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Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S33
AFRICA
Simplifying the screening of hypertension in Cameroonian children and adolescents using blood pressure to height ratio
Yanwou Nguemnang Nathan Yves
Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
Introduction:
The diagnosis of arterial hypertension in children is complex due to constraints regarding time needed to use the recommended tools.
Simpler methods are thus necessary.
Methods:
This study aimed to evaluate the performance of a new tool, the blood pressure to height ratio, in the diagnosis of hypertension in a paediatric
group. From November 2017 - April 2018, school aged children in Yaoundé were recruited in the study. Height and blood pressure were measured according
to international recommendations. SBPHR and DBPHR were calculated. The sensitivity, specificity and precision of threshold identifying prehypertension and
hypertension in children and adolescents were evaluated using the ROC curves. The level of statistical significance was set at 95%.
Results:
A total of 1 239 children and adolescents were enrolled in this study. Adolescents (58.9%) and female sex (61.9%) were most represented.
Cut-off values of BPHR/DBPHR for the diagnosis of prehypertension and hypertension were 0.77/0.52 and 0.81/0.53 in children aged 6 - 11 years, while it
was 0.72/0.40 and 0.76/0.45 in adolescence aged 12 - 17 years, respectively. The areas under the cut-off curve for the diagnosis of hypertension were all
greater than 0.9. Specificity and sensitivity of threshold were greater than 97%, but negative predictive value was poor, ranging from 0.5% - 2.5%.
Conclusion:
Blood pressure to height ratio is an effective, readily available and simple tool to use in the screening of hypertension and pre-hypertension in
children. Though it may not substitute the gold standard in term of diagnosis, it remains a reliable screening tool.
The management of pulmonary embolism at the cardiology department of Grand Yoff General Hospital in Dakar, Senegal:
Cross-sectional study of 61 cases
Aliou Alassane Ngaide*, Maimouna Sow
#
, Ngoné Diaba Gaye
†
, Momar Dioum
‡
, Fatou Aw#, Sérigne Mor Beye
§
, Salimatou Dela Diallo
§
, Cheikh Gaye
§
,
Khadidiatou Gueye§ and Alassane Mbaye
§
*University Cheikh Anta DIOP of Dakar, Senegal.
#
Hospital Aristide Le Dantec, Dakar, Senegal.
†
Institute of Medico-Social Foresight Hospital, Dakar, Senegal.
‡
FANN National Hospital, Dakar, Senegal.
◊
Regional Hospital of Saint Louis General Hospital, Dakar, Senegal.
§
General Hospital of Grand Yoff, Dakar, Senegal
Introduction:
Pulmonary embolism is a serious, life-threatening condition. Once considered rare in Africa, it is becoming increasingly frequent. We aim to
evaluate the aetiological, therapeutic and prognostic factors of pulmonary embolism in a cardiology department in Dakar, Senegal.
Methodology:
This is a retrospective and descriptive study conducted from 1 January 2010 - 31 December 2015 at the cardiology department of the
General Hospital of Grand Yoff amongst patients admitted for pulmonary embolism confirmed with CT angiography.
Results:
Sixty-one (61) cases of pulmonary embolism were recorded (1.7%) with a sex ratio of 0.30 and an average age of 54.85 ± 17.01 years. Aetiologies
were dominated by medical factors (age over 60, diabetes, smoking and phlebitis) with 70.5% of cases, gynaecological or obstetric factors (13.1%) and surgical
or orthopaedic factors (16.4%). Pulmonary embolism was bilateral in 39 cases and unilateral in other cases. Echocardiography showed dilation of the right
ventricle in 34 patients and pulmonary hypertension in 29. Pulmonary embolism was at high risk of premature death in 9 cases (14.75%), at intermediate risk
in 32 cases (52.45%) and at low risk in 20 cases (32.78%). All patients were treated with anticoagulants and 7 with thrombolysis following a cardiovascular
collapse. NOACs were prescribed because of the very high cost. Five patients died, 2 of the 9 cases of high-risk pulmonary embolism (22.2%) and 3 of 53 cases
(5.8%) who were not considered at high risk (p=0.037).
Conclusion:
Our study shows the prevalence of pulmonary embolism in women. Aetiological factors are essentially medical. The prognostical risk of
premature death is often intermediate, or low, but mortality is significantly higher in high-risk patients. The anticoagulant treatment is still based on the anti-
vitamin K.
Management and aetiological profile of heart failure in a general cardiology service in Senegal: Cross-sectional descriptive
study of about 103 cases
Aliou Alassane Ngaide*, Maimouna Sow
#
, Ngoné Diaba Gaye
†
, Momar Dioum
‡
, Fatou Aw
#
, Sérigne Mor Beye
§
, Salimatou Dela Diallo
§
, Cheikh Gaye
§
,
Simon Antoine Sarr
#
, Mouhamed Haris
§
and Alassane Mbaye
§
*University Cheikh Anta DIOP of Dakar/General Hospital of Grand Yoff.
#
Hospital Aristide Le Dantec, Dakar, Senegal. †Institute of Medico-Social Foresight
Hospital, Dakar, Senegal.
‡
FANN National Hospital, Dakar, Senegal.
◊
Regional Hospital of Saint Louis General Hospital, Dakar, Senegal.
§
General Hospital of
Grand Yoff, Dakar, Senegal
Objectives:
The aim of this study was to evaluate management and the aetiological profile of heart failure in a cardiology department in Dakar, Senegal.
Methodology:
A cross-sectional study was conducted at Grand Yoff General Hospital from 1 June - 30 September. Patients aged 15 years or younger
hospitalised for heart failure were included. Heart failure was defined by the presence of symptoms and clinical signs (dyspnea, distension of jugular vena,
hepatomegaly, oedema of the lower limbs, rales) and confirmed by echocardiography. Heart failure was divided in 3 categories: heart failure with reduced
ejection fraction (less than 40%), heart failure with preserved ejection fraction (normal >50%) and intermediate ejection fraction (between 40% - 49%).
Diagnosis of ischaemic heart disease was based on proven coronary history and/or segmental contraction abnormalities on echocardiography. Data were
analysed with Sphinx V.5 software.
Results:
A total of 103 patients, hospitalised for heart failure, were enrolled. Mean age was 58.92 years. Sex ratio M/F was 1.02. Most common cardiovascular
risk factors were age (65.05%) and hypertension (46.6%). Left ventricular ejection fraction was reduced in 48% of patients. Most frequent aetiologies were
dilated cardiomyopathy (35%) and ischaemic cardiomyopathy (27,2%). In the acute phase, 72% of patients were hospitalised in intensive care units in
cardiology and the prescription consisted mainly of loop diuretics (92.2%), spironolactone (59.2%) and angiotensin conversion enzyme inhibitors (61.2%).
At discharge, spironolactone was prescribed in 60.2% of cases, thiazidic diuretics in 28.2%, ACE inhibitors in 48.50% and beta-blockers in 33%.
Conclusion:
Heart failure, with reduced ejection fraction, was most common in our population. Dilated and ischaemic cardiomyopathies were the most
frequent aetiologies.