38 / 46
AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S38
Methods:
This monocentric prospective study collected data at the echolab, and during consultations with patients suffering from valvular disease for a
period of 12 months. The Mini Mental Status Evaluation, a 30-point questionnaire used extensively in clinical and research settings, was employed to assess
MCI. After exclusion for neurological problems and psychiatric disorders, we defined MCI by MMSE <24. We compared 2 groups of patients G1 <70 years and
G2 >70 who were eligible to take part in the study. Eighty-six patients were included, 48 in G1 and 38 in G2, mean age was G1: 58 ± 7 vs. G2: 78 ± 5 years. MCI
was correlated with female gender (54% vs. 35% p=0.03) and a lower level of education (10% vs. 35% p=0.001). AF was present in 5% in G1 vs. 12% in G2 and
heart failure (HF 22% vs. 37%, p=0.035). Mitral stenosis was identified (20% vs. 17%), mitral regurgitation (10% vs. 12%), LVEF >50% in 80% vs. 65%, pulmonary
hypertension 38% in each group, whereas aortic stenosis was significantly associated with MCI in the second group of elderly patients (5% vs. 12%, p=0.04).
Medical therapy was similar for both groups. Mortality and rehospitalisation in 3 months were significantly higher in G2 (3.6% vs. 12%, p=0.01 and 20% vs.
36%, p=0.002).
Conclusion:
Routine assessment of MCI should be done in elderly patients with valvular heart disease, especially in the population with AS. Specific
management of such patients should be considered.
Impact of serum lipid levels at admission in acute coronary syndrome
Zakaria Qechchar, Monia El Mourid, Fatima Ezzahra Talhi, Abdenasser Drighil, Leila Azzouzi and Rachida Habbal
Ibn Rochd University Hospital, Cardiology Department, Casablanca, Morocco
Introduction:
Blood cholesterol (TC) and triglyceride (TG) levels should be measured when admitting patients with acute coronary syndrome (ACS).
However, few data have examined the predictive performance of these tests in our centre.
Methods:
The study included 98 patients (63 men and 35 women, aged 59.9 ± 12 years) diagnosed with ACS. Unfortunately, 14 patients’ lipid data were lost.
We identified 2 groups of patients: Group1 (n=28) defined by lipid abnormalities at admission (CT >200mg/dL, HDL cholesterol >65mg/dL, LDL cholesterol
>180mg/dL or TG >200mg/dL) and Group 2 (n=56) defined by normal values of lipid parameters. Lipid profiles and glucose values were collected on days 1
and 4 at the onset of myocardial infarction. We compared cardiovascular risk factors (CVRFs), left ventricular ejection fraction (LVEF) and, less than 3 days after
admission, CRP, troponins and intra-hospital and 1-year mortality.
Results:
The patient cohort in Group 1, compared to Group 2, was younger (57.8 years vs. 61 years), more prone to hypertension (54% vs. 41%),
more prone to diabetes (50% vs. 37.5%), included more dyslipidemias (14.28% vs. 1.25%) but contained fewer chronic smokers (35.7% vs. 60.7%). LVEF was not
significantly different in the 2 groups. Troponin I (50.9 vs. 17.82ng/ml) and CRP (81.3 vs. 45mg/l) were higher in Group 1. Lipids tended to decrease on post-
phase. No difference was noted in the objective of intra-hospital mortality. At 1 year, 13% succumbed in Group 1 compared to no patients in Group 2.
Conclusion:
Lipid levels decreased during the first few days of admission. Differences were noted between cardiovascular risk factors, troponin and CRP
values. Patients with increased lipid counts on admission had a poor prognosis at 1 year.
Rationale and design: The host-microbiome interaction in participants at high risk of rheumatic heart disease
Kimona Rampersadh*, Kelin Engel*, Taariq Salie*, James Dale
#
and Mark Engel*
*University of Cape Town, Rondebosch, South Africa.
#
University of Tennessee Health Science Centre, Memphis, United States of America
Introduction:
Streptococcus pyogenes, also known as Group A streptococcus (GAS), is a gram-positive, ubiquitous bacterial pathogen which causes a range
of infections including pharyngitis and post-infectious auto-immune rheumatic heart disease (RHD). Previous studies have reported a GAS prevalence of 21%
among children with pharyngeal infection at clinics and 3% GAS carriage in asymptomatic individuals from an endemic RHD community in Cape Town, South
Africa. The interaction between the host and GAS has been poorly studied to date. We are seeking to characterise the pharyngeal microbiome of children
presenting with pharyngitis to gain an understanding of the transmission dynamics of GAS and the association between the microbiome and host genetics
during active and latent GAS infections.
Methods:
The proposed study is designed as a longitudinal evaluation of throat cultures from individuals aged 5 - 17 years in Vanguard, Cape Town, with
GAS symptomatic and GAS asymptomatic infections. Participants will be evaluated at baseline and every 2 months thereafter, over a 24-month period
of observation, with serial throat cultures for genome and microbiome analysis. Additionally, participants will be evaluated should there be intervening
pharyngitis episodes. GAS clonality will be assessed by whole genome sequencing while microbiome analysis will be evaluated by 16SrRNA sequencing to
investigate taxonomic composition and diversity of the pharyngeal microbiome. Results will be correlated with immune response status to a panel of known
GAS antigens.
Results:
This project is expected to provide insight into the dynamics between the pharyngeal microbiome and GAS pharyngitis. Microbiome profiles,
correlated with specific-strain type and clinical symptoms, will shed light on the nature of active vs. latent infection.
Conclusion:
This study seeks to contribute further knowledge to GAS vaccine development efforts as well as the identification of commensal bacteria, or
bacterial products, from a healthy microbiome for therapeutic use.
Balloon valvuloplasty for valvular pulmonary stenosis: A 30-year experience at a large tertiary level hospital in South Africa
Phophi Raphulu* and Antoinette Cilliers
#
*Gauteng Department of Health, Johannesburg, South Africa.
#
Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg,
South Africa
Introduction:
Congenital pulmonary valve stenosis (PS) is one of the most common congenital cardiac defects, accounting for 8% - 12% of all congenital
cardiac defects. Patients with PS were candidates for surgical valvotomy in the past. Percutaneous balloon pulmonary valvuloplasty (PBPV) has been the
preferred alternative treatment since its introduction in 1982 by Kan
et al
. The aim of this study was to evaluate the efficacy and safety of PBPV over the last
3 decades.
Methods:
A retrospective descriptive study was conducted at Chris Hani Baragwanath Academic Hospital (CHBAH) to evaluate patients who underwent
PBPV between 1985 and May 2019. Data were extracted from the paediatric cardiology electronic database at CHBAH.