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Screening for Peripheral Artery Disease (PAD) in Hypertensive Black Patients: Ankle-Brachial Index in a Senegalese Primary Care Setting

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World Journal of Cardiovascular Diseases 2024年第10期14卷 613-621页

作者： Ngoné Diaba Gaye Aliou Alassane Ngaïdé Mame Madjiguène Ka abdoul kane Department of Cardiac Rehabilitation Ibra Mamadou Wane Medical Center Dakar Senegal Department of Cardiology Dalal Jam Hospital Dakar Senegal School of Medicine Cheikh Anta Diop University Dakar Senegal Department of Cardiology Principal Hospital Dakar Senegal

Background: Peripheral artery disease (PAD) poses a significant health concern, particularly in Sub-Saharan Africa, where its prevalence is increasing. [1] Despite its significance, there is limited understanding of PAD among hypertensive patients in this region, highlighting a critical gap in knowledge. This study aimed to investigate the prevalence of PAD and associated factors in black hypertensive patients. Methods: A descriptive and analytical cross-sectional study was conducted over two years at a primary care center in Senegal using their ankle-brachial index (ABI) database. Data collection was strictly retrospective, and sociodemographic characteristics and clinical parameters were retrieved from the local patient database. We included all hypertensive patients who had benefited from an ABI. Statistical analysis was performed using the SPSS 18.0 software program. Results: Among the 220 hypertensive patients enrolled, PAD prevalence was 35%. Significant associations were observed between PAD occurrence and older age (>75 years, p = 0.008) and triple therapy (p = 0.015). Multivariate analysis confirmed age >75 years as a strong predictor of PAD in hypertensive patients (p = 0.01, OR = 4.6). Furthermore, PAD prevalence increased with the severity of hypertension (p = 0.03), emphasizing the need for targeted screening strategies in this population. Conclusion: Despite its limits, this study underscores the urgent need for improved access to healthcare services and tailored screening programs. The findings highlight the growing burden of PAD in Sub-Saharan Africa and the essential role of early detection and intervention, particularly in high-risk populations such as hypertensive individuals. Collaborative efforts involving healthcare providers, policymakers, and community stakeholders are crucial to implement effective interventions and reduce the impact of PAD on population health outcomes.

关键词： Peripheral Artery Disease Hypertension Africa South of the Sahara

Double Compression of Left Atrium and Pulmonary Artery by a Huge Descending Aortic Aneurysm with Intramural Hematoma Mimicking Pulmonary Embolism: A Case Report

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World Journal of Cardiovascular Diseases 2019年第6期9卷 419-424页

作者： Djibril Marie BA Aminata Diack Alain Affangla Khadidiatou Dia Mouhamed Cherif Mboup Mouhamed Leye abdoul kane Unit of Training and Research in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Cheikh Anta Diop University Dakar Senegal

Hemodynamic instability secondary to left atrial (LA) compression by an aortic aneurysm is a rare entity. We report?the case of a 43-year old woman with no previous diagnosis of congestive heart failure who was admitted for an initial diagnosis of pulmonary embolism (PE) based on shortness of breath, hypotension and D-Dimers?elevation. The electrocardiogram and blood counts were within normal limits. The chest X-ray revealed widening of the mediastinum. Transthoracic echocardiography demonstrated LA compression by a large descending thoracic aortic aneurysm. Left and right ventricle systolic functions were preserved. Chest angiography showed LA and left pulmonary artery (LPA) compression by a descending aortic aneurysm and an intramural hematoma with no evidence of PE evidence. Emergency surgery could not be done because of her financial status. She was treated medically and was discharged 1?week later with significant improvement. However she remained hypotensive.

关键词： Aortic Aneurysm Left Atrium Compression Pulmonary Artery Compression Intramural Hematoma Echocardiography

Comparative Study of Acute Coronary Syndrome with Persistent ST-Segment Elevation (STEMI) between Diabetics and Non-Diabetics in Dakar, Senegal

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World Journal of Cardiovascular Diseases 2024年第10期14卷 631-643页

作者： Ngoné Diaba Gaye Aliou Alassane Ngaïdé Joseph Salvador Mingou Massar Wague Momar Dioum Alassane Mbaye abdoul kane Faculty of Medicine Cheikh Anta Diop University Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Idrissa Pouye General Hospital Dakar Senegal Cardiology Department Fann Hospital Dakar Senegal

Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions.

关键词： Acute Coronary Syndrome with Persistent ST-Segment Elevation Diabetes Senegal

Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

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World Journal of Cardiovascular Diseases 2024年第10期14卷 644-655页

作者： Aliou Alassane Ngaïdé Ngoné Diaba Gaye Joseph Salvador Mingou Zineb Zinia Mouhamadou Bamba Ndiaye Alassane Diouf abdoul kane Faculty of Medicine Cheikh Anta Diop University Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Gynecology Department Pikune Hospital Dakar Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

关键词： Cardiovascular Risk Factors Pregnancy Prenatal Consultation

Epidemiology of Cardiovascular Mortality in Patients under 60 Years Old in a Cardiology Department in West Africa, Dakar-Senegal

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World Journal of Cardiovascular Diseases 2024年第8期14卷 502-514页

作者： Aliou Alassane Ngaide Ngone Diaba Gaye Joseph Salvador Mingou Mame Diarra Sene Momar Dioum Mouhamadou Bamba Ndiaye Alassane Mbaye abdoul kane Faculty of Medicine University Cheikh Anta Diop of Dakar Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Idrissa Pouye General Hospital Dakar Senegal Cardiology Department Fann Hospital Dakar Senegal

Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and va

关键词： Mortality Under 60 Years Cardiovascular Dakar

Study of the Frequency of Cardiovascular Diseases and Their Risk Factors in the Emergency Units of Two Hospitals in Dakar (Senegal)

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Open Journal of Internal Medicine 2021年第3期11卷 123-139页

作者： Pêngd-Wendé Habib Boussé Traore Jean Augustin Diegane Tine Oumar Bassoum Cheikh Tidiane Mbow Ababacar Diop abdoul kane Adama Faye Institute of Health and Development Public Health Service Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University Dakar Senegal Cardiology Department H&ocirc pital Dalal Jamm Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University Dakar Senegal Emergency Unit H&ocirc pital Principal de Dakar Dakar Senegal Emergency Unit H&ocirc pital de Pikine Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop University Dakar Senegal

Introduction: Cardiovascular diseases constitute the deadliest pathology in the world with 31% of global mortality in 2018. This is how we felt it necessary to conduct a study on cardiovascular diseases in emergency units of Senegal, more precisely in Dakar, in order to know epidemiological profile of these patients. Methods: The study setting was the reception and emergency units of the Hôpital de Pikine and Hôpital Principal de Dakar. This was an observational, descriptive cross-sectional study with an analytical aim to search for factors associated with the occurrence of cardiovascular disease. The study ran from January 25th to February 5th, 2018 at the Hôpital de Pikine and from February 25th to March 5th, 2018 at Hôpital Principal de Dakar. The source population consisted of patients over 18 years of age and not in a state of pregnancy, who were been received there and had given their free and informed consent to participate in the survey. A representative sample had drawn and a consecutive recruitment of eligible patients were been carried out. The data collection tools were been based on the WHO STEPwise survey questionnaire. Data collection was been carried out in accordance with ethical rules. Results: The study involved 615 patients. The proportions of sedentary lifestyle, low daily consumption of fruits/vegetables, overweight and obesity were 72.4%, 96.4%, 22.7% and 17.3% respectively. This was 55.5% of women who had a waist circumference that corresponded to a high risk of a cardiovascular event and 10.2% for men. 38.9% of patients had blood pressure above 140/90mmhg and 32.2% said they had never controlled their blood pressure in their life. The use of a consultation in a health structure to control his blood pressure was by far the most frequent modality with 61.4%. The proportion of people with cardiovascular disease was 50.1%. Hypertensive flare-ups/hypertensive emergencies were the leading complica

关键词： Risk Factors Cardiovascular Diseases Emergency Units Senegal

Study of the Right Heart of High-Level African Adult Athletes: Electrocardiographic and Echocardiographic Aspects

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World Journal of Cardiovascular Diseases 2018年第7期8卷 360-369页

作者： Simon Antoine Sarr Joseph Salvador Mingou Hamidy Hassal Mhoussine Fatou Aw Malick Bodian Mouhamadou Bamba Ndiaye Alassane Mbaye Adama kane Maboury Diao abdoul kane Serigne Abdou Ba Department of Cardiology Aristide Le Dantec Hospital University Dakar Senegal Department of Cardiology HOGGY Dakar Senegal Departement of Cardiology Regional Hospital of Saint Louis Saint Louis Senegal Departement of Cardiology Dalal Jamm Hospital Dakar Senegal

Despite the growing interest in athlete’s right ventricle and various work carried out, many uncertainties are remaining. The interest of this work resides in the determination of the particularity in right heart of the black athlete subject. We conducted a prospective study from August to October 2016 in the cardiology department of Aristide Le Dantec University Hospital in Dakar. The included patients were divided according to the sporting practice as enduring, resistant and non-athletes. The parameters studied were electrocardiographic (atrial or ventricular hypertrophies), echocardiographic: dimensions of the right cavities, systolic and diastolic functions of the right ventricle. We included 58 subjects: 38 athletes including 28 endurance and 10 resistance and 20 non-athletes. The average age of the endurance athletes was 21.9 ± 3, 75 years, 26.30 ± 4.64 in resistance ones and 24.10 ± 1.89 in the non-athletic group. Two cases of first-degree atrioventricular block were recorded in athletes. On the echocardiographic point, the atrium surfaces, as well as the transverse diameter, were greater in athletes, especially in the endurance group. The mean diameters of the admission chamber and those of the right ventricular flush chamber were larger in the group of endurance athletes. It was the same for the annular and sagittal basal mean diameters of the RV as well as the RV/LV ratio. The anterior wall of the right ventricle was larger in athletes compared to non-athletes. The vena cava was greater in athletes, the pulmonary arterial pressure higher in resistance ones.

关键词： Right Ventricle Black African Athletes Dilation Endurance

Deep Vein Thrombosis of the Upper Limb: About 6 Cases Collected in Dakar

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World Journal of Cardiovascular Diseases 2020年第2期10卷 57-66页

作者： Mouhamadou Bamba Ndiaye Fatou Aw Marguerite Téning Diouf Joseph Salvador Mingou Simon Antoine Sarr Malick Bodiian Aliou Alassane Ngaidé Alassane Mbaye Adama kane Maboury Diao abdoul kane Department of Cardiology Aristide Le Dantec Hospital University Dakar Senegal Department of Cardiology HOGGY Dakar Senegal Departement of Cardiology Regional Hospital of Saint Louis Saint Louis Senegal Departement of Cardiology Dalal Jamm Hospital Dakar Senegal

Deep vein thrombosis of the upper limb is a rare location of venous thromboembolic disease. Data on this form of thrombosis are limited. We report six cases collected in Dakar. The sex ratio was 0.5 and the average age was 27.6 years with extremes of 17 and 39. Painful limb edema was the most constant sign and involved the non-dominant limb in almost all patients. Thrombosis occurred in a field of peripartum cardiomyopathy in two patients and SS sickle cell disease in one patient taking oral contraception. There was neither cancer nor venous catheter in medical history. The diagnosis was made by venous Doppler ultrasound in all patients. Subclavian involvement was the most common. The thrombophilia assessment, done for two patients, was normal. It was about exertion thrombosis on three (3) patients. All the patients had received antivitamin K treatment relaying a low molecular weight heparin. Venous limb compression was associated with anticoagulation for all patients. The treatment duration was six (6) months. There were no reports of pulmonary embolism or death. One patient presented a post-thrombotic syndrome.

关键词： Deep Vein Thrombosis Upper Limb Dakar

Osler’s Subacute Infective Endocarditis on Rheumatic Heart: A Complicated Clinical Case That Reflects Four (4) Major Public Health Issues in Sub-Saharan Africa

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Case Reports in Clinical Medicine 2022年第12期11卷 507-519页

作者： Pêngd-Wendé Habib Boussé Traore Aliou Alassane Ngaide Aliou Alassane Ngaide Jean Augustin Diégane Tine Alioune kane Akouètè Jean Paul Degue Alassane Mbaye Bouna Diack abdoul kane Cardiology Department Idrissa Pouye General Hospital Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop University Dakar Senegal Institute of Health and Development Public Health Service Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop Univer-sity Dakar Senegal Cardiology Department Dalal Jamm Hospital Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop University Dakar Senegal

Endocarditis is an inflammation of the endocardium and its structures (valves), most often of infectious origin, described by William Osler in 1885. In the 21st century, infective endocarditis remains a reality in our countries. We report a complicated case of infective endocarditis (IE). This is a 53-year-old woman, obese and passive smoker who died on the 5th day of her hospitalization following an infective endocarditis (IE) with bacterial strains resistant to the usual antibiotics: daughter of acute lithiasic cholecystitis, mother of major mitral valve perforation, brain abscess, ischemic stroke and atrial fibrillation. All were responsible for septic shock and fatal coma. Surgical management of the infective endocarditis in the first hours of her admission could have improved her prognosis. To conclude, in addition to its interests and its clinical particularities, our present observation has highlighted major public health problems specific to our sub-Saharan African countries, namely: The problem of the double health burden, the problem of delays in seeking care, the problem of resistance to antibiotics and the problem of the insufficiency of reference health technical platforms.

关键词： Infective Endocarditis Rheumatic Heart Disease Cardiovascular Risk Factors Antibiotic Resistance Acute Lithiasis Cholecystitis Neurological Complications Delayed Consultation Senegal