
, Rog Paterne Bakekolo
#
,
Jospin Makani Bassakouahou
#
, Meo Ikama* and Suzy-Gisèle Kimbally Kaky*
*Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of the Congo.
#
Department of Cardiology, University Hospital of Brazzaville,
Brazzaville, Republic of the Congo
Introduction:
Chronic heart failure (CHF) is worldwide regarded as a public health problem which impacts patients’everyday lives. The aim of this study was
to determine the associated poor quality of life (QoL) factors in patients with CHF.
Methods:
This cross-sectional study was conducted from March to December 2018 at the Department of Cardiology of the Teaching University Hospital of
Brazzaville. We included outpatients with compensated CHF following an ambulatory consultation. The Framingham criteria were used for the diagnosis of HF.
For the evaluation of QoL, the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used.
Results:
Ninety-one patients, 58 women (63.7%), were included. The mean age was 61.8 ± 12.7 years. Patients were aged 60 years and older (n=48, 52.8%)
and belonged to a low-income bracket (n=79, 86.8%). CHF had been evolving for over 3 years in 28 cases (30.8%). Rehospitalisation for HF was 39 (42.9%).
Comorbidities were hypertension (n=58, 63.7%) and diabetes (n=10, 11%). Left ventricular ejection fraction was under 40% in 52 cases (57.1%). Patients
had poor adherence in 25 cases (27.5%). Stress dyspnea was reported in 27 cases (29.7%). The mean MLHFQ score was 18 ± 14.9 points (range: 0 and 78
points). Poor QoL was noted in 17 cases (18.7%). The psychological and physical domains contributed to poor QoL. The associated factors of poor QoL were:
rehospitalisation (n=39, 42.9%, OR 4.18, 95% CI 1.3 - 13.1, p=0.02), dyspnea (n=27, 29.7%, OR 13.9, 95% CI 3.9 -49.2, p<0.001), poor adherence (n=10, 58.8%, OR
5.6, 95% CI 1.8 - 17.2, p=0.002), tachycardia (n=10, 58.8%, OR 6.7, 95% CI 2.1 - 21, p=0.001) and reduced mobility during the 6 minute walk test (n=4, 23.5%, OR
14, 95% CI 1.7 - 113, p=0.006). Low income was not associated with poor QoL (n=14, 82.4%, OR 0.64, 95% CI 0.15 - 2.6, p=0.5).
Conclusion:
Factors associated with poor quality of life in patients living with CHF are: rehospitalisation, dyspnea, reduced mobility and poor
adherence. Effective actions must be taken to improve therapeutic education.
Atrial myxoma: A report of 5 cases
Moleboheng Molopa*, Shungu Mogaladi
#
and Ruchika Meel
†
*Gauteng Department of Health, Johannesburg, South Africa.
#
Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
†
Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
Introduction:
Atrial myxomas are rare tumours with an occurrence of 0.02%. There are few case reports from Africa, the last report comprised 5 patients over
a period of 10 years. Herein, we report 5 cases of atrial myxoma over the period of a year.
Methods:
We reviewed clinical, echocardiographic and histology of 5 cases of atrial myxoma which were operated on at Charlotte Maxeke Academic
Hospital over a 1-year period.
Results:
Five patients with atrial myxoma are described. The case series comprised 4 females and 1 male with a mean age of 44.8 years (youngest 23 and
oldest 79 years), all Africans. Dyspnea and coughing being the most common presentation and a tumour plop was heard in all patients with left atrial (LA)
myxoma. Systemic embolic presentations included dry gangrene of the left hand 5th digit and expressive aphasia. Ascites and pedal oedema were noted
with right atrial (RA) myxoma. Twenty percent presented with anaemia needing transfusion. On echocardiography, all had preserved ejection fraction, atrial
myxoma was noted in the LA in 60% of the patients and 40% in the RA. Forty percent of patients had functional tricuspid regurgitation and 40% had mitral
inflow obstruction. The mean size of the myxoma on echocardiography was 12mm x 22mm. Intra-operatively, all specimens were pedunculated, friable
gelatinous masses with mean size of 10mm x 25mm. One RA myxoma was protruding into the IVC, deep hypothermic circulatory arrest was initiated to
inspect the IVC for tumour extension. Modified De Vega tricuspid annuloplasty was performed in patients with RA myxoma. Histological findings were in
keeping with atrial myxoma in all cases. Mean post-operative stay was 5 days. All patients had uneventful hospital stays and were discharged home and
remained well on follow-up.
Conclusion:
We have described 5 cases of myxoma with unique presentations.
Tricuspid atresia: A retrospective review and 20-years’ experience at a large SA tertiary care centre
Mohamed Monareng and Antoinette Cilliers
Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
Introduction:
Tricuspid atresia (TA) accounts for 1% - 3% of congenital heart defects. It is the third most common form of cyanotic congenital heart lesions.
It is a single ventricle defect and results from a complete lack of formation of the tricuspid valve that leads to hypoplasia, or absence of the right ventricle. The
objectives of this study was to review cases with TA seen at Chris Hani Baragwanath Academic Hospital (CHBAH) Paediatric Cardiology Unit (PCU), Soweto,
Gauteng, over a 20-year period and to document the clinical outcomes.
Methods:
Retrospective, descriptive study of children diagnosed with TA over the past 20 years. Data were extracted from the paediatric cardiology
electronic database at CHBAH.
Results:
A total of 115 patients were diagnosed with a median age at diagnosis of 2 months (range, day 1 - 23 years). Female to male ratio 1:0.85.
The most common anatomical types were: type 1 (82.6%), type 2 (16.5%) and type 3 (0.9%). Of type 1, 62% had 1B, 21% had 1A and 17% had 1C. Of type 2,
37% had 2B, followed by 32% for both types 2A and 2C. Only 1 patient had type 3B and none had 3A. Most frequent presenting feature was cyanosis (100%).
A total of 54 patients underwent surgery; 33 had a Blalock-Taussig (BT) shunt initially of which 7 proceeded to at Glenn shunt and 1 to a Fontan operation.
Fifteen patients had an initial Glenn shunt of which 1 had a Fontan. Six patients with increased pulmonary blood flow had an initial pulmonary artery band of
which 1 proceeded to a Glenn shunt. The overall case fatality rate was 26% ascribed to the cardiac lesion and sepsis post-surgery.
Conclusion:
The majority of patients have TA 1B. Management is a series of complex operations. Only half of the study cohort underwent surgery.
The case fatality rate is high.