CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 3, September – October 2024 AFRICA 133 From the Editor’s Desk In this issue of the journal, there are some interesting questions addressed. I highlight some below. Ayob and colleagues (page 178) ask pertinent questions about our ‘clients’, our patients and the public, and their grasp of the entities we are managing them for and our advice given. They tracked down studies from Cameroon, Kuwait, Tanzania, South Africa, USA, Malaysia, Australia, Ghana and Uganda, which is a wide spectrum. The conclusion was that there is generally little grasp of what cardiovascular disease is about: poor riskfactor awareness, not buying into lifestyle modification and not appreciating the need for monitoring and for medication compliance. Phanzu and co-workers (page 147) took an unconventional approach and reasoned that the left ventricular mass, calculated by echocardiography according to Devereux’s formula, has different contributing components. They asked to what extent insulin resistance and/or hyperinsulinaemia are associated with average left ventricular mass or with components of Devereux’s formula, and also separately analysed parameters of left ventricular diastolic function. The article makes interesting reading as it presents sophisticated work incorporating lateral thinking. Similarly, the association between CHA2DS2-VASc score, a score used to calculate the chance of stroke in persons with atrial fibrillation, and aortic valve sclerosis are not conditions that we normally associate with each other. The article by Başyiğit et al. (page 134) outlines some interesting reasoning on how the formula for risk in atrial fibrillation and aortic valve sclerosis can be co-evaluated, and they come to some interesting conclusions. Amendezo and co-workers (page 155) describe how the COVID-19 crisis led to fewer training episodes for budding cardiologists, and limited the fellows from achieving the necessary amount of skills base, often in highly technical areas, by the end of their training. They also suggest how it could be rectified. In an interesting case report, Ahadzi and colleagues (page 185) take us through the long-term follow up of an individual who was initially treated presumptively for heart failure with preserved ejection fraction from hypertensive disease, based on his clinical presentation and echocardiographic findings from three years earlier. By adopting a stepwise approach to the evaluation and revisiting the history, together with multimodality cardiac imaging, the diagnosis of cardiac amyloidosis was made. Several interesting fillers are also found at the end of some of the articles, such as how overweight as a child, with excess kilos in the teen years, can double the later risk of stroke; the cardiovascular benefits from weight-loss drugs, including semaglutide; experts challenge ‘one-size-fits-all’ aspirin guidelines; and frequent cannabis use bumps up heart attack risk. PA Brink Acting Editor-in-Chief Paul Brink
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