CARDIOVASCULAR JOURNAL OF AFRICA:
VOLUME 22, ISSUE 5, OCTOBER 2011
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- Title: From the editor's desk
Authors: Brink, A.J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 233
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Abstract: For the first time, the Cardiovascular Journal of Africa has been evaluated for impact factor in the new Journal Citation Report of the ISI.
- Title: Raynaud's phenomenon : letter
to the editor
Authors: Solomons, H.D.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 233
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Abstract: Raynaud's phenomenon is a disorder, causing discolouration of the fingers. It is thought to be related to vasospasm. It can also affect the toes and other areas. The nails become brittle with longitudinal ridges. The condition was named after Maurice Raynaud (1834-1881).
- Title: CEPHEUS SA : a South African
survey on the undertreatment of
hypercholesterolaemia : cardiovascular topics
Authors: Raal, Frederick; Schamroth, Colin; Blom, Dirk; Marx, Jan; Rajput, Mangoo; Haus, Matthias; Hussain, Razia; Cassim, Fatima; Nortje, Michelle; Vandenhoven, Guy; Temmerman, Anne-Marie
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 234-240
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DOI Number: 10.5830/CVJA-2011-044
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2011-044
Abstract: Aim: The aim of the CEntralised Pan-South African survey on tHE Under-treatment of hypercholeSterolaemia (CEPHEUS SA) was to evaluate the current use and efficacy of lipid-lowering drugs (LLDs), and to identify possible patient and physician characteristics associated with failure, if any, to achieve low-density lipoprotein cholesterol (LDL-C) targets.
Methods: The survey was conducted in 69 study centres in South Africa and recruited consecutive consenting patients who had been prescribed LLDs for at least three months. One visit was scheduled for data collection, including fasting plasma lipid and glucose levels. Physicians and patients completed questionnaires regarding their knowledge, awareness and perceptions of hypercholesterolaemia and the treatment thereof.
Results: Of the 3 001 patients recruited, 2 996 were included in the final analyses. The mean age was 59.4 years, and 47.5% were female. Only 60.5 and 52.3% of patients on LLDs for at least three months achieved the LDL-C target recommended by the NCEP ATP III/2004 updated NCEP ATP III and the Fourth JETF/South African guidelines, respectively. Being male, older than 40 years, falling into the lower-risk categories, compliance with the medication regimen, and patient knowledge that the LDL-C goal had been reached, were associated with the highest probability of attaining LDL-C goals.
Conclusion: The results of this survey highlight the sub-optimal lipid control achieved in many South African patients taking lipid-lowering therapy.
- Title: The R563Q mutation of the
epithelial sodium channel beta-subunit is
associated with hypertension : cardiovascular
topics
Authors: Jones, E.S.W.; Owen, E.P.; Davidson, J.S.; Van der Merwe, L.; Rayner, B.L.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 241-244
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DOI Number: 10.5830/CVJA-2010-084
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-084
Abstract: Background: A high prevalence of the R563Q mutation of the epithelial sodium channel β-subunit has been reported in South African hypertensives compared with unrelated normotensive controls. To delineate the effects of this mutation against a more uniform genetic background, this study investigated the association of the mutation with hypertension within affected kindreds.
Methods: Forty-five index patients and members of their kindreds were studied. Blood pressure, serum potassium and the presence of the R563Q mutation were determined.
Results: Of the 136 individuals studied, 89 were heterozygous for the R563Q mutation and 47 homozygous RR. The mean arterial pressure was significantly higher in the R563Q heterozygous group (p = 0.005) after adjusting for gender, race, age and kindred membership. Of the R563Q heterozygous subjects, 71 (80%) had hypertension, while 17 (36%) of the R563Q homozygous RR subjects were hypertensive. Six R563Q heterozygous subjects had hypokalaemia and one R563Q homozygous RR subject had hypokalaemia, but the difference was not statistically significant. Two heterozygous patients had Liddle's syndrome, both occurring during pregnancy.
Conclusion: The R563Q mutation of β-ENaC is associated with hypertension within affected kindreds, but does not usually cause the full Liddle's syndrome phenotype.
- Title: Echocardiographic findings in
children with Marfan syndrome : cardiovascular
topics
Authors: Ozdemir, Osman; Olgunturk, Rana; Kula, Serdar; Tunaoglu, Fatma Sedef
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 245-248
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DOI Number: 10.5830/CVJA-2010-085
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-085
Abstract: Background: The typical cardiac manifestations of Marfan syndrome are aortic regurgitation with progressive dilatation of the aortic root, which may cause dissection and rupture of the ascending aorta, mitral valve prolapse and mitral valve regurgitation. In this study, we aimed to show echocardiographic findings in 11 patients with Marfan syndrome.
Methods: Diagnosis of Marfan syndrome was based on the Ghent criteria. All patients had a full echocardiographic evaluation. During the evaluation, we investigated the presence of mitral valve prolapse, mitral valve regurgitation, tricuspid valve prolapse, dilatation of the aortic root, and aortic regurgitation.
Results: Eleven patients were diagnosed as Marfan syndrome(seven male, four female, age 4-14 years). All had mitral valve prolapse (nine with mitral valve regurgitation). Among these 11 patients, seven had accompanying tricuspid valve prolapse, six had dilatation of the aortic root and two had aortic regurgitation.
Conclusion: Eleven patients in our clinic were diagnosed as Marfan syndrome since they had distinct characteristics of marfanoid phenotype. Echocardiographic evaluation of these patients showed marked heart valve involvement. In Marfan syndrome, it is known that the aortic valve is affected following mitral valve involvement. In our experience, aortic root dilatation is less common. However, particular attention should be given to following up aortic root status with noninvasive echocardiography to institute measures to prevent complications.
- Title: The relationship between
indices of iron status and selected
anthropometric cardiovascular disease risk
markers in an African population : the THUSA
study : cardiovascular topics
Authors: Ozdemir, O.; Olgunturk, R.; Kula, S.; Tunaogl, F.S.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 249-256
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DOI Number: 10.5830/CVJA-2011-015
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2011-015
Abstract: There is evidence that certain indices of iron status are associated with anthropometric measures, which are used independently as markers of cardiovascular disease (CVD) risk. This study examined whether this association exists in an African population. The study was a cross-sectional comparative study that examined a total of 1 854 African participants. Ferritin was positively associated with body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), percentage body fat and subscapular skinfold thickness. Serum ferritin concentration was higher in the high-WHR category than the normal-WHR category for both genders. Additionally, WC and WHR increased with increasing ferritin concentrations in both genders. Serum iron was lower in the obese than the normal-weight and pre-obese women only. In this population-based study, increased serum ferritin concentrations associated positively with increased WHR and WC, indicating that individuals or populations at risk of iron overload as defined by high serum ferritin concentrations may be at a greater risk of developing CVD.
- Title: Diabetes diary for 2011 -
2012 congresses
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 256
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Abstract: Diabetes diary for 2011 - 2012 congresses
- Title: Effect of short-term
isometric handgrip training on blood pressure in
middle-aged females : cardiovascular topics
Authors: Mortimer, J.; Mckune, A.J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 257-260
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DOI Number: 10.5830/CVJA-2010-090
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-090
Abstract: Objective: To determine the effect of isometric handgrip training on blood pressure (BP) in middle-aged women (47.88 ± 1.8 years).
Methods: Isometric handgrip training was performed over five consecutive days. In each session, the treatment group (n = 9) performed four isometric contractions of 45 seconds each at 30% of their maximal grip strength. The control group (n = 9) sat for 15 minutes without exercising, for five consecutive days. Resting systolic (SBP) and diastolic blood pressure (DBP) were measured pre- and post-intervention. Data were analysed using a two-factor ANOVA (p ≤ 0.05).
Results: Blood pressure readings were reduced in both groups (SBP: p = 0.036; DBP: p = 0.0079), however there was no interaction effect for SBP or DBP.
Conclusions: The findings suggest that 15 minutes of sitting per day for five consecutive days is just as effective as isometric handgrip training for reducing BP levels. Future research is required to investigate the optimal isometric handgrip training stimulus required to reduce resting BP levels.
- Title: Global cardiovascular risk
profiles of untreated hypertensives in an urban,
developing community in Africa : cardiovascular
topics
Authors: Maseko, M.J.; Norton, G.R.; Majane, O.H.; Molebatsi, N.; Woodiwiss, A.J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 261-267
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DOI Number: 10.5830/CVJA-2010-094
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-094
Abstract: Introduction: Blood pressure (BP) control in people of African descent is poor, largely because of a lack of treatment. Although the requirements for immediate initiation of antihypertensive drug therapy are defined by global cardiovascular risk, the global cardiovascular risk profiles of untreated hypertensives at a community level are uncertain.
Aim: To identify the distribution of global cardiovascular risk profiles of untreated hypertensives in an urban, developing community of African descent in South Africa.
Methods: As part of the African Programme on Genes in Hypertension, we assessed nurse-derived clinic BP (the mean of five standardised BP values obtained according to guidelines), current antihypertensive therapy, and total cardiovascular risk in 1 029 participants older than 16 years of age from randomly selected nuclear families from the South West Township of Gauteng (SOWETO).
Results: Approximately 46% of participants had systolic/diastolic BP values ≥ 140/90 mmHg and ∼23% of participants were hypertensives not receiving antihypertensive medication. Approximately 12% of untreated hypertensives had a high added risk and ∼18% a very high added risk (6.7% of the total sample). In untreated hypertensives, in contrast to the absence of severe hypertension and diabetes mellitus in those with lower risk profiles, a high cardiovascular risk profile in this group was characterised by severe hypertension in ∼52% and diabetes mellitus in ∼33%. Based on a high added risk carrying at least a 20% chance and a very high added risk at least a 30% chance of a cardiovascular event in 10 years, this translates into 1 740 events per 100 000 of the population within 10 years, events that could be prevented through antihypertensive drug therapy.
Conclusions: In an urban, developing community of African ancestry, a significant proportion (6.7%) of people may have untreated hypertension and a global cardiovascular risk profile that suggests a need for antihypertensive drug therapy. Cardiovascular risk in this group is driven largely by the presence of severe hypertension or diabetes mellitus.
- Title: Cardiovascular diary for 2011
- 2012 congresses
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 267
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Abstract: Cardiovascular diary for 2011 - 2012 congresses
- Title: Anomalous origin of the left
pulmonary artery from the ascending aorta in two
children with pulmonary atresia, subaortic
ventricular septal defect and right-sided major
aorto-pulmonary collateral arteries :
cardiovascular topics
Authors: Pepeta, L.; Takawira, F.F.; Cilliers, A.M.; Adams, P.E.; Ntsinjana, N.H.; Mitchell, B.J.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 268-271
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DOI Number: 10.5830/CVJA-2010-081
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-081
Abstract: We report two rare cases of an anomalous origin of the left pulmonary artery (AOLPA) from the ascending aorta, associated with pulmonary atresia, a ventricular septal defect and a left aortic arch. The cases are unusual because an AOLPA is more commonly associated with a right aortic arch, and it is more usual for the right pulmonary artery to originate anomalously from the ascending aorta. The pulmonary blood supply to the right lung in both patients was absent and provided instead by major aorto-pulmonary collateral arteries, which were stenosed at multiple levels. The AOLPA in both patients originated from the postero-lateral aspect of the ascending aorta just distal to the sino-tubular junction. Only one patient showed the more common association of an unusual aortic arch branching pattern in the form of an anomalous right subclavian artery. Neither patient was in heart failure and the chest X-ray in both revealed differential pulmonary perfusion with prominent vascularity of the left lung. Cardiac catheterisation showed systemic pressures within the anomalous left pulmonary artery. Karyotyping revealed normal chromosomes, and fluorescent in-situ hybridisation done in one patient was negative for chromosome 22q11.2 microdeletion. Both patients have been managed conservatively.
- Title: Isolated tricuspid valve
prolapse : identification using two- and
three-dimensional echocardiography and
transoesophageal echocardiography :
cardiovascular topics
Authors: Kocabay, Gonenc; Sirma, Dicle; Mert, Meral; Tigen, Kursat
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 272-273
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DOI Number: 10.5830/CVJA-2011-006
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2011-006
Abstract: We present a case of isolated prolapse of the tricuspid anterior leaflet in an asymptomatic 34-year-old man who was referred to our hospital for a routine check up. We performed two-and three-dimensional transoesophageal echocardiography (TEE). We found three-dimensional TEE a useful, non-invasive tool that can provide additional information to two-dimensional echocardiography in the assessment of tricuspid valve prolapse.
- Title: Double-chambered right
ventricle : an uncommon congenital heart
disease. Case report and literature review :
cardiovascular topics
Authors: Animasahun, B.A.; Ekure, E.N.; Njokanma, O.F.
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 274-277
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DOI Number: 10.5830/CVJA-2010-068
DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-068
Abstract: A double-chambered right ventricle (DCRV) is a rare congenital heart disease and an uncommon cause of congestive cardiac failure. An anomalous muscle band divides the right ventricle into two cavities, causing variable degrees of obstruction. Echocardiography is considered a useful method for the diagnosis of this pathology, especially in children.
An eight-year-old patient with a small ventricular septal defect (VSD) and double-chambered right ventricle presented with a history of palpitations, easy fatigability and recurrent fever. On presentation, she had features of congestive cardiac failure. A complete diagnosis was initially missed with transthoracic two-dimensional (2-D) echocardiography but later obtained based on transthoracic 2-D echocardiography with Doppler facility. This was confirmed with cardiac catheterisation. The patient was referred for surgical correction, which was successful.
Due to the rarity of this condition and the consequences of missing the diagnosis, we present this case in order to highlight the rarity of this congenital heart disease in childhood.
- Title: South Africa's PACE is a
winner of Boehringer-Ingelheim's international
atrial fibrillation awareness programme : cardio
news
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 278
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Abstract: PACE (Prevent Arrhythmic Cardiac Events) outpaced some 200 global applicants in the Boehringer-Ingelheim Atrial Fibrillation Awareness Campaign to win R500 000 (50 000 Euros) for an AF awareness programme in South Africa. They won this award in the Silver category and were the most highly ranked winners outside Europe.
- Title: Medtronic news from European
Society of Cardiology congress, Paris, September
2011 : industry news
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 279
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Abstract: Medtronic Inc. has received CE (Conformite Europeenne) Mark for its 31-mm Medtronic CoreValve® System, the only transcatheter aortic valve available in the world that can treat without surgery, patients with larger valve openings (up to 29 mm). It is the largest transcatheter valve available and, because it can be compressed into a small delivery system, is deployed through the same 18-Fr (less than ¼ inch or approx 6 mm in diameter) delivery system as smaller CoreValve sizes.
- Title: Remote care of patients with
ICD
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 279-280
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Abstract: The REMOTE follow-up of patients with ICDs appears to be safe, and a large French trial found no significant difference in outcome between patients who were tele-monitored and those who had conventional check ups in the clinic. However, the trial failed to confirm the non-inferiority of the new technology.
- Title: Expanded coverage for
warfarin patients in the USA monitoring clotting
time at home : industry news
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 280
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Abstract: Medicare will now cover and pay for meter training, equipment and supplies for all long-term warfarin users in the USA who monitor their prothrombin time at home with a portable handheld meter. The change opens the door to greater convenience and potentially fewer complications for a broader spectrum of anticoagulation patients.
- Title: Namibia becomes first country
in Africa to launch dabigatran etexilate for
atrial fibrillation : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 283
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Abstract: On 1 August 2011, Namibia became the first African country to make available Boehringer Ingelheim's novel oral blood thinner, Pradaxa (dabigatran etexilate), the first real breakthrough in anticoagulation therapy in over 50 years. The Namibian Medicines Control Council has approved the prophylactic use of dabigatran etexilate for the prevention of stroke in patients with atrial fibrillation (AF), the most common type of arrhythmia.
- Title: New insights and results from
the RE-LY trial : drug trends in cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 284, 286
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Abstract: The RE-LY trial with dabigatran has provided clinicians worldwide with a new benchmark standard for anticoagulation and stroke prevention in atrial fibrillation. This view was presented at the 2011 European Society of Cardiology (ESC) congress by Dr Gregory Lip, professor of cardiovascular medicine at the University of Birmingham, who is well placed to evaluate clinical expectations for these new agents.
- Title: European Society of
Cardiology congress 2011 : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 287
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Abstract: The FDA's Cardiovascular and Renal Drugs advisory committee has now voted nine to two (with one abstention) in favour of recommending rivaroxaban, an oral factor Xa inhibitor, for prevention of stroke in atrial fibrillation.
- Title: New ESC guidelines for acute
coronary syndromes (NSTEMI) : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 288
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Abstract: Representatives of the Cardiovascular Journal of Africa attending the ESC in Paris interviewed Prof Robert F Storey, University of Sheffield, United Kingdom, a member of the ESC task force who worked on the recently released guidelines.
- Title: Heart rate now a risk factor
for cardiovascular disease : drug trends in
cardiology
From: Cardiovascular Journal of Africa, Vol 22, Issue 5, Sep / Oct
Published: 2011
Pages: 291-292
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Abstract: SHIfT echocardiographic study supports ivabradine's heart rate-lowering benefits
Comments from South African experts
