Title: From the Editor’s Desk
Authors: Commerford, P
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 3
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Abstract: It is interesting to one trained in
the era that preceded the availability of new
and sophisticated imaging modalities to see just
how well the ‘old’ and often currently poorly
regarded imaging techniques still serve.
Title: Filamin C: a novel component
of the KCNE2 interactome during hypoxia
Authors:Neethling, A; Mouton, J; Loos, B;
Corfield, V; de Villiers, C; Kinnear, C
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 4-11
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DOI Number:10.5830/CVJA-2015-049
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-049
Aim: KCNE2 encodes for the potassium
voltage-gated channel, KCNE2. Mutations in KCNE2
have been associated with long-QT syndrome
(LQTS). While KCNE2 has been extensively
studied, the functions of its C-terminal domain
remain inadequately described. Here, we aimed to
elucidate the functions of this domain by
identifying its protein interactors using yeast
two-hybrid analysis.
Methods: The C-terminal domain of KCNE2 was used
as bait to screen a human cardiac cDNA library
for putative interacting proteins.
Co-localisation and co-immunoprecipitation
analyses were used for verification.
Results: Filamin C (FLNC) was identified as a
putative interactor with KCNE2. FLNC and KCNE2
co-localised within the cell, however, a
physical interaction was only observed under
hypoxic conditions.
Conclusion: The identification of FLNC as a
novel KCNE2 ligand not only enhances current
understanding of ion channel function and
regulation, but also provides valuable
information about possible pathways likely to be
involved in LQTS pathogenesis.
Title: The effect of anatomical factors on mortality rates after
endovascular aneurysm repair
Authors: Ay, D; Erdolu, B; Yumun, G; Demir, A;
Aydin, U; Ozkan, H; Erkoc, K; Tiryakioglu, O;
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 12-15
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DOI Number:10.5830/CVJA-2015-057
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-057
Objective: The objective of this study was to
investigate the effect of anatomical characteristics on mortality rates after
endovascular aneurysm repair (EVAR).
Methods: We investigated 56 EVAR procedures for infrarenal aortic aneurysms
performed between January 2010 and December 2013, and the data were supplemented
with a prospective review. The patients were divided into two groups according
to the diameter of the aneurysm. Group I (n = 30): patients with aneurysm
diameters less than 6 cm, group II (n = 26): patients with aneurysm diameters
larger than 6 cm. The pre-operative anatomical data of the aneurysms were noted
and the groups were compared with regard to postoperative results.
Results: There were no correlations between diameter of aneurysm (p > 0.05),
aneurysm neck angle (p > 0.05) and mortality rate. The long-term mortality rate
was found to be high in patients in whom an endoleak occurred.
Conclusion: We found that aneurysm diameter did not have an effect on
postoperative mortality rates. An increased EuroSCORE value and the development
of endoleaks had an effect on long-term mortality rates.
Title: Electrocardiographic
abnormalities and dyslipidaemic syndrome in
children with sickle cell anaemia
Authors: Adegoke, SA; Okeniyi, JAO; Akintunde,
AA
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 16-20
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DOI Number: 10.5830/CVJA-2015-059
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-059
Background: Lipid and electrocardiographic (ECG)
abnormalities have been reported in adults with
sickle cell anaemia (SCA) and may reflect
underlying structural and/ or functional damage.
However, the relationship between ECG and lipid
abnormalities among children with sickle cell
disease is not fully understood.
Objectives: To compare the steady-state lipid
and ECG abnormalities in children with SCA to
the controls and examine the hypothesis that
lipid abnormalities are closely related to
electrocardiographic abnormalities, and
therefore are a reflection of cardiac damage
among these children.
Methods: Clinical, laboratory and ECG profiles
of 62 children with SCA and 40 age- and
gender-matched haemoglobin AA controls were
compared. The influence of clinical
characteristics, lipids profiles, markers of
haemolysis, and renal and hepatic dysfunction on
ECG pattern in children with SCA was then
determined.
Results: The patients had lower average
diastolic and mean arterial blood pressure,
total cholesterol and low-density lipoprotein
cholesterol (LDL-C) levels than the controls, (p
= 0.001, 0.002, 0.000 and 0.000, respectively).
The mean triglyceride level was significantly
higher (p < 0.001), while high-density
lipoprotein cholesterol (HDL-C) levels were
comparable (p = 0.858). The cases were about six
times more likely to have left ventricular
hypertrophy than the controls (OR = 6.4, 95% CI
= 2.7–15.6, p = 0.000). Haematocrit level had a
negative correlation with QTC (r = –0.3, p =
0.016) and QT intervals (r = – 0.3, p = 0.044).
Triglyceride levels had a positive correlation
with the PR interval (r = 0.3, p = 0.012), while
serum alanine transferase (ALT) concentrations
had an inverse correlation with PR interval (r =
–0.3, p = 0.015). There was no statistical
difference in the sociodemographic and clinical
characteristics of the SCA children with or
without ECG abnormalities. However, the mean
triglyceride and serum ALT levels in those with
ECG abnormalities were significantly higher than
those without (p = 0.007 and 0.045,
respectively).
Conclusion: Lipid and ECG abnormalities are
common in children with SCA. Elevated
triglyceride and serum ALT levels are possible
biochemical markers of ECG abnormalities in
these patients.
Title: Combined effects of FTO rs9939609 and MC4R rs17782313 on
elevated nocturnal blood pressure in the Chinese Han population
Authors: Sun, Y; Sun, J; Wu, J; Yang, M
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 21-24
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DOI Number: 10.5830/CVJA-2015-064
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-064
Aim: In this study we investigated the
association of FTO rs9939609 and MC4R rs17782313 with elevated blood pressure in
the Chinese Han population, and analysed the relationship between the rs9939609
and rs17782313 variants.
Methods:We tested the rs9939609 and rs17782313 variants with the
sequence-retrieval method.
Results: The increase in odds ratios of the A allele of rs9939609 and the C
allele of rs17782313 for nocturnal blood pressure were 1.37 and 1.69. The
nocturnal blood pressure of participants simultaneously carrying the A and C
alleles was significantly higher than the blood pressure of those carrying
neither FTO nor MC4R risk alleles (p < 0.05), and that of the controls carrying
only the A or C alleles (p < 0.05). No association between the FTO or MC4R genes
with daytime hypertension was found in this Chinese population (p > 0.05).
Conclusion: Our data suggest that the rs9939609 and rs17782313 variants
may be significantly associated with nocturnal but not daytime blood pressure
levels and their combined effects were significant in this Chinese Han
population.
Title: Left ventricular systolic
function in Nigerian children infected with
HIV/AIDS: a cross-sectional study
Authors: Arodiwe, I; Ikefuna, A; Obidike, E;
Arodiwe, E; Anisuba, B; Ibeziako, N; Omokoidion,
S; Okoroma, C
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 25-29
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DOI Number: 10.5830/CVJA-2015-066
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-066
Background: Cardiac complications contribute
significantly to morbidity and mortality in
children with HIV/AIDS. These rates have been
under-reported in sub-Saharan African children.
Methods: This was an observational,
cross-sectional Doppler echocardiographic study
of ventricular systolic function, performed at a
tertiary clinic on children with HIV/AIDS.
Results: Left ventricular systolic dysfunction
was present in 27.0% of the children with HIV
infection and 81.2% of those with AIDS. The mean
fractional shortening in the AIDS group (31.6 ±
9.5%) was significantly lower than in the
HIV-infected group (35.3 ± 10.5%, p = 0.001). A
significant correlation was found with CD4+ cell
count and age, and these were the best
predictors of left ventricular systolic
dysfunction in the stepwise multiple regression
analysis (r = 0.396, p = 0.038; r = –0.212, p =
0.025, respectively).
Conclusion: Left ventricular systolic
dysfunction is common in Nigerian children with
HIV/AIDS.
Title: Vascular rings: a radiological review of anatomical
variations
Authors: Ganie, IS; Amod, K; Reddy, D
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 30-36
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DOI Number: 10.5830/CVJA-2015-076
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-076
Background: The imaging modalities used to
diagnose vascular rings have evolved over time, from basic radiographic studies
to advanced cross-sectional imaging. The goal of preoperative imaging is to
provide the surgeon with an accurate representation of the ring configuration so
that the surgical approach may be planned.
Objectives : To assess the feasibility and potential benefits of producing an
electronic RHD patient register.
Methods: We conducted a review of all patients with vascular rings who underwent
surgery at Inkosi Albert Luthuli Central Hospital, Durban, South Africa from 1
July 2008 to 1 July 2013.
Results: Eight patients were diagnosed with vascular rings. Seven patients had
an abnormal plain chest radiograph (right aortic arch, tracheal narrowing, or
abnormal mediastinal silhouette), while in six patients the contrast
oesophagogram demonstrated a fixed extrinsic oesophageal indentation. Computed
tomography angiography confirmed the pathology in all cases, with six double
aortic arches and two right aortic arches with aberrant left subclavian artery
and left ligamentum arteriosum.
Conclusions: We advocate a diagnostic imaging algorithm consisting of plain
chest radiography, contrast oesophagogram and computed tomography angiography
prior to surgery. Magnetic resonance imaging may provide an alternative axial
imaging modality depending on institutional preference.
Title: The change in right ventricular systolic function according
to the revascularisation method used, following acute ST -segment elevation
myocardial infarction
Authors: Gul, I; Zungur, M; Aykan, AC; Gokdeniz,
T; Alkan, MB; Sayin, A; Islamli, A; Bilgin, M; Kalaycioğlu, E; Turan, T
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 37-44
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DOI Number: 10.5830/CVJA-2015-077
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-077
Objective: The level of right ventricular (RV)
systolic function has prognostic importance in right ventricular ST-segment
elevation myocardial infarction (RV-STEMI). This study aimed to evaluate the
changes in RV systolic function in patients with RV-STEMI according to the
revascularisation method used for their management.
Methods: The first group consisted of 132 patients who received primary
percutaneous coronary intervention (PPCI). The 78 patients who had received
thrombolytic therapy (TT) in external centres before referral to our centre for
PCI within three to 12 hours of RV-STEMI were included in the second group. All
patients were evaluated by conventional and two-dimensional speckle-tracking
echocardiography.
Results: There were 172 male patients and their mean age was 63.7 ± 11.8 years.
There were no significant differences between the two groups with regard to
right ventricular systolic parameters at admission and at the one-month
follow-up visit. The echocardiographic changes between admission and the
one-month follow up were investigated for the patients included in the study
groups. Mean values of each parameter observed at the one-month follow up were
significantly increased compared to those at admission within each group.
Conclusion: Our study demonstrated that PCI within three to 12 hours following
TT provided similar benefits on right ventricular systolic function compared to
PPCI in patients with RV-STEMI.
Title: A rare case of heterotaxy and left ventricular non-compaction
in an adult Authors: Chacko, A; Scholtz, L;
Vedajallam, S; van Wyk, C
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 45-48
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DOI Number: 10.5830/CVJA-2015-063
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-063
Abstract: Heterotaxy syndrome with left
ventricular non-compaction is a rare co-existence of abnormalities with unknown
cause. It can be isolated with no other associations, or associated with
congenital heart diseases, or it can occur with multiple other congenital
abnormalities. We describe the third reported case of heterotaxy syndrome with
left ventricular non-compaction presenting in an adult.
Title: Intimomedial mucoid
degeneration causing aortic and renal artery
aneurysms in a young adult Authors: Viljoen, C; Szymanski, P;
Osman, N; Henning, KC; Scholtz, P; Rayner, B;
Naidoo, N
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 49-52
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DOI Number: 10.5830/CVJA-2015-079
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-079
Abstract: Intimomedial mucoid degeneration
(IMMD) is characterised by aneurysm formation
following mucin deposition in the intima and
media, with elastic tissue degeneration of the
arterial wall. We present a case of a young
adult who developed a diffusely aneurysmal aorta
and its major branches, which was
histopathologically confirmed as intimomedial
mucoid degeneration, and a review of the
literature. This case report attempts to raise
the awareness of the reader to this rare cause
of aortic aneurysm and to the bleeding diathesis
associated with IMMD that may complicate
surgery.
Title: First reported cases: renal denervation with secondgeneration
multi-electrode catheter via brachial and radial access Authors: Heradien, MJ; Augustyn, J; Saaiman, A; Brink, PA
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: 53-55
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DOI Number: 10.5830/CVJA-2015-089
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-089
Abstract: Renal denervation is a minimally
invasive procedure that aims to reduce brain–kidney sympathetic cross-talk.
Despite the negative results of the recent SYMPLICITY HTN-3 trial, the procedure
is considered safe and has been associated with many beneficial effects,
including the reversal of hypertensive heart disease substrate and the
prevention of cardiac arrhythmia. The first-generation radiofrequency catheter
system featured a monopolar catheter that required sequential singlepoint energy
application, followed by rotation, partial withdrawal of the catheter and
re-application of energy. The latest generation device features four electrodes
configured in a helical arrangement that can simultaneously ablate in four
quadrants of the vessel circumference. Renal denervation via brachial or radial
arterial access with the second-generation system has not been described before.
Title: Localised pericardial effusion mimicking anterior myocardial
infarction following coronary angiography
Authors: Acibuca, A; Menekse Gerede, DM; Baris,
VO; Kilickap, M
From: Cardiovascular Journal of Africa, Vol 27,
Issue 1, Jan/Feb
Published: 2016
Pages: e1-e3
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DOI Number: 10.5830/CVJA-2015-086
DOI Citation Reference Link:
dx.doi.org/10.5830/CVJA-2015-086
Abstract: The diagnosis of pericarditis is
important, especially in patients assumed to have acute coronary syndrome.
Distinguishing these two conditions is vital but not always easy. Accurate
diagnosis is essential to provide appropriate treatment as soon as possible and
to avoid inappropriate invasive procedures. By highlighting this distinction, we
report a case of pericarditis that occurred after percutaneous coronary
intervention and mimicked acute coronary syndrome.