CARDIOVASCULAR JOURNAL OF AFRICA:
VOLUME 21, ISSUE 4, JULY 2011
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- Title: The cost of coping : a
cardio-neuro-metabolic risk for black South
Africans : editorial
Authors: Malan, Leone; Malan, N.T.; Du Plessis, A.; Wissing, M.P.; Potgieter, J.C.; Seedat, Y.K.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 183-185
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Abstract: Psychosocial stress is a contributing factor to cardiovascular disease. An important way of investigating the mechanisms underlying this association is acute psycho-physiological stress testing, involving measurement of physiological responses to laboratory-induced stress. Psycho-physiological stress testing allows individual differences in responses to standardised stress to be evaluated and related to psychosocial and cardiovascular risk factors. Accumulating evidence has demonstrated associations of disturbed psycho-physiological responses with sub-clinical measures of atherosclerosis, hypertension and metabolic risk.
- Title: From the editor's desk
Authors: Brink, A.J.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 185
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Abstract: Advance publications
The office of the Cardiovascular Journal of Africa has recently experienced a dramatic increase in the number of articles submitted to this journal. The articles emanate from authors in many diverse countries. As a consequence of the volume of articles, we are experiencing delays in the length of time to publish them.
- Title: Assessment of right
ventricular systolic function using tricuspid
annular-plane systolic excursion in Nigerians
with systemic hypertension : cardiovascular
topics
Authors: Karaye, K.M.; Habib, A.G.; Mohammed, S.; Rabiu, M.; Shehu, M.N.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 186-190
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DOI: 10.5830/CVJA-2010-031
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-031
Abstract: Aim: Right ventricular (RV) systolic function in patients with hypertensive heart disease (HHD) is not well characterised. The primary aim of this study was to assess the systolic function of the right ventricle in patients with HHD using tricuspid annular-plane systolic excursion (TAPSE).
Methods: The study was cross-sectional in design and carried out in Kano, Nigeria. Patients were recruited if they had HHD on echocardiography and were at least 15 years of age. Patients with other cardiac pathologies such as ischaemic and valvular heart diseases were excluded. Patients were considered to have abnormal RV systolic function if they had reduced values of TAPSE (< 15 mm). A p-value of < 0.05 was considered statistically significant.
Results: A total of 186 patients were serially recruited over seven months. Of these, 131 (70.4%) had normal RV systolic function (group 1) and 55 patients (29.6%) had abnormal function (group 2). Group 2 patients were older (p = 0.002) and had a higher prevalence of peripheral oedema (p = 0.002), moderate to severe dyspnoea, higher heart rate and lower left ventricular ejection fraction (p < 0.001). Atrial arrhythmias were also more prevalent among group 2 patients (p < 0.05). The best correlate to TAPSE was the septal mitral annularplane systolic excursion (r = +0.541, p < 0.001). Several variables such as age predicted the presence of reduced TAPSE.
Conclusion: The study found that almost one-third of patients with HHD in Kano had RV systolic dysfunction as defined by reduced TAPSE, and these patients had a greater prevalence of factors associated with morbidity and mortality.
- Title: News from the American
Diabetes Association (ADA ) Update from Orlando,
USA , 25 - 29 June 2010 : cardiovascular topics
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 190
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Abstract: ACCORD retinopathy study shows intensive glycaemic control, and combination dyslipidaemia therapy with fenofibrate reduces retinopathy progression.
- Title: Value of trans-oesophageal
echocardiography as a method of encouraging
patients with chronic atrial fibrillation to use
anticoagulation therapy : cardiovascular topics
Authors: Bakalli, A.; Kamberi, L.; Dragusha, G.; Zeqiri, N.; Gashi, F.; Prekpalaj, L.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 192-194
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DOI: 10.5830/CVJA-2010-017
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-017
Abstract: Background: Despite the indisputable role of anticoagulation therapy for atrial fibrillation (AF) patients at risk for stroke, anticoagulants remain under-used in everyday clinical practice. We assumed that by performing trans-oesophageal echocardiography (TEE) on patients with AF who were not on anticoagulation treatment prior to the procedure, and by explaining to them the TEE images obtained, as well as the possible consequences of these findings, we could convince patients to start anticoagulation therapy. The main objective of the study was to assess the examined patients’ adherence to warfarin therapy over a two-year period.
Methods and results: We conducted a prospective TEE study from February 2006 to December 2008 on 70 patients with chronic AF who were not on anticoagulation treatment. Mean patient age was 65.85 ± 10.02 years and 68.57% were women. Thrombus in the left atrial appendage was found in 25 (35.71%) patients. Fifty-four (77.14%) patients had thrombi or spontaneous echo contrast in at least one of their supraventricular cavities.
Following the procedure and with detailed explanation to the patients of their TEE findings, we managed to start anticoagulation therapy on 60 (85.71%) patients. At the end of the follow-up period of 23.76 ± 2.8 months, 53 (75.71%) patients remained on warfarin therapy. The rest of the surviving patients settled for thrombo-prophylaxis with aspirin.
Conclusion: TEE is a valuable method that, in addition to its diagnostic possibilities, could also serve as a convincing visual method of putting atrial fibrillation patients onto an anticoagulation regimen.
- Title: Concurrent resistance and
aerobic training as protection against heart
disease : cardiovascular topics
Authors: Shaw, Ina; Shaw, Brandon S.; Brown, Gregory A.; Cilliers, Jones F.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 196-199
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Abstract: This study was designed to compare the effects of aerobic and concurrent aerobic and resistance training on their ability to slow the rate of development and progression of coronary heart disease (CHD) in young adult males at low risk, as determined by the Framingham risk assessment (FRA) score. Subjects were assigned to 16 weeks of three-times weekly aerobic training (AT) (n = 13), concurrent aerobic and resistance training (CART) (n = 13) or no exercise (NO) (n = 12). Both AT and CART resulted in significant (p < 0.05) changes in total cholesterol (from 173.67 ± 29.93 to 161.75 ± 26.78 mg.dl-1 and from 190.00 ± 38.20 to 164.31 ± 28.73 mg.dl-1, respectively), smoking status (from 12.25 ± 5.08 to 10.33 ± 5.37 cigarettes per day and 12.00 ± 4.71 to 8.77 ± 5.10 cigarettes per day, respectively), high-density lipoprotein cholesterol (from 47.00 ± 11.85 to 57.50 ± 5.99 mg.dl-1 and 34.00 ± 8.53 to 46.77 ± 14.32 mg.dl-1, respectively), systolic blood pressure (from 126.17 ± 7.00 to 122.33 ± 3.17 mmHg and 131.54 ± 9.28 to 121.69 ± 7.87 mmHg, respectively) and therefore FRA score (from 3.58 ± 2.19 to 1.33 ± 2.27 and 5.77 ± 3.09 to 2.46 ± 2.90, respectively). Both modes of exercise were found to be equally effective in reducing CHD risk. These findings support the inclusion of resistance training into an aerobic training programme to lower CHD risk, which will afford subjects the unique benefits of each mode of exercise.
- Title: Prevalence of
microalbuminuria in hypertensive patients and
its associated cardiovascular risk in clinical
cardiology : Moroccan results of the global
i-SEARCH survey - a sub-analysis of a survey
with 21 050 patients in 26 countries worldwide :
cardiovascular topics
Authors: Shaw, I.; Shaw, B.S.; Brown, G.A.; Cilliers, J.F.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 200-205
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Abstract: Objectives: To determine the prevalence of microalbuminuria (MAU) in hypertensive outpatients visiting a cardiologist's office or clinic and to describe the relationship between MAU and cardiovascular risk factors.
Methods: This was an international, observational, cross-sectional study of 22 282 patients, with 457 subjects from Morocco in 40 cardiology centres. Inclusion criteria were: male and female outpatients aged ≥ 18 years with currently treated or newly diagnosed hypertension (≥ 140/90 mmHg at rest on the day of the study visit) and no reason for false positive microalbuminuria dipstick tests.
Outcome measures: Prevalence of microalbuminuria assessed using a dipstick test, co-morbid cardiovascular risk factors or disease and their relationship with the presence of MAU, and role of pharmacotherapy in modulating the prevalence of MAU.
Results: The prevalence of microalbuminuria in hypertensive patients in Morocco (67.8%) was high compared to the worldwide prevalence (58.3%). Despite the fact that all physicians regarded MAU as important for risk assessment and therapeutic decisions, routine MAU measurement was performed in only 35% of the practices. In clinical cardiology, MAU is highly correlated with a wide variety of cardiovascular risk factors and cardiovascular disease.
While angiotensin receptor blockers (ARBs) appeared to be associated with the lowest risk of MAU, calcium channel blockers (CCBs) were more often used in this patient group.
Conclusions: Hypertensive, high-risk cardiovascular patients are common in clinical cardiology. Given the high prevalence detected, screening of MAU in addition to more aggressive multi-factorial treatment to reduce blood pressure as well as other cardiovascular risk factors is required.
- Title: Cardiovascular function and
psychological distress in urbanised black South
Africans : the SABPA study : cardiovascular
topics
Authors: Mashele, N.; Van Rooyen, J.M.; Malan, L.; Potgieter, J.C.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 206-211
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Abstract: Objective: The increased prevalence of cardiovascular disease risk factors in sub-Saharan Africa has increased the incidence of cardiovascular disease in this region but whether psychological distress contributes to this observed increased risk remains largely unclear.
The aim of this study was to investigate the association between cardiovascular function and psychological distress in urbanised black South African men (n = 101) and women (n = 99).
Methods: Resting cardiovascular variables were obtained by making use of the Finometer device and 24-hour ambulatory blood pressure (BP) measurements with the Cardiotens apparatus. Psychological questionnaires assessed the perception of health (General Health questionnaire) and depression status (DSM-IV criteria). The resting ECG (NORAV PC-1200) was used to determine left ventricular hypertrophy (LVH) by making use of the Cornell product. Confounders included age, obesity, alcohol intake, smoking and physical activity.
Results: The hypertensive groups were overweight, with lower vascular compliance and higher LVH (only men) compared to the normotensive groups. In hypertensive men, perception of health (somatic symptoms) was positively associated with blood pressure, while in hypertensive women it was associated with heart rate. Major depression was associated with LVH in hypertensive men and mean arterial pressure in hypertensive women. LVH and depression showed odds ratios of 1.02 (95% CI: 0.997-1.05) and 1.15 (95% CI: 1.01-1.32), respectively, in predicting hypertension in women.
Conclusions: Psychological distress was associated with higher blood pressure in hypertensive African men but also with the development of left ventricular hypertrophy in hypertensive African men and women.
- Title: Letter to the Editor
Authors: Bonny, Aime
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 211
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Abstract: Letter to the Editor
- Title: The clinical quandary of left
and right ventricular diastolic dysfunction and
diastolic heart failure : case report
Authors: Schwarz, Ernst R.; Dashti, Raja
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 212-220
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Abstract: Diastolic heart failure is a common clinical entity that is indistinguishable from systolic heart failure without direct evaluation of left ventricular function. Diastolic heart failure is a clinical diagnosis in patients with signs and symptoms of heart failure but with preserved left ventricular function and normal ejection fraction, and is often seen in patients with a long-standing history of hypertension or infiltrative cardiac diseases. In contrast, diastolic dysfunction represents a mechanical malfunction of the relaxation of the left ventricular chamber that is primarily diagnosed by two-dimensional transthoracic echocardiography and usually does not present clinically as heart failure. The abnormal relaxation is usually separated in different degrees, based on the severity of reduction in passive compliance and active myocardial relaxation. The question whether diastolic dysfunction ultimately will lead to diastolic heart failure is critically reviewed, based on data from the literature. Treatment recommendations for diastolic heart failure are primarily targeted at risk reduction and symptom relief. Currently, few data only are reported on diastolic dysfunction and its progression to systolic heart failure.
- Title: Adcock enters deal with MSD ;
also with regard to the cardiovascular
therapeutic arena
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 220
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Abstract: Adcock Ingram entered into a five-year deal to co-promote and distribute MSD's over-the-counter medicines and a selection of prescription medicines that are registered in South Africa. Although the financial effects of the transaction at this stage will not be material, it should go a long way in helping the country's second-largest pharmaceutical firm to grow, as it will enhance its diverse portfolio and broaden its pipeline of new products in the marketplace.
- Title: A halo in the heart during
coronary angiography : calcified left
ventricular aneurysm with thrombus formation :
case report
Authors: Fotbolcu, H.; Ozden, K.; Sengul, C.; Duman, D.; Dindar, i.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 221-222
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Abstract: A 74-year-old man presented with chest pain and dyspnoea at the cardiology outpatient clinic. His past medical history included an anterior myocardial infarction in 2008. In the coronary angiogram, a 'halo image' was seen right after the injection of the contrast agent, and it corresponded with the location of the left ventricular aneurysm. A calcified left ventricular aneurysm with mural thrombus was confirmed with cardiac MRI and a CT scan.
- Title: A coronary artery anomaly :
type IV dual left anterior descending artery :
case report
Authors: Celik, M.; Iyisoy, A.; Celik, T.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 223-224
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DOI: 10.5830/CVJA-2010-032
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-032
Abstract: Coronary artery anomalies are seen in about 1.3% of patients undergoing coronary angiography. However, the dual type of left anterior descending (LAD) artery is a rare form of coronary artery anomaly. There are four types of dual LAD; type IV describes the anomaly of a rudimentary LAD artery terminating in the mid-portion of the anterior interventricular sulcus, and the presence of another LAD originating from the right coronary artery and continuing to the anterior interventricular sulcus.
- Title: Serotonin and
catecholaminergic polymorphic ventricular
tachycardia : a possible therapeutic role for
SSRIs? : case report
Authors: Chen, S.; Duan, Q.; Tang, K.; Zhao, D.; Xu, Y.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 225-228
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DOI: 10.5830/CVJA-2010-023
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-023
Abstract: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare malignant arrhythmia, usually diagnosed in the adolescent years. The diagnosis can typically be made by one or more of the following: a positive family history, exercise electrocardiography, ambulatory ECG monitoring and / or an intra-cardiac, electrophysiological examination. This is a case report of a patient with CPVT that was refractory to treatment with beta-blockade and an implanted automatic cardioverter defibrillator. However, after a selective serotonin re-uptake inhibitor (SSRI) was added to the therapeutic regimen, no further episodes of ventricular tachycardia occurred during the following two years.
- Title: Coeur en sabot : case report
Authors: Aziz, F.; Abed, M.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 229-231
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DOI: 10.5830/CVJA-2010-026
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-026
Abstract: In tetralogy of Fallot (TOF), the most common form of cyanotic congenital heart disease, only a few patients reach adulthood without surgical correction. We present a case of a woman with TOF who was diagnosed at the age of 39 when she presented with features of congestive heart failure. The main factor contributing to her longevity included the slow development of her pulmonary artery stenosis together with left ventricular hypertrophy. Less than 3% of all patients with uncorrected TOF survive beyond their 40s but late operative repair is still a valuable option. This case provides an insight into the late outcome of an older patient with uncorrected TOF.
- Title: Watch these dates
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 231
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Abstract: Watch these dates
- Title: ARBs and possible cancer risk
: drug trends in cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 232
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Abstract: The recent meta-analysis published in the Lancet Oncology, with comment from Dr Steve Nissen, has raised questions around a possible cancer risk and the use of ARBs. The Cardiovascular Journal of Africa will be publishing a fuller report on this matter in a forthcoming issue of the Journal.
- Title: High-risk patients benefit
most from nifedipine GITS-telmisartan
combination : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 235
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Abstract: Two very effective antihypertensive medications with well-established and significant cardiovascular outcome studies have been combined and used for the first time in early combination therapy in the TALENT study.
- Title: Litha Healthcare Group Ltd
has acquired balance of shares in Pharmafrica
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 235
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Abstract: With the concluding of the final signatories, Litha Healthcare Group Ltd has acquired the balance of shares in Pharmafrica that were not owned by the group. Four years ago the company purchased a 26% stake in Pharmafrica as part of that company's equity drive.
- Title: Increased heart rate in
high-risk hypertensives related to increased
heart failure and sudden death : drug trends in
cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 236
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Abstract: High-risk hypertensives with a heart rate above 80 beats per minute (bpm) have an increased risk of cardiovascular events, particularly heart failure and sudden death, according to a new analysis of the Valsartan Anti-hypertensive Long-term Use Evaluation (VALUE) trial, presented at the 2010 American Society of Hypertension congress (ASH). Both baseline and in-trial tachycardia, measured every year by ECG, were strong, independent predictors of cardiovascular events.
- Title: Cardiovascular and diabetes
research in Africa to benefit from Servier
sponsorship : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 240
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Abstract: South African experts in the field of cardiovascular and diabetes medicine have recently been awarded significant support by Servier Laboratories, South Africa, to provide missing vital data on these conditions in African communities.
- Title: Amlodipine + atorvastatin
single pill is the most effective choice for
primary prevention : drug trends in cardiology
Authors: Aalbers, J.
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 243
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Abstract: Preventing cardiovascular events in at-risk patients is greatly enhanced if a single pill is prescribed for the commonly occurring risks of hypertension and dyslipidaemia.
- Title: The Sinatra Solution.
Metabolic Cardiology, Stephen T. Sinatra : book
review
Authors: Straughan, John
From: Cardiovascular Journal of Africa, Vol 21, Issue 4, Jul / Aug
Published: 2010
Pages: 244
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Abstract: With less self-aggrandisement, this book might have carried an alternative title You and your Mitochondria, with a subtitle such as Take Care of your Mitochondria, and your Body Will Take Care of the Rest!
