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AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S28
Peripheral arterial disease of the lower limbs in asymptomatic diabetic patients: Prevalence and determining factors
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Peripheral arterial disease (PAD) of the lower limbs is an important predictor of cardiovascular disease. It is, however, still underdiagnosed
in asymptomatic diabetic patients, free of cardiovascular disease. The purpose of this study is to determine the prevalence and risk factors for PAD in an
asymptomatic population of diabetic patients at low, or intermediate, risk of cardiovascular disease, with a history free of cardiovascular disease.
Methods:
This was a prospective study conducted over a 14-month period, from November 2017 - January 2018. A total of 309 diabetic patients were
included from 2 diabetes centres. PAD was defined as an ankle-brachial index (ABI), less than 0.9.
Results:
Amongst the 309 patients, the ankle-brachial index (ABI) was <0.9 in 98 (31.71%) patients who were considered to have PAD. The ABI was >1.3 in
36 (11.35%) patients who had suspected mediacalcosis. The average age of the PAD population was 56.2 years. Female gender predominated (57%). The
mean duration of diabetes was 11years, 80% type II diabetes. PAD of the lower limbs was mild in 26 patients (26.53%), moderate in 49 (50%) and severe in 23
(23.46%). Duplex Doppler commonly showed lesions of the femoral and tibial arteries. Factors associated with PAD were advanced age (p<0.0001), duration
of diabetes >6 years (p<0.0001), uncontrolled diabetes as assessed by HbA1c levels >7% (p<0.0001), elevated fasting glucose levels (p=0.039), hypertension
(p<0.0001) and dyslipidemia (p<0.0001). For mediacalcosis, male gender was the only factor identified.
Conclusion:
Primary prevention outpatient screening of asymptomatic diabetic patients with lower, or intermediate, cardiovascular risk can identify
numerous patients with PAD. Advanced age, mean duration of diabetes over 6 years, uncontrolled diabetes, hypertension and dyslipidemia were predictive
factors for diabetic PAD of the lower limbs in our population.
Left ventricular diastolic dysfunction in normotensive non diabetic patients with abdominal obesity
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Abdominal obesity is an independent risk factor for cardiovascular disease. The effect of abdominal obesity on myocardial function in young
obese patients remains unknown.
Methods:
To assess the influence of obesity on left ventricular function, 50 obese asymptomatic patients [mean body mass index (BMI) 35.8 ±
4.2kg/m
2
and mean age 39.2 ± 2.4 years] without evidence of heart disease were evaluated by echocardiography.
Results:
Results showed that diastolic dysfunction was present in 21 (42%) patients. Diastolic dysfunction was more common amongst females (68.18%)
when compared to males (50.17%). The mean left ventricular mass index was 103 ± 22g/m
2
.
Conclusion:
In conclusion, diastolic dysfunction might be an early indicator of cardiac involvement in obesity.
Left ventricular diastolic dysfunction in type II diabetes mellitus with preserved systolic function: Prevalence and associated
factors
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Doppler echocardiography has contributed significantly to identifying the existence of a distinct diabetic cardiomyopathy, independent
of concomitant risk factors. The objective of our study was to evaluate the prevalence of diastolic dysfunction, and identify its associated factors, in type II
diabetic patients in light of the 2016 recommendations of the American Society of Echocardiography.
Methods:
A cross-sectional observational study, with a descriptive and analytic focus, was done over a 6-month period from July - December 2017.
We studied 66 asymptomatic patients with type II diabetes mellitus without evidence of cardiovascular involvement, blood pressure less than 130/80mmHg
and with a maximal treadmill exercise test showing no ischaemia. LVDD was evaluated by Doppler echocardiography.
Results:
The mean age of our population, was 42 ± 9 years with extremes ranging from 39 - 84 years. A female predominance (68%) was noted with a
sex ratio of 2.14. The prevalence of diastolic dysfunction was 27%. Factors associated with this change in diastolic function were advanced age (p<0.0001),
duration of diabetes >10 years (p<0.0001), uncontrolled diabetes as assessed by HbA
1c
levels >7% (p<0.0001) and elevated fasting glucose levels (p=0.039),
obesity (p<0.0001), dyslipidemia (p<0.0001) and menopause (p=0.002).
Conclusion:
Diastolic dysfunction affects a significant percentage of patients with type II diabetes. Therefore, we propose strict glycaemic control in those
subjects at-risk as well as early cardiographic echo screening to improve their management and to limit their progression to more serious complications.
Metabolic syndrome in hypertensive women
Maryam Mouadili
CHU MED VI Marrakech Maroc, Marrakesh, Morocco
Introduction:
Metabolic syndrome (MetS) is recognised as a cluster of cardiovascular risk factors. Appropriate treatment can reduce cardiovascular morbidity
and mortality. However, cardiologists may not routinely diagnose MetS. The aim of this study was to identify the prevalence of MetS amongst hypertensive
women and to study the characteristics of this population.
Methods:
We studied 248 hypertensive women, median age 61 years (range 18 - 86). Ten percent of them were diagnosed with MetS. A health questionnaire,
including personal history of hypertension, diabetes mellitus (DM), smoking habits and medication, was completed for all participants. Waist circumference
and blood pressure were measured and plasma glucose and a complete lipid profile were done.
Results:
One hundred and twenty-two patients (49.19%) met the criteria for MetS. We divided our patients into 3 groups according to their age (<40, 40 - 65
and >65 years). No statistical significant difference was noted in the prevalence of MetS in these 3 groups (50.7, 43.6 and 53% respectively). Concerning MetS