Cardiovascular Journal of Africa: Vol 26 No 5 (September/October 2015)

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CARDIOVASCULAR JOURNAL OF AFRICA • Vol 26, No 5, October/November 2015 AFRICA 9
ENGLISH ABSTRACTS
ARRHYTHMIC PATTERNS AND HEART RATE VARI-
ABILITY OF 24-HOUR HOLTER ELECTROCARDIO-
GRAPHY AMONG NIGERIANS WITH CARDIOVASCU-
LAR DISEASES
Adebayo Rasaaq*, Ikwu Amanze, Balogun Michael
Department of Medicine, Obafemi Awolowo University, Ile-Ife,
Nigeria;
Background: Facilities for Holter electrocardiography (ECG)
monitoring in many Nigerian hospitals are limited. There are
few published works in Nigeria on the use of 24-hour Holter
ECG in cardiac arrhythmic evaluation of patients with cardio-
vascular diseases.
Objective: To study the clinical indications, arrhythmic pattern
and heart rate variability (HRV) among subjects referred for
24-Holter ECG at our Cardiac Care Unit.
Methods: A total of 310 patients were studied consecutively over
a 48-month period using a Schiller-type (MT-101) Holter ECG
machine.
Results: Out of the 310 patients reviewed, 134 were males
(43.2%) and 176 were females (56.8%).The commonest indica-
tion for Holter ECG was palpitation, followed by syncope in
71 (23%) and 49 (15.8%) of subjects, respectively. Premature
ventricular complex and premature atrial complex were the
commonest type of arrhythmia in 51.5 and 15% of subjects,
respectively. Ventricular arrhythmia was more prevalent in
dilated cardiomyopathy patients (85.7%). The HRV of subjects
with palpitation, stroke and DM with autonomic neuropathy,
using SDNN average (ms), were 107.32 ± 49.61, 79.15 ± 49.15
and 66.50 ± 15.54, respectively. The HRV, using SDANN aver-
age (ms), of patients with palpitation, stroke and DM with
autonomic neuropathy were 77.39 ± 62.34, 57.82 ± 37.05 and
55.50 ± 12.71, respectively.
Conclusion: Palpitation and syncope were the commonest indi-
cations for Holter ECG among our subjects. The commonest
arrhythmic patterns were premature ventricular complex and
premature atrial complex, with ventricular arrhythmia being
more prevalent in dilated cardiomyopathy. There was a reduc-
tion in HRV in patients with stroke and diabetic autonomic
neuropathy.
SHORT-TERM OUTCOME AND DETERMINANTS OF
OUTCOME IN HEART FAILURE IN A COHORT OF AFRI-
CAN PATIENTS IN PORT HARCOURT, NIGERIA
Akpa Maclean*, Iheji Okechukwu
University of Port Harcourt, Teaching Hospital, Port Harcourt,
Nigeria;
Background: Heart failure (HF) has assumed an important
public health burden in Nigeria. Unfortunately there is paucity
of data on the outcome pattern in patients with HF in our envi-
ronment. The study aimed to determine the short-term outcome
and the factors that determine these outcomes in patients
treated for HF in the University of Port Harcourt Teaching
Hospital (UPTH).
Methods: It was a hospital-based prospective study. Subjects
were consecutive patients with HF admitted into the medical
wards of the UPTH who gave informed consent. All the subjects
had full physical examinations and transthoracic echocardiog-
raphy to confirm HF and determine left ventricular function.
Patients were followed up for six months and reassessed for
outcome/endpoint, which were rehospitalisation or death.
Results: A total of 160 patients were studied over a one-year
period, constituting 84 females and 76 males. The ages of the
subjects ranged between 20 and 87 years with a mean of 52.49
± 13.89 years. Follow-up period was six months and at the end,
each patient was re-evaluated. A total of 16 subjects (10%) were
lost to follow up, 66 subjects (41.3%) showed improvement clini-
cally and continued their regular out-patient clinic attendance,
57 subjects (35.6%) were rehospitalised for HF exacerbations,
while 21 subjects (13.1%) died.
The sociodemographic profile of the patients did not have any
significant effect on rehospitalisation and mortality. There was
a significant association between rehospitalisation and NYHA
class, type of HF, body mass index, haemoglobin level, LVEF
and the estimated glomerular filtration rate (eGFR). However
when the effects of confounding variables were removed, the
real determinants of rehospitalisation were the NYHA class,
type of heart failure, haemoglobin level and the eGFR.
There was a significant association between mortality and
NYHA class, haemoglobin level and LVEF. However after the
effects of confounding variables were removed, the effect of
LVEF disappeared, leaving only NYHA class and haemoglobin
level as the real determinants of mortality.
Conclusion: HF remains a major public health problem and the
rehospitalisation rate of 35.6% and mortality rate of 13.1% in
this study was high. There is therefore need to search for and
control the identified determinants of these adverse outcomes.
GENDER DISPARITIES IN CLINICAL CHARACTERIS-
TICS AND OUTCOME OF PATIENTS WITH PULMO-
NARY HYPERTENSION IN DOUALA, CAMEROON
Aminde Leopold* 1, Dzudie Anastase2, Mapoh Sylvester1, Takah
Noah3, Ndjebet Jules 4, Kuelang Xavier5, Ngu Kathleen Blackett6,
Sliwa Karen7, Kengne Andre Pascal8
1 Faculty of Health Sciences, University of Buea, Buea,
Cameroon and Clinical Research Education, Networking and
Consultancy, Douala, Cameroon;
2 Faculty of Health Sciences, University of Buea, Buea,
Cameroon; Clinical Research Education, Networking &
Consultancy, Douala, Cameroon; Cardiology Unit, Department
of Internal Medicine, General Hospital Douala, Douala,
Cameroon; Faculty of Health Sciences, University of Cape
Town, Cape Town, South Africa