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Hypertension (Htn) among Young People of 18 to 35 Years Old in Cardiology Department of Gabriel Toure University Teaching Hospital

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World Journal of Cardiovascular Diseases 2018年第1期8卷 11-17页

作者： Ichaka Menta Hamidou O. Ba Kassoum M. Sanogo Cardiology Department of “Gabrièl Touré” University Teaching Hospital Bamako Mali

Few studies have been conducted on hypertension among youth in Mali?hence the interest of our study aimed to clarify certain aspects what are not taken account yet in previous studies.?Objective: Determine the clinical and para-clinical characteristics of hypertension among 18 to 35 years old young people.?Methods:?This cross-sectional and retrospective study of 24 months from January 1st, 2009 to December 31st, 2010?in the cardiology department of the Gabriel Touré UTH.?Results:?We identified 132 cases during the study period out of 2146 cases of hypertension with a prevalence of 6.1%. The female gender represented 81.8%, with a sex ratio of 45.59, 1% of patients had an unknown family history of hypertension. The age group of 31 to 35 years accounted for 43.9%. The circumstances of discovery were dominated by exertional dyspnea (37.9%). Body mass index was normal in 45.5% of patients. The higher BMI was more common in female patients with 39.39% (p?= 0.045). In the sample,53% of patients had a systolic blood pressure between 140?and 159 mmHg and 38.6% had diastolic blood pressure ≥ 110 mmHg with no significant difference (p?> 0.5). The high creatinine level was found in 18.18% of our patients. The ECG?found?84.6%?of left ventricular hypertrophy among cavitary hypertrophies. The echocardiography has found cavitary?dilatation in 40.04% of cases;it concerned the left ventricle in 25.71%. Also 18.57% of our patients had impaired left ventricular systolic function. Among the complications found in our patients, kidney failure led with 56%.?Conclusion:?Hypertension is not a rare event among young population even with a normal body mass index. It is often discovered during complications that can be dreadful.

关键词： Hypertension Young People Complications

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

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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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Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2022年第2期12卷 123-132页

作者： Bassirima Traore Samba Sidibé Souleymane Mariko Karamoko Kantako Massama Konaté Kalifa Diallo Nouhoum Diallo Mariam Sako Abdoul Karim Sacko Youssouf Kassambara Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Cardiology Department of the Point G University Hospital Bamako Mali Cardiology Department Mali Hospital Bamako Mali Cardiology Department CHU Gabriel TOURE Bamako Mali

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

关键词： Cardio-Renal Syndrome Epidemiology Tombouctou 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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Prevalence, Pattern and Evolution of Rheumatic Heart Disease: About 120 Cases at Mother-Children University Hospital Luxembourg (MC UHL), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 319-327页

作者： Ba Hamidou Oumar Maiga Asmaou Kéita Doumbia Coumba Thiam Maiga Salma Souleimane Sidibé Noumou Sangaré Ibrahima Camara Youssouf Sidibé Salimata Diallo Souleymane menta ichaka Diarra Mamadou Bocary CHU Gabriel Touré Bamako Mali CHU Mère Enfant le Luxembourg Bamako Mali CHU Sidy Bocar Sall Kati Mali

Introduction: Acute rheumatic fever (ARF) and its complications including rheumatic heart disease (RHD) remain one of the leading causes of cardiovascular disease worldwide. In our setting with no cardiac surgery, data on RHD are therefore important to point out the need for such structure. In this study, we therefore describe rheumatic disease in terms of prevalence, patients’ characteristics and management of patients. Methods: We performed a retrospective study from May to September 2012, involving children aged 3 to 15 years old and seen at the Mother and Child University Hospital Luxembourg (MC UHL). Included were all children diagnosed with RHD. The diagnosis of rheumatic fever (RF) was defined using the revised Jones criteria from 1992 and RHD defined according to the WHO/NIH joint criteria. Data of interview, clinical examination, complementary and those on evolution were recorded. Results: We found an hospital prevalence of 6.2%. Mean age was 15.33 years ± 6.005 (3 to 36), females representing 54.2% and students 70%. Mitral regurgitation (MR), Mitral Stenosis (MS) and concomitant MR + MS were most found RHD with resp. 43.3%, 15% and 13.3%. Complications occurred in 74.1% before surgery. An operative indication was set in 90% of all cases whereas only 36% underwent surgery. After surgery immediate complications were dominated by anemia (11.6%) and late ones by heart failure in 18.5% of cases. Conclusion: Despite advances in medical diagnostic approach and therapeutical progress which partly explained the relatively high prevalence, the evolution of rheumatic heart disease in our context is unfavorable due to the lack of a surgical management structure. While waiting for a cardiology institute, the focus should be on information and awareness in primary prevention.

关键词： Retrospective Acute Rheumatic Fever Rheumatic Heart Disease Bamako

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Hypertension in Clinical Practice: Control Rate in Short Term and Associated Factors in the Cardiology Department of the University Hospital Gabriel Touré(UH-GT) in Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第6期8卷 288-297页

作者： Hamidou Oumar Ba Ichaka Menta Ibrahima Sangare Youssouf Camara Noumou Sidibe Souleymane Coulibaly Djénébou Traoré Réné Dakouo Samba Samaké Aladji Traoré Samba Sidibé Mamadou Cissouma Cheick Hamala Fofana Lamine Sidibe Kassoum Mamourou Sanogo University Hospital Gabriel Touré Bamako Mali University Hospital Kati Kati Mali University Hospital Point G Bamako Mali University Hospital of Mali Bamako Mali

Introduction: Hypertension (HTN) is for many decades a worldwide major risk factor for cardiovascular disease.However, hypertension control rates are globally low in the world. Studies on observance have been published in Mali but there is to our knowledge no published data about HTN control rate. We therefore conducted this study to assess the control rate in short term after 3 months management and to look for factors associated with HTN control. Materials and Methods: This study designed as prospective was conducted in the cardiology department of the University Hospital Gabriel Touré (UH-GT) from March 24 to September 24, 2017. All outpatients aged 18 years and more who came for visit and with hypertension as diagnose were involved. All patients have consented to participate in the study. Sociodemographic and data on physical examination including measures for BP, height, weight, waist circumference (WC) and direct costs as reported by the patients were recorded. Patients were asked about medication discontinuation and if yes why and then they were informed about the need to take regularly medication. The concept of chronic disease was explained to them. A formulary served to collect data that were inserted into a Microsoft Access database and analyzed using SPSS version 18. After describing of sociodemographics and continuous variables, crosstabs and finally a logistic regression was performed to look for blood pressure control predictors. Results: There was no statistical difference in sociodemographics between older and newly diagnosed patients. At 3 months globally 40.90% (31.1 for old Patients and 09.8% for newPatients) of the sample were controlled (Figure 1). For old patients, hypertension control rate at inclusion was 12.78% and reached 49.44% at 3 months (Figure 2). After logistic regression only HTN duration was significant predictor with Odd-ratio of 0.365 [0.213 - 0.624] 95% CI and p-value patients as reference). During the study period therapeutic regimen remained unchanged in 73.1% (44.4 for old

关键词： Hypertension Control Rate Old Patient New Patient Medication Bamako Outpatient

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Epidemiology and Management of Heart Failure in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2023年第3期13卷 105-113页

作者： Bassirima Traoré Souleymane Mariko Samba Sidibé Karamoko Kantako Mariam Sako Massama Konaté Nouhoum Diallo Abdoul Karim Sacko Kalifa Diallo Youssouf Kassambara Djibril Kassogue Oumar Ongoiba Oumar Sanogo Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Department of Cardiology Point G University Hospital Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology CHU Gabriel TOURE Bamako Mali

Introduction: Heart failure is a complex syndrome and very frequently observed and secondary to the outcome of many advanced heart diseases. It is made up of a set of symptoms that reflect the tissue and visceral consequences of heart failure. The objective was to determine the hospital prevalence and to describe the management of heart failure in the medical department of Tombouctou hospital in Mali. Methods: This is a descriptive cross-sectional study with retrospective data collection, carried out over 24 months and involving the analysis of 266 records of patients hospitalized for heart failure. Results: The frequency of heart failure was 17.6% with a female predominance. The average age was 48 years with extremes of 16 and 90 years. Cardiovascular risk factors were dominated by high blood pressure with 38%. Global heart failure was the mode of discovery in 72.2% of cases. The etiologies were dominated by hypertensive dilated cardiomyopathy in 36.8% and peripartum cardiomyopathy in 32% of cases. The majority of our patients benefited from diuretic treatment, i.e. 95.9% frequency;with a favorable evolution in 96.2% of cases. We recorded 10 deaths, i.e. a lethality of 3.7%. We report some difficulties encountered during our security study because Tombouctou is a war zone and the lack of a technical platform for biology such as (BNP or NT-proBNP). Conclusion: Heart failure is a real public health problem. Its prevalence is increasing due to the aging of the population and especially the poor management of arterial hypertension in our context.

关键词： Heart Failure Epidemiology Etiology Treatment Tombouctou Hospital

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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the Cardiology Department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou Thiam Abdoul Karim Sacko Mamadou Diakite Mariam Dagnoko Souleymane Coulibaly Nouhoum Diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné Mamadou Touré Mariam Sako Ichaka Menta Illo Bela Diall Boubakar Diallo Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Kati Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Mali Bamako Mali Medical Department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection Cardiology Point G Hospital

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Ischemic Stroke Revealing Infective Endocarditis in a Young Subject: About a Clinical Case

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World Journal of Cardiovascular Diseases 2022年第4期12卷 209-215页

作者： Coumba Thiam Boubacar Sonfo Massama Konaté Mahan Ameri Abba Diall Asmaou Keita Mariam Sako Youssouf Camara Hamidou Oumar Bâ Ibrahima Sangaré Mamadou Touré Samba Sidibé Massama Camara Simo Moyo Souleymane Coulibaly Ichaka Menta Cardiology Department of Kati University Hospital Kati Mali Internal Medicine Department of Mali Hospital Bamako Mali Cardiology Department of the Mother-Child University Hospital Bamako Mali Cardiology Department CHU Point G Bamako Mali Cardiology Department of the CHU Gabriel Touré Bamako Mali

Introduction: Neurological complications are possible during infective endocarditis. They are often life-threatening and can be a source of sequelae. Case Presentation: We report the case of an 11-year-old patient admitted to the cardiology department of the CHU-ME “LUXEMBOURG” in Bamako for functional impotence of the left hemibody, accompanied by fever and NYHA stage II dyspnea. The clinical examination on admission shows the poor general condition, normal consciousness, and sensory-motor deficit of the pyramidal type of the left hemibody. The cardiovascular examination notes a systolic murmur at the mitral focus, hepato-jugular reflux, hepatomegaly, and slight edema in the lower limbs. Brain CT showed localized hypodensity in favor of an ischemic stroke. The electrocardiogram shows a sinus rhythm. Transthoracic Doppler echocardiography revealed mitral insufficiency with vegetation of 17 × 14 mm on the anterior mitral valve, with left ventricular ejection fraction estimated at 75%. Dual antibiotic therapy associated with conventional treatment for heart failure was initiated. The clinical evolution was marked by the persistence of the deficit of the left upper limb, the cardiac Doppler echography of control after 6 weeks of treatment found the same vegetation. A discussion with the heart team with a view to a surgical cure has been initiated for the rest of the treatment. Conclusion: A motor deficit associated with fever related to an ischemic vascular accident should lead to a search for infective endocarditis on cardiac Doppler ultrasound.

关键词： Ischemic Stroke-Infectious Endocarditis-Young Subject

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Venous Thromboembolic Disease in the Cardiology Department of the Nianakoro Fomba Hospital in Segou (HNF)

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World Journal of Cardiovascular Diseases 2022年第11期12卷 507-513页

作者： Mariam Sako Mamadou Touré Boureima Dembélé Yves R. Koumaré Massama Konaté Mamadou Diakité Coumba Thiam Aniessa Kodio Samba Sidibé Asmaou Keita Aichata Dao Youssouf Camara Boubacar Sonfo Bassirima Traoré Souleymane Mariko Souleymane Coulibaly Ichaka Menta Point G Hospital Bamako Mali Mother Child Hospital Luxembourg Bamako Mali Mali Hospital Bamako Mali Kati Hospital Kati Mali Ségou Hospital Ségou Mali Tombouctou Hospital Tombouctou Mali Gabriel Touré Hospital Bamako Mali

Venous thromboembolic disease (VTE) is a nosological group that consists mainly of deep vein thrombosis (DVT) and pulmonary embolism (PE). The objective of our study was to determine the hospital prevalence of VTE in this Nianakoro Fomba Regional Hospital (HNF) in Ségou, Mali, to describe the sociodemographic aspects of these patients and the therapeutic possibilities in this locality. Materials and Methods: We conducted a prospective descriptive study from June 2019 to June 2020 in the cardiology department of the HNF of Ségou. All patients of all ages and both sexes who had VTE on clinical and paraclinical criteria (pulmonary Angio scan and/or venous Doppler echo) during the study period were included. Result: 31 patients were included out of 366 hospitalized patients, with a hospital prevalence of 8.47%. The 41-60 and 61 - 80 age groups were both dominant with 35.48% of cases each. The female sex was the most represented with 58.06% of cases and a sex ratio of 0.97. High blood pressure (hypertension) was the preeminent cardiovascular risk factor in 32.2% of cases and predisposing factors for VTE were dominated by immobilization (41.94%), peripartum (16.13%) and heart failure (16.13%). Dyspnea and chest pain were the frequent reasons for consultation with 93.54% and 83.87% of cases respectively and 6 patients (19.35%) had calf pain. More than 3/4 of the patients had tachypnea or 90.32% and tachycardia in nearly 74.19%. The clinical probability of VTE was intermediate at 51.61% according to the Wells score. D-Dimers were elevated in 38.70%, or all 12 patients who performed it. The electrocardiogram (ECG) recorded a sinus rhythm in 93.54% of cases, a right branch block and atrial fibrillation (AF) in 35.48% and 6.45% of cases, respectively. Dilation of the right ventricle was present in 64.51% of cases with PAH in 61.29% on cardiac Doppler ultrasound. In the majority of cases (82.15%) it was a massive bilateral proximal and distal pulmonary embolism. Treatment was based on low molecular weight heparin (HPBM) and

关键词： Venous Thromboembolic Disease Nianakoro Fomba-Ségou-Mali Hospital

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