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Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali

World Journal of Cardiovascular Diseases 2024年第2期14卷 77-87页

作者： Youssouf Camara hamidou oumar ba Ibrahima Sangaré Boubacar Sonfo Coumba Adiaratou Thiam Mahamadou Sékou Diakité Koniba Diarra Karamba Touré Massama Konaté Ichaka Menta Cardiology Department University Hospital Professeur Bocar Sidi Sall Kati Kati Mali Cardiology Department University Hospital Gabriel Touré Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.

关键词： Stress Test Ischemic Heart Disease Mali

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Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

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World Journal of Cardiovascular Diseases 2024年第3期14卷 129-139页

作者： Konaté Massama Mamadou Touré Mariam Sako Samba Sidibé Souleymane Mariko Djeneba Sylla Sow Elhaj Mahamane Maiga Coumba Adiaratou Thiam Youssouf Camara hamidou oumar ba Asmao Keita Maiga Djenebou Traoré Zoumana Traoré Souleymane Coulibaly bah Traoré Modibo Mariko Nouhoum Ouologuem Amadou Koné Ichaka Menta Faculty of Medicine and Dentistry bamako USTTB Department of Medicine Hospital of Mali Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali Department of Cardiology CHU Point G Bamako Mali Department of Medicine Hospital of Timbuktu Bamako Mali Department of Cardiology Hospital of Kati Bamako Mali Department of Cardiology CHU Mother and Child bamako Bamako Mali Department of Internal Medicine CHU Point G Bamako Mali

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

关键词： Diabetes Echocardiography Mali Hospital

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Cardiovascular Risk Factors (CVrf) in Rural and Urban Areas Mali: Data from the Step 2013 Survey

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World Journal of Cardiovascular Diseases 2018年第1期8卷 35-47页

作者： hamidou oumar ba Ichaka Menta Youssouf Camara Ibrahima Sangaré Guida Landouré Georges Rosario Christian Millogo Souleymane Coulibaly Ilo Bella Diall CHU Gabriel Touré bamako Bamako Mali CHU Kati Bamako Mali CHU Point G Bamako Mali CHU YO-Ouagadougou Ouagadougou Burkina-Faso

background: Traditional cardiovascular risk factors (CVrf) like hypertension, diabetes, dyslipidemia, obesity, smoking have been studied extensively through theses in hospital studies. Therefore, recent published data from community based studies are rare in Mali. Available data are old justifying to perform a community based study on traditional CVrf in rural and urban areas. Materials and Methods: We retrospectively performed a study which data stemmed from the last STEPS survey carried out in 2013 in some rural and urban areas of Mali. We studied hypertension, diabetes, tobacco smoking, obesity based on body mass index, waist circumference and waist-to-hip ratio. After bivariates analyses, we conducted a logistic regression with rural/urban as dependent variable using SPSS as analysis software for this purpose. Results: Weight, height, WC and HC were higher in urban area with 69.77 Kg, 169.13 cm, 85.98 cm and 97.26 cm compared to 66.27, 165.42, 81.46 and 93.23 in rural area (p as more prevalent in urban area while elevated waist-to-hip ratio was more prevalent in rural area. But in logistic regression for female, the Odds for Tobacco smoking rural as reference was 0.334 [CI: 0.151 - 0.738] (p = 0.007) and that for WHr is 0.582 [CI: 0.415 - 0.815] (p p p = 0.038). Conclusion: Traditional cardiovascular risk factors have high prevalence in this study and need to be monitored with larger studies. Female predictors were raised waist circumference in favour of urban and tobacco smoking and waist-to-hip ratio in favour of urban dwellers. Male diabetes was the only predictor we found.

关键词： Cardiovascular Risk Factor Rural Urban Community Mali

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Management of Hypertension (HTN) in a Cardiology Department in bamako (Mali): Financial Aspects

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World Journal of Cardiovascular Diseases 2019年第6期9卷 394-403页

作者： hamidou oumar ba Ichaka Menta Ibrahima Sangaré Noumou Sidibé Youssouf Camara Souleymane Coulibaly hamidou Camara Cheick Hamala Fofana Aladji Traoré Adama Sogodogo Mamadou Touré Kéita Asmaou Maiga Doumbia Coumba Thiam Adama Daou Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Mother Children Bamako Mali National Center for Disease Fighting Bamako Mali

background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

关键词： Hypertension New Patients Untreated Patients Costs Cardiology bamako

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High Blood Pressure in External Consultation in Cardiology of Kati

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World Journal of Cardiovascular Diseases 2018年第12期8卷 533-538页

作者： Ichaka Menta hamidou oumar ba Souleymane Coulibaly Ibrahima Sangare Djénébou Traore Coumba Thiam Yacouba Fofana Ilo Bella Diall Youssouf Camara Samba Sidibe Mamadou Diakite Massama Konate Kassoum Mamourou Sanogo Cardiology Service of Gabriel Touré University Hospital Center (CHU Gabriel Touré) Bamako Mali Cardiology Service of Point G University Hospital Center (CHU Point G) Bamako Mali Internal Medicine Service of Point G University Hospital Center (CHU Point G) Bamako Mali Cardiology Service of Kati University Hospital Center (CHU Kati) Kati Mali

Objective: To study hypertension and its manifestations in?Out-patients’ Department of Cardiology of Kati. Methods: The study was traversal and it was based on a sample of 300 patients, reached during the interval of 12 (twelve) months (from June 2012 to June 2013). Results: The predominance was among the females with 68.7%. The average age was about?55.8 ± 12.2 years old. The extreme ages were?about 21 and 90 years?old. In the set,?66% of the patients lived in the town of Kati.?The symptoms of Dieulafoy were predominantly the reasons for consultation with 55.7%. The cardiac frequency in the vast majority of cases was normal (85.3%). The left ventricular hypertrophy in the electrocardiogram was observed in more than half of the cases,?that is to say,?51.3%. In a bit higher proportion,?the echocardiography Doppler became normal,?that is to say,?54%. Brain scanner done on 9 patients found out signs of cerebrovascular stroke in 8 patients,?that is to say,?a frequency of 88.9%. In 76% of cases?of orthostatic hypotension,?the patients were hypertensive.?The blood pressure was normal during the passage of orthostatism in the cases of 258 of our patients,?that is to say,?86.0% of the cases. However, the orthostatic hypotension (OH) was observed in the cases of 42 patients, that is to say,?14.0% of the cases. In this set of patients,?41.6% of the moans were due to cephalgias and dizziness’s. The monotherapy of patients with OH represented 47.6% of the cases. Blood pressure was not controlled in 66.7% of the?cases of?OH. The biological examinations required were normal in 52.4% of the cases. Conclusion: The hypertension is a disease which is frequently the reason for consultation in cardiology. The symptoms of Dieulafoy can be the signs of call. The complications are sometimes recurrent. The orthostatic hypotension should be found out even under monotherapy on a balanced or non-balanced hypertensive patient through treatment.

关键词： High Blood Pressure Out-Patients’ Department Cardiology Kati

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Pulmonary Embolism in Hospitalization in the Department of Cardiology of Gabriel Toure University Hospital

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World Journal of Cardiovascular Diseases 2018年第1期8卷 18-23页

作者： Ichaka Menta Souleymane Coulibaly hamidou oumar ba Djénébou Traore Mougnon Walbane Youssouf Camara Ibrahima Sangare Illo Bela Diall Samba Sidibé Noumou Sidibé Mamadou Diakité Coumba Thiam Kassoum Sanogo Cardiology Department Gabriel Touré Hospital Bamako Mali CHU Point G Cardiology Department Bamako Mali Department of Internal Medicine and Endocrinology Mali Hospital Bamako Mali Kati Hospital Center Cardiology Service Bamako Mali

Objective: The aim of this study was to describe the epidemiological, clinical and Para clinical characteristics in patients hospitalized for pulmonary embolism in the cardiology department of Gabriel Toure University Hospital. Methodology: It was a retrospective and descriptive study from January 2011 to December 2014 and involved all patients hospitalized during the study period. Results: The study included 21 patients out of 1738 hospitalized patients, with a prevalence of 1.21%. The mean age was 38.57 years with extreme ages of 18 and 64 years. The sex ratio was 0.40. Risk factors found in the study were oral contraception (19.05%), overweight (19.05%), smoking (14.28%), HIV (4.76%) and heart failure (4, 76%). 61.90% (n = 13) had isolated pulmonary embolism, 38.09% (n = 8) had venous thrombosis and pulmonary embolism association. Through the chest angio-CT, 28.57% of obstructions were located at the left branch of the pulmonary artery, 9.52% at the right branch and 61.90% were bilateral obstructions. Four deaths were recorded, all in a context of massive pulmonary embolism, with a fatality rate of 19.05%. Conclusion: Pulmonary embolism is a serious and common disease, often difficult to diagnose. It is a cardiovascular emergency and requires immediate and adequate care.

关键词： Pulmonary Embolism Cardiology Gabriel Toure Hospital

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ECG and Echocardiography Findings: A Comparative Study between Sportive and Sedentary Female Patients (bamako, Mali)

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World Journal of Cardiovascular Diseases 2019年第7期9卷 458-466页

作者： Ibrahima Sangaré hamidou oumar ba Youssouf Camara Ichaka Menta Rokiatou Mété Noumou Sidibé Souleymane Coulibaly Fousseyni Coulibaly Aladji Traoré Illo Diall Lydia Berenice Sita Sangaré Boubakar Diallo Kassoum Mamourou Sanogo University Hospital Gabriel Touré Cardiology Bamako Mali University Hospital Sidy Bocar Sall Cardiology Kati Mali University Hospital Point G Cardiology Bamako Mali University Hospital for Odontostomatology Bamako Mali

Objective: To study cardiovascular cardiac and echocardiographic features in high-level footballers and sedentary women in bamako. Materials and Methods: This was a cross-sectional study conducted in bamako from April 2015 to March 2016 among 14 to 35 years old high-level footballers and a group of untrained women. Data including socio-demographic, physical examination, ECG record and echocardiogram was inserted in Microsoft Excel and analyzed with IBM SPSS. Chi Square and Fisher statistical tests were used to compare our results. The significance level was p 0.05. Results: Forty-three female subjects, 51% being sedentary were recruited. Mean age, weight and height were significantly higher in sportswomen than in sedentary women with respectively p of bably due to the small size of the sample.

关键词： ECG Echocardiography Footballers Women Sedentary bamako

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Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Touré(UH-GT) in bamako

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World Journal of Cardiovascular Diseases 2020年第3期10卷 131-143页

作者： hamidou oumar ba Ibrahima Sangaré Youssouf Camara Sidibé Noumou Daou Ousmane Maiga Asmaou Kéita Touré Mamadou Coulibaly Souleymane Sidibé Samba Konaté Massama Doumbia Coumba Thiam Sonfo Boubacar Diakité Mamadou Menta Ichaka Ilo Bella Diall Ahmed ba Boubacar ba Sanogo Kassoum Mamourou Service de Cardiologie CHU Gabriel Touré Bamako Mali Service de Cardiologie CHU Kati Bamako Mali CHU Odontostomatologie Bamako Mali Service de Cardiologie CHU Mère-Enfant Bamako Mali Service de Cardiologie du CHU Point G Bamako Mali Service de Médecine Interne et d’Endocrinologie Hôpital du Mali Bamako Mali

Introduction: Little is known through the literature about dental status of patients seen in cardiology department, motivating this study which aims to assess most dental indices of outpatients and the need for periodontal treatment. Methodology: It was a cross-sectional study from November 2016 to April 2017 in the cardiology outpatient unit of the University Hospital Gabriel Touré (UH-GT) in bamako. Included were all patients with minimum 24 teeth and willing to be involved in the study. History, cardiovascular parameters and dental examination by a resident in Odontostomatology were performed for each patient. Data were analyzed using SPSS 18, quantitative as means and standard deviation (SD) and categorical as proportions. Khi-2 Test, analysis of variance were applied with a significance level set at 0.05. All patients give their verbal consent after being informed about the procedures in the study. Results: Our sample involved 100 patients (66% female, mean age of 54.12 ± 16.150 and patients ≥ 60 years most represented with 50% for male and 37.9 for female patients. Tooth brush use was practiced by 100% and 98.5% respectively for male and female patients and twice daily brushing by 97.1% of male and 97% of female patients. Brushing duration was less than 3 minutes for 35.3% and 31.8% of respectively male and female patients. Plaque index and calculus index were in the male group with respectively 0.79 and 1.06 for male and 0.63 and 0.79 for female (p = 0.047 and 0.020). Mean Decayed Missed and Filled Teeth (DFMT) index showed a significantly increase from 0.22 in the age group under 30 to 0.68 for that other 60 years. Only 2.9% and 9.1% of respectively male and female patients had community paradontal index for treatment needs (CPITN) classe 0. The need for treatment was TN1 meaning instruction to an oral cavity hygiene, similar for both sex (55.9 and 57.6 respectively for male and female patients) and highest in the age-group 30 - 44 increased to 70%. The need for professional intervention in oral cavity wa

关键词： Dental Indices Cardiology Outpatients bamako

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ECG and Echocardiographic Findings of Athletes in bamako—A Study among 227 Footballers

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World Journal of Cardiovascular Diseases 2019年第1期9卷 31-41页

作者： Ibrahima Sangare hamidou oumar ba Youssouf Camara Ichaka Menta Noumou Sidibé Souleymane Coulibaly Aladji Traoré Fousseyni Coulibaly Ilo Diall Lydie Bérenice S. Sangaré hamidou Camara Adama Sogodogo Mohamed A. C. Cissé Mamadou Bocary Diarra Massama Konaté Kassoum M. Sanogo Boubakar A. Diallo University Hospital Gabriel Touré Bamako Mali University Hospital Sidy Bocar Sall Kati Mali University Hospital Point G Bamako Mali University Hospital Odonto-Stomatology Bamako Mali University Hospital “Hô pital du Mali” Bamako Mali University Hospital Mother-Child “Le Luxembourg” Bamako Mali

background: A cardiovascular assessment is rarely performed among athletes despite more and more frequently reported fatal events. Most of these accidents are of cardiovascular origin. Moreover, data on ECG or Echocardiography are rare in our context justifying our study to assess electrical and echocardiographic pattern among high-level footballer in bamako. Methods: It was a cross-sectional study conducted in bamako from April 2015 to?March 2016 among high-level footballers aged 14 to 35 years old without distinction of sex with at least 10 hours weekly training since one year. The ECG and echocardiographies were recorded respectively with a 12-lead CONTEC and an ATL 5000 echocardiographic machine. Each ECG record was analyzed by a cardiologist in accordance with the Seattle 2013 criteria and those pathological reviewed by a second cardiologist according to the same criteria and definitively classified as normal (physiological) or abnormal ECG (requiring complementary explorations). A third cardiologist was associated in case of discordance of the first results. The collected data were inserted in a Microsoft Excel sheet and analyzed with SPSS version 20. Chi Square and Fisher statistical tests were used to compare our results. The significance level was set at 0.05. Results: We collected data of 227 top footballers with male sex represented in 90.3% giving a sex ratio of 3.04. Means for age, weight, height, body mass index (BMI) were respectively 22 years, 69.90 kg, 177.21 cm and 22.21 kg/m2. Sinus bradycardia was found in a proportion of 45.8% more represented in the age group of 30 and more years (p = 0.275). First-degree atrioventricular block (AVB) was present in 19.4%. Short PR was found in 0.4% of the sample. Left ventricular hypertrophy (LVG) according to the Sokolow index was found in 70.5% (96.9% males and 3.1% females) with p Conclusion: Many electrical and echocardiographic signs of cardiac adaptation were found in our sample and must lead to a closer follow-up of these trained footballers to avoid

关键词： Sport Football bamako ECG Echocardiography

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Hypertension (HTN) Knowledge and with Its Associated Factors: About 456 Outpatients Seen in Cardiology Department in University Hospital (UH) Gabriel Touré—bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第1期8卷 24-34页

作者： hamidou oumar ba Ichaka Menta Ibrahima Sangaré Youssouf Camara Georges Rosario Christian Millogo Noumou Sidibé Ilo Bella Diall Souleymane Coulibaly Guida Landouré Mandé Berthé Ibrahim Maiga Bréhima Mariko Cheick Hamala Fofana Aladji Traoré Kassoum Mamourou Sanogo CHU Gabriel Touré bamako Bamako Mali CHU Kati Bamako Mali CHU YO-Ouagadougou Ouagadougou Burkina-Faso CHU Point G Bamako Mali

background: High Blood Pressure (HBP) is high prevalent among adult population in bamako, but little is known about factors associated with knowledge. Methods: It was a cross-sectional study involving patients aged 15 years and more with a first classification in normal blood pressure (HTN-) and high blood pressure (HTN+), and Second classification inpatients without knowledge (who answered No) (K-) and patients with knowledge (who answered Yes) (K+). A logistic regression was performed to look up predictors among different variables. Results: The sample involved 456 patients with a mean age of 51.39 years and 65.1% of female. The age group 45 - 59 years old made 32.5% and unschooled patients 60.3%. Patients with HBP accounted for 69.7% and those reporting to know about it 67.3%. HTN- and HTN+ differed significantly except for HR, height, sex and level of schooling. HBP prevalence increased with age up to 74 years. Regarding knowledge, sex, age group and number of FDRs did not differ significantly. High education level and duration of HBP was predictive of knowledge with an OR of 1.186 [CI 0.058 - 0.796] and 1.192 [CI 0.332 - 4.275] respectively. Conclusions: Our study provided data on HBP knowledge among outpatients with high educational level and HBP duration associated with better knowledge on HBP.

关键词： Hypertension Knowledge Outpatient bamako Cardiology

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