CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 3, April 2012
142
AFRICA
could not be accurately determined because a large number of
patients were lost to follow up as they were not contactable.
There was no standard follow-up time. Not all patients had
repeat echocardiograms and echocardiograms were performed at
variable time periods by different echocardiographers.
Conclusions
This is one of the largest retrospective studies of TIC and the
first large series from Africa. This study is the first to compare
features of pure and impure TIC. Impure TIC patients have
shorter duration and more severe symptoms at presentation.
This study reports the first description of ECG findings of
TIC. Patients with pure TIC have shorter QRS durations, fewer
Q waves, and less LVH and repolarisation abnormalities at
presentation compared to DCMO patients.
This is the second study to report that TIC patients have
smaller LVIDd dimensions at presentation and have persistence
of adverse LV remodelling as characterised by persistent
enlargement of LVIDd dimensions at late follow up. Patients
who have larger LVIDd dimensions at presentation tended to
have larger LVIDd dimensions at late follow up, identifying a
subgroup of patients where careful follow up is required.
This study confirms that maximal improvement of LV
function generally occurs by three to six months. However, we
noted slower improvement in LV function over 12 months in
patients who had severe LV dysfunction and in patients with
lenient heart rate control. We managed to identify 45 patients
with this condition at a large regional referral centre in Cape
Town over a 15-year period, suggesting that this condition is
frequently under-diagnosed and missed.
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