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FIRST ADVANCE ONLINE PUBLICATION (ePublication ahead
of print)
The Cardiovascular Journal of Africa has launched an online
First Advance Online Publication (ePublication ahead of print) with full text availability via Pubmed and this
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E-publication, ahead of print and offers
authors the opportunity to publish their research articles
sooner for an international audience.
January 2012
Title: The prevalence and outcome of effusive
constrictive pericarditis: a systematic review of the literature
Authors: Mpiko Ntsekhe, Charles Shey Wiysonge, Patrick J
Commerford, Bongani M Mayosi
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Submitted 14/6/11, accepted 22/11/11
DOI:
10.5830/CVJA-2011-072
Abstract: There is
sparse information on the epidemiology of effusive constrictive
pericarditis (ECP). The objective of this article was to review
and summarise the literature on the prevalence and outcome of
ECP, and identify gaps for further research. The prevalence of
ECP ranged from 2.4 to 14.8%, with a weighted average of 4.5%
[95% confidence interval (CI) 2.2–7.5%]. Sixty-five per cent
(95% CI: 43–82%) of patients required pericardiectomy regardless
of the aetiology. The combined death rate across the studies was
22% (95% CI: 4–50%). The prevalence of ECP is low in non-tuberculous
pericarditis, while pericardiectomy rates are high and mortality
is variable. In this review, of 10 patients identified with
tuberculous ECP, only one presumed case had a definite diagnosis
of ECP. Appropriate studies are needed to determine the
epidemiology of ECP in tuberculous pericarditis, which is one of
the leading causes of pericardial disease in the world
Keywords: effusive constrictive pericarditis,
prevalence, pericardiectomy and death
December 2011
- Title: Severe haemoptysis due to subclavian
arteritis
Authors: A Lioulias, P Misthos, P
Drosos, N Karagiannidis, D Pavlopoulos, M Mitselou
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Submitted 8/6/10, accepted 26/11/10
DOI:
10.5830/CVJA-2010-096
Abstract: Severe
haemoptysis due to infective subclavian arteritis has, to
our knowledge, never been documented. We report a case of
subclavian arterial vasculitis that eroded into the left
lung apex, causing a large intraparenchymal mycotic
pseudoaneurysm. The patient presented with high fever and
blood expectoration. An emergent left lateral thoracotomy
was performed. The inflamed segment of the subclavian artery
was resected and continuity was restored with a reversed
saphenous vein graft. The postoperative course was
uneventful and the patient was discharged on the 10th
postoperative day.
Keywords: haemoptysis,
subclavian artery, arteritis, lung
- Title: p53 negatively regulates the osteogenic
differentiation of vascular smooth muscle cells in mice with
chronic kidney disease
Authors: KL Li, J Chen, ZH Li, J Zhan, L Zhao,
YN He
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Submitted 1/3/11, accepted 22/11/11
DOI:
10.5830/CVJA-2011-069
Aim: To
investigate the osteogenic differentiation of vascular smooth
muscle cells (VSMCs) in mice with chronic kidney disease (CKD)
and to evaluate the effects of p53 on the osteogenic
differentiation of the VSMCs.
Methods:
Experimental models of CKD-associated vascular calcification
generated by five-sixth (5/6) nephrectomy (Nx) and a
high-phosphate (HP) diet were used in p53+/+ and p53–/– mice.
Following 5/6 Nx, aortic calcification, markers of osteogenic
differentiation, VSMCs and p53 protein in aortic tissues were
studied.
Results: Aortic calcification was
observed after eight weeks following 5/6 Nx in mice of both
genotypes, and expression of the markers of osteogenic
differentiation in the VSMCs was increased. These changes were
continuously observed up to 12 weeks after 5/6 Nx, and
particularly after 5/6 Nx + HP. Compared with p53+/+ mice,
aortic calcification in p53–/– mice was more severe (p < 0.001).
Expression of the markers of osteogenic differentiation was
noticeably increased (p < 0.001), while expression of the marker
of VSMCs had decreased (p < 0.001). Statistical analysis
demonstrated that the markers of osteogenic differentiation were
negatively correlated with p53, and the marker of VSMCs was
positively correlated with p53 (p < 0.001).
Conclusion: p53 has the potential to negatively
regulate the osteogenic differentiation of VSMCs in CKD mice.
Keywords: chronic kidney disease, mouse,
osteogenic differentiation, P53, vascular smooth muscle cells
October 2011
Title: Obesity and blood pressure levels of
adolescents in Abeokuta, Nigeria
Authors: IO
Senbanjo, KA Oshikoya
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Submitted 30/1/11, accepted 11/7/11
DOI:
10.5830/CVJA-2011-037
Background: We
determined the prevalence of general and central obesity and
their relationship with blood pressure levels among adolescents
in Abeokuta, Nigeria.
Methods: We selected
423 adolescents from seven schools in Abeokuta, Nigeria, using a
multistage random-sampling technique. Body mass index (BMI),
waist circumference
(WC) and blood pressures were measured.
Results: Twenty-one (5%) children had
general obesity and 109 (24.5%) had central obesity. Of those
with general obesity, 20 (95.1%) children were centrally obese.
With simple linear regression analysis, BMI and WC explained
10.7 and 8.4%, respectively of the variance in systolic blood
pressure (SBP), and 3.6 and 2.7%, respectively of the variance
in diastolic blood pressure (DBP). Following logistic regression
analysis, BMI was the major factor determining SBP levels (OR
0.8, 95% CI: 0.65–0.99, p < 0.05).
Conclusion:
BMI remains an important anthropometric screening tool
for high blood pressure in Nigerian adolescents.
Keyword: overweight, obesity, central obesity, blood
pressure, adolescents, Nigeria
Title: Prevalence, awareness, treatment and control
of hypertension among adults 50 years and older in Dakar,
Senegal
Authors: E Macia , P Duboz, L Gueye
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Submitted 11/5/11, accepted 19/7/11
DOI:
10.5830/CVJA-2011-039
Background: Older adults are disproportionately
affected by hypertension, which is an established risk factor
for cardiovascular disease. Despite these facts, no study of the
prevalence, awareness, treatment and control on arterial
hypertension in Senegal has been conducted, specifically among
elderly people.
Methods: Five hundred people
aged 50 years and older, living in the city of Dakar were
interviewed. This sample was
constructed using the combined
quota method in order to strive for representativeness of the
target population.
Results: Prevalence of
hypertension was 65.4% in our sample. Half of those suffering
from high blood pressure
were aware of their problem and
among the latter, 70% said they were on treatment. However, of
these, only 17% had
controlled arterial blood pressure. The
only factor associated with awareness, treatment and control of
hypertension was the frequency of doctor visits.
Conclusion: Improving follow-up health checks of older
adults are necessary to limit the consequences of hypertension
in Dakar.
Keywords: hypertension, risk
factors, older adults, Senegal
September 2011
Title: A systematic overview of prospective
cohort studies of cardiovascular disease in sub-Saharan Africa
Authors: Andre Pascal Kengne, Lucas M Ntyintyane, Bongani M
Mayosi
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Submitted 3/7/10, accepted 15/8/11
DOI: 10.5830/CVJA-2011-042
Background: Cardiovascular diseases (CVDs) are
becoming increasingly significant in sub-Saharan Africa (SSA).Reliable
measures of the contribution of major determinants are essential
for informing health services and policy solutions.
Objective: To perform a systematic review of all
longitudinal studies of CVDs and related risk factors that have
been conducted in SSA. Data source: We searched electronic
databases from 1966 to October 2009. Published studies were
retrieved from PubMed and Africa EBSCO. Reference lists of
identified articles were scanned for additional publications.
Study selection: Any longitudinal study
with data collection at baseline on major cardiovascular risk
factors or CVD, including 30 or more participants, and with at
least six months of follow up were included.
Data
extraction: Data were extracted on the country of study, year of
inception, baseline evaluation, primary focus of the study,
outcomes, and number of participants at baseline and final
evaluation.
Results: Eighty-one
publications relating to 41 studies from 11 SSA countries with a
wide range of participants were included. Twenty-two were
historical/prospective hospitalbased studies. These studies
focused on risk factors, particularly diabetes mellitus and
hypertension, or CVD including stroke, heart failure and
rheumatic heart disease. The rate of participants followed
through the whole duration of studies was 72% (64–80%), with a
significant heterogeneity between studies (for heterogeneity, p
< 0.001). Outcomes monitored during follow up included
trajectories of risk markers and mortality.
Conclusions:
Well-designed prospective cohort studies are needed to inform
and update our knowledge regarding the epidemiology CVDs and
their interactions with known risk factors in the context of
common infectious diseases in this region.
Keywords:
cohort studies, cardiovascular diseases, risk
factors, outcomes, sub-Saharan Africa
August 2011
Title: Treatment of subaortic stenosis in hearts with
singleventricle physiology
Authors: Bulent Saritas,
Emre Ozker, Can Vuran, Çağri Gunaydin, Canan Ayabakan, Riza
Turkoz
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Submitted 11/4/110, accepted 31/5/11
DOI:
10.5830/CVJA-2011-023
Background: We evaluated the patients who had
had a Damus-Kaye-Stansel (DKS) operation for single-ventricular
physiology with the aorta originating from a hypoplastic
ventricle and the pulmonary artery from the systemic ventricle.
Methods: Seven patients who were operated on
between May 2007 and November 2010 were evaluated
retrospectively. The patients had been diagnosed with a
transposed doubleinlet left ventricle and triscuspid atresia,
and had been waiting for a Fontan operation. Systemic outflow
stenosis was defined echocardiographically as those with a
gradient greater than 20 mmHg, and angiographically those with
greater than 5 mmHg in the subaortic region.
Results:
The mean age and weight of the patients was 15 ± 9.7 months and
8 ± 3.3 kg, respectively. The mean gradient
between the
systemic ventricle and the aorta was 35 ± 25 mmHg. This gradient
decreased to 14.3 ± 4 mmHg postoperatively. The early hospital
mortality was 14% (one patient).The mean extubation time and
mean time in the intensive care unit (ICU) were 13 ± 7.3 hours
and 2.2 ± 0.5 days, respectively. The mean follow-up time was 11
± 2 months. No mortality and semi-lunar valve insufficiency were
observed after discharge.
Conclusions: One
of the major problems that occur while waiting for a Fontan
operation is systemic ventricular hypertrophy and deterioration
in the compliance of the ventricle due to systemic ventricular
outflow stenosis. When the disadvantages of outflow resection
are encountered, a DKS proves to be a good alternative.
Keywords: pulmonary artery band, univentricular
heart, Fontan procedure, subaortic stenosis
July 2011
Title: Feeding the emergence of advanced heart
disease in Soweto: a nutritional survey of black African
patients with heart failure
Authors: Sandra
Pretorius, Karen Sliwa, Verena Ruf, Karen Walker, Simon Stewart
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Submitted 17/9/10, accepted 21/5/11
DOI: CVJ-21.100
Summary: Aim: To describe dietary
habits and potential nutritional deficiencies in black African
patients diagnosed with heart failure (HF). Methods and
Results: Dietary intake in 50 consecutively consenting HF
patients (mean age: 47 ± 18 years, 54% female) attending a major
hospital in Soweto, South Africa were surveyed using validated
quantitative food frequency questionnaires. Food intakes,
translated into nutrient data were compared with recommended
values. In women, food choices likely to negatively impact on
heart health included added sugar [consumed by 75%: median daily
intake (interquartile range) 16 g (10–20)], sweet drinks [54%:
310 ml (85–400)] and salted snacks [61%: 15 g (2–17)].
Corresponding figures for men were added sugar [74%: 15 g
(10–15)], sweet drinks [65%: 439 ml (71–670)] and salted
snacks [74%: 15 g (4–22)]. The womens’ intake of calcium,
vitamin C and vitamin E was only 66, 37 and 40% of the
age-specific requirement, respectively. For men, equivalent
figures were 66, 87 and 67%. Mean sodium intake was 2 372 g/day
for men and 1 972 g/day for women, 470 and 294% respectively, of
recommended consumption levels.
Keywords:
heart failure, Africa, food preferences, malnutrition, salt
June 2011
- Title: Mobile atheromatous plaque of the aortic
arch diagnosed by transthoracic echocardiography prior to
coronary artery bypass surgery. Which one would you
choose: scepticism or wishful thinking?
Authors:
AC Hatemi, O Omay, M Baskurt, S Kücükoglu, B Öz, K Süzer
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Submitted 26/1/10, accepted 3/6/11
DOI: CVJ-21.115
Abstract: A routine pre-operative chest
X-ray of a patient admitted to our institution for an
elective coronary artery bypass operation revealed a mildly
dilated mediastinal silhouette, which led the cardiovascular
surgery resident to schedule emergency transthoracic
echocardiography (TTE), with a special note asking for
detailed evaluation of the ascending aorta and aortic arch.
TTE revealed a mobile atheroma at the aortic arch, which
obliged the cardiac surgery team to modify their strategy to
combined hemi-arcus aortae replacement and coronary artery
bypass grafting (CABG). Although with transoesophageal
echocardiography (TEE) a small portion of the ascending
aorta may be obscured by the trachea, TEE provides higher
resolution images than TTE. Therefore one can conclude that
TEE is the imaging modality of choice for detecting aortic
atheromatous plaques but in patients with low risk for
stroke and aortic atheromas, a detailed TTE may be
sufficient for the pre-operative assessment.
Keywords: aortic arch, atherosclerosis, aorta,
echocardiography, circulatory arrest, coronary artery bypass
grafts, CABG
- Title: Isolated tricuspid valve prolapse:
identification using two- and three-dimensional
echocardiography and transoesophageal echocardiography
Authors: Gonenc Kocabay, Dicle Sirma, Meral Mert, Kursat
Tigen
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Submitted 17/12/10, accepted 16/2/11
DOI: CVJ-21.094
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.
Keywords: isolated tricuspid
valve prolapse
- Title: Heart rate variability in physically
active individuals: reliability and gender characteristics
Authors: Takshita Sookan, Andrew J Mckune
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Submitted 10/12/10, accepted 9/5/11
DOI: CVJ-21.108
Purpose: To evaluate the reliability of
short-term recordings (five minutes) of heart rate
variability (HRV) and the association between HRV and
gender. Methods: HRV time- and frequency-domain parameters
were calculated in 44 physically active students (21 males
and 23 females) over four consecutive days. A Suunto t6
heart
rate monitor was used to obtain inter-beat
intervals (IBIs) that were then transferred to Kubios HRV
analysis software. The relative reliability [intra-class
correlation (ICC)] and absolute reliability, [typical error
of measurement (TEM) and typical error of measurement as a
percentage (TEM%)] of the HRV parameters were then
calculated for day 2 versus day 3 and day 3 versus day 4,
with day 1 being a familiarisation day. The following HRV
parameters were calculated: (1) time domain: resting heart
rate (RHR), R–R intervals (IBI),
standard deviation of
normal-to-normal intervals (SDNN), root mean square
differences of the standard deviation (RMSSD), percentage of
beats that changed more than 50 ms from the previous beat
(pNN50); and (2) frequency domain: low-frequency normalised
units (LFnu), high-frequency normalised units (HFnu),
low-frequency to high-frequency ratio in normalised units
(LF/HFnu). An analysis of variance (ANOVA) with Tukey
post-hoc testing was performed to compare HRV parameters in
males and females. Significance was set at p ≤ 0.05.
Keywords: heart rate variability,
sympathovagal balance, reliability
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