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Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S35
AFRICA
46 ± 8.0% FP. By day 3, fibrin and FP released more than 90 ± 5.7% of bound VEGF whilst FPH continued to release an average of 8.58 ± 0.05ng/day with
41 ± 5.1% still bound by 11 days. In vitro, spheroids viability was maintained post encapsulation with significant invasion. From thromboelastograms,
FPH inhibited coagulation in blood.
Conclusion:
To our knowledge, this is the first study to conjugate heparin to fibrinogen in this manner, forming anti-thrombotic fibrin with enhanced growth
factor binding. This offers a natural and convenient delivery vehicle, mimicking the extracellular matrix. The gel will be evaluated in vivo for neovascularisation.
A case of severe tricuspid regurgitation due to traumatic tricuspid valve papillary muscle rupture
Bongane Ngutshane*, Shungu Mogaladi
#
and Ruchika Meel
†
*Gauteng Department of Health, Johannesburg, South Africa.
#
Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand,
Johannesburg, South Africa.
†
Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
Introduction:
There have been at least 160 published case reports pertaining to the subject of traumatic tricuspid valve injury since the 1960s. These reports
emanated from different parts of the world, however, reports from Africa have been scarce. Herein, we report in detail a case of trauma related tricuspid valve
insufficiency from South Africa. Further, we highlight the importance of 2 and 3 dimensional (3D) echocardiographic imaging of the tricuspid valve and its
utility in aiding a successful surgical repair.
Methods:
A case of a patient with suspected tricuspid valve papillary muscle rupture is described with the aid of 2 and 3D echocardiographic imaging.
Further, a successful tricuspid valve repair is reported.
Results:
A 25-year-old male with no co-morbidities presented to a peripheral hospital emergency unit after having sustained a blunt chest trauma in a motor
vehicle accident (MVA). On admission he was assessed to have soft tissue injury and a haemo-pneumothorax for which an intercostal drain was inserted. He
was referred for a routine echocardiogram 3 weeks post MVA. The patient was asymptomatic with a soft tricuspid regurgitation murmur in the tricuspid area
and prominent V waves in the jugular venous pulsation. On echocardiography, severe tricuspid regurgitation (TR) secondary to possible papillary muscle
rupture was noted. A subsequent trans-oesophageal 3D echocardiographic imaging study confirmed a flail anterior tricuspid valve leaflet secondary to
papillary muscle rupture as the mechanism of severe TR. The patient was referred for urgent surgery and underwent a successful tricuspid valve repair. He
continues to do well on follow-up.
Conclusion:
This case highlights and reinforces the value of routine echocardiography post-traumatic injury. Further 3D imaging enabled a comprehensive
assessment of the tricuspid valve anatomy prior to surgery.
From national plan to local action in fighting hypertension: Situational analysis to strengthen primary healthcare in low-
income high-burden urban communities in Senegal
Cheikh Niang
†
, Mouhamadoul Mounir Dia
#
, Jose Maria Ferrer*, Mouhamadoul Mounir Dia
#
, Joseph Silva Barboza†, Karim Seck
‡
, Elhadji Babacar
Gueye
†
, Sujata Bijou
†
, Roberta Bosurgi
‡
, Melanie Joiner
†
, Lakshmi Venkitachalam* and Jason Shellaby
‡
*American Heart Association, Dallas, Texas, United States of America.
#
Centre Médico-social de la Fonction Publique, Dakar, Senegal.
†
IntraHealth International,
North Carolina, United States of America.
‡
Novartis Foundation, Johannesburg, South Africa
Introduction:
In Senegal, CVDs cause 17% of deaths. Thirty percent of adults have hypertension, of these: 46% are aware of their condition, 17% are under
treatment and 8% have controlled BP. In 2017, we initiated a multi-sector programme to support the MOH’s first national operational plan
on CVDs starting with a situational analysis on hypertension care in the capital, Dakar.
Methods:
Between October 2017 and July 2018, we conducted a cross-sectional study of 3 health districts in Dakar evaluating: availability of hypertension
services, hypertension knowledge, attitudes and practices of healthcare providers and knowledge of patients. Data were collected using a facility inventory,
questionnaire and interview guide. Overall, we surveyed 52 facilities covering a population of 1 121 924.
Results:
All health facilities in the 3 districts had functional consultation rooms but only 10% had dedicated spaces for CVD or hypertension management.
The number of blood pressure monitors, ECG machines and medical laboratories was insufficient given the growing number of patients. None of the facilities
had posters, standardised algorithms or tools such as patient records or registries to ensure adequate hypertension management. Of the 443 healthcare
providers interviewed, only 60% had been trained regarding effective hypertension care, 55% were aware of the concept of cardiovascular risk and 65% knew
how to measure blood pressure properly. This demonstrated a clear need to retrain providers with the latest guidelines. Of the 1 546 patients interviewed,
only 21% knew at least 3 signs of hypertension, 21% were hypertensive of whom only 18% were aware of at least 3 risk factors for hypertension. This showed
a lack of patient understanding and a pressing need for better health education.
Conclusion:
This situational analysis highlighted gaps in hypertension management in Dakar’s primary healthcare system. These findings form the basis of an
ongoing educational process and clinical interventions designed to improve quality of care and reduce related morbidity and mortality.
Hot and cold water extracts of Panaeolus Cyanescens Magic Mushroom display dissimilar properties on arginase activity in
endothelial cells
Sanah Nkadimeng*, Chris Steinmann
#
and Jakobus Eloff*
*University of Pretoria, Pretoria, South Africa.
#
Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
Introduction:
Increased arginase activity has been implicated in various conditions characterised by impaired endothelial dysfunctions, including pulmonary
hypertension. Arginase competes with nitric oxide synthase (NOS) for intracellular L-arginine substrate and, as a result, contributes to reductions in endothelial
nitric oxide generation, promotes reactive oxygen species production and endothelial NOS uncoupling. Panaeolus cyanescens (P. cyan) is a potent psilocybin
mushroom in the Panaeolus genus which grows in different countries, including South Africa. Psilocybin and psilocybin mushrooms have been found
to possess antidepressant effects with a temporary increase in blood pressure (BP) of which the mechanisms are unknown. We hypothesised that P. cyan
increases BP by mechanisms that involve arginase activity pathways in endothelial cells.
Methods:
The mushrooms were oven dried and extracted with cold and hot water. Antioxidant activity was measured with 1.1-Diphenyl-2-picrylhydrazyl
and 2.2’-azino-bis (3-ethyl-benzothiazoline-6 sulfonic acid) diammonium salt assays. The P. cyan extracts were tested for cytotoxicity using the tetrazolium