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Lifestyle Changes for Abdominal Obesity Prevention and Encouraging Fruit Consumption may Be Beneficial in Preventing Left Ventricular Hypertrophy in Sub-Saharan African and maghreb

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World Journal of Cardiovascular Diseases 2017年第2期7卷 46-56页

作者： Charifa Annis Bernard Kianu Phanzu Sidibe moussa mustapha El Hattaoui Benzaroual Dounia jean-rené m’buyamba kabangu Benjamin Longo-mbenza Cardiology Unit CHU Mohammed VI Marrakech Kingdom of Morocco Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Faculty of Health Sciences Walter Sisulu University Mthatha Republic of South Africa

There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The mA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (mAG-SALVAGES) participants. methods: The mAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin maghreb within the age of 18 to 55 years underwent a resting echocardiography. multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.

关键词： Left Ventricular Hypertrophy Abdominal Obesity Diet Sub-Saharan African maghreb

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A Pilot Study about the First Cases of Coronary Angioplasty in Democratic Republic of Congo/Kinshasa: Patient Profile

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Case Reports in Clinical medicine 2023年第10期12卷 371-388页

作者： David Ipungu Gondele Eulethère Vita Kintoki Yves Lubenga Georges Ngoyi Trésor mvunzi Dominique mupepe Nathan Buila Zéphirin Kamuanga Fahd Qureshi Aliosha Nkodila jean Robert Rissasi makulo jean rené m’buyamba-kabangu Cardiology Unit University of Kinshasa Hospital Kinshasa The Democratic Republic of Congo Cardiology Unit Centre Hospitalier Victor Dupouy Argenteuil France Cardiology Unit H.J. Hospitals Kinshasa The Democratic Republic of Congo Public Health and Familly medecine Protestant University of Congo Kinshasa The Democratic Republic of Congo Nephrology Unit University of Kinshasa Hospital Kinshasa The Democratic Republic of Congo

Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in the first and only one cardiac catheterization center opened in Kinshasa. methods: An analytical cross-sectional study was carried out over a period from October 2019 (date of establishment of the first coronary angiography unit in DR Congo) to march 2021. We proceeded to a serial sampling of the consecutive cases of all the patients who have an angiographic exploration of coronary arteries. Clinical, ECG and cardiac ultrasound data were collected in all patients. The indications for the coronary angiography examination were set by differents cardiologists on the basis of repolarization troubles in the electrocardiogram, cinetic troubles in echocardiography, positive stress test and chest pain in patients with cardiovascular risq factors. Results: The serie (47 patients) was predominantly male with a sex ratio m/W of 2.6. The average age was 59.8 ± 10.5 years. Arterial hypertension (HBP) was the main risk factor (89.4%);followed by diabetes mellitus (14.9%). Chest pain was the main functional sign with an atypical character in 44.7%. The ECG showed ST segment depression (17%) and T wave inversion (17%), the anterior region being the most affected. Hypokinesia was the most common echocardiographic abnormality (34%), followed by akinesia (10.6%). The anteroseptal and apical territories were affected in 12.8%. Dilated myocardiopathy (DmC) was significantly predominant in the male sex (29.4% vs 7.7%;p = 0.011). With radial puncture as the main approach, coronary angiography was pathological in 44% revealing mono-truncal lesions. The left coronary network was the most affected: the middle inter ventricular artery (12.8%), the proximal interventricular artery (10.6%) and the proximal circonflex artery (10.6%). In multivariate logistic regression analysis, age

关键词： Heart Disease Coronary Angioplasty Patient Profile Pilot Study Democratic Republic of Congo

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Prehypertension, Hypertension and Associated Cardiovascular Risk Factors among Adult Congolese Urban Dwellers: Results of the Vitaraa Study

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World Journal of Cardiovascular Diseases 2014年第8期4卷 390-398页

作者： mwasa Pascal Bayauli jean-rene m’buyamba-Kayamba Daniel Lemogoum Robert Fagard jean Paul Degaute mpandamadi Symphorien Ditu Bompeka Francois Lepira jean-rene m’buyamba-kabangu Hypertension Unit/Cardiology Department of Internal MedicineUniversity of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo Division of Endocrinology and Nuclear medicine Department of Internal MedicineUniversity of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo Erasmus Hospital Brussels Free UniversityBrusselsBelgium Division of Hypertension and Cardiovascular Rehabilitation University of LeuvenLeuvenBelgium Division of Nephrology Department of Internal MedicineUniversity of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo

Objective: To assess the prevalence of prehypertension and hypertension, their determinants and associated cardiovascular risk factors in Congolese urban dwellers. methods: From July 2007 to march 2008, we collected information on lifestyle habits, medical history and anthropometric data in 1292 household members of Adoula Quarter, Kinshasa, aged 20 years or more, 731 women (56.6%). We obtained measurements of BP, blood glucose, serum lipids and qualitative proteinuria. We defined blood pressure categories according to JNC7 classification and used logistic regression analyses to assess their independent determinants. We obtained age adjustment of continuous and categorical variables using GLm and Genmod procedures, respectively. Results: Prehypertension was observed in 30.3% of subjects, 34.9% of men and 26.7% of women (P = 0.0045). The prevalence of hypertension amounted to 30.9% with no difference between genders. Participants with prehypertension had average age, BmI and waist circumference intermediate between those with normal BP and hypertensive subjects. Their glucose and lipids levels were similar to those of normotensives. The prevalence of prehypertension amounted to 33% at age 20 - 29 years and decreased to 16.7% at ≥60 years whereas the prevalence of hypertension increased from 11.2% to 71.4%. The rates of diabetes mellitus were similar accross blood pressure catogo- ries whilst prevalences of overweight/obesity, abdominal adiposity, dyslipidemia and metabolic syndrome significatively increased (P = 0.05 or less). Among participants with prehypertension, 73% had two or more additional cardiovascular risk factors. In the logistic model the probability of prehypertension was higher in men (OR: 1.429;95% CI: 1.099 - 1.857) and participants with overweight/obesity (OR: 1.666;1.146 - 2.422), lower in participants aged ≥ 55 years (0.427;0.267 - 0.683) and those with high fruit intake (0.691;0.488 - 0.977). The probability of hypertension was higher in particip

关键词： Prehypertension Hypertension Cardiovascular Risk Factors Africans

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The Influence of Ethnicity in the Relationship between Sedentary Screen Time and Left Ventricular mass: Insights from the mAG-SALVAGES

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World Journal of Cardiovascular Diseases 2017年第2期7卷 11-23页

作者： Charifa Annis Bernard Kianu Phanzu moussa Sidibe mustapha El Hattaoui Benzaroual Dounia jean-Réné m’buyamba kabangu Benjamin Longo-mbenza Unit of Cardiology CHU Mohammed VI Cady Ayyad University Marrakech Kingdom of Morocco Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Faculty of Health Sciences Walter Sisulu University Mthatha Republic of South Africa

Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in mAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (mAG-SALVAGES) participants. methods: 100 blacks sub-Saharan African and 187 white maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVm within quartiles of physical activity. Results: Among White maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.

关键词： Left Ventricular mass Sedentary Ethnicity White maghreb Black Sub-Saharan Africa

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Influence of Diet Behavior on Insulin Resistance in Hypertensive Black Sub-Saharan Africans: A multicentric, Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2020年第9期10卷 615-638页

作者： Kianu Phanzu Bernard Nkodila Natuhoyila Aliocha Kokusa Zamani Roger Limbole Baliko Emmanuel Kintoki Vita Eleuthère m’buyamba kabangu jean-Réné Longo-mbenza Benjamin Unit of Cardiology University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Centre médical de Kinshasa (CmK) Kinshasa Democratic Republic of Congo Public Health School Department of Biostatistics Kinshasa Democratic Republic of Congo Provincial Reference Hospital of Kinshasa Kinshasa Democratic Republic of Congo Clinique Ngaliema Kinshasa Democratic Republic of Congo

Background: Insulin resistance (IR) is the backbone of cardiovascular diseases (CVDs). The latter are the most common non-communicable diseases globally. Diet is an important determinant of CVDs. The link between diet and cardiovascular health could be explained by an association between diet pattern and IR. Aims: To investigate the association between salt and specific food consumption as well as different diet patterns (Mediterranean, westernized, and intermediate dietary patterns) with HOMAIR as a surrogate marker of IR, and fasting insulin in Black, sub-Saharan essential hypertensive patients. methods: The multicentric, cross-sectional analysis involved 77 Congolese Black hypertensive participants with no history of cardiovascular disease. Daily sodium chloride intake (NaCl g/24h) was estimated from 24-hour urine collection. Dietary behaviours were evaluated through a semi-quantitative food frequency questionnaire (FFQ). Homeostatic model assessment of insulin resistance (HOmAIR) ≥ 2.5 was used as surrogate marker of IR. Results: A decrease in weekly consumption of fruits, vegetables and fish would significantly explain an increase of 29% (r = 0.292;p = 0.010), 24% (r = 0.242;p = 0.034) and 23% (r = 0.226;p = 0.048) of the value of HOmAIR respectively. In contrast, an increase in daily sodium chloride intake was associated with 28% (r = 0.283, p = 0.027) of the increase in HOmAIR. Also, a decrease in the average weekly consumption of fruit, vegetables and fish would significantly explain an increase of 25% (r = 0.247;p = 0.030), 30% (r = 0.302;p = 0.008) and 31% (r = 0.313;p = 0.006) of fasting insulin. In contrast, an increase in red meat consumption was associated with a 26% increase (r = 0.257, p = 0.024) in fasting insulin. In multivariable adjusted analysis 45% of variation in fasting insulin (R2 = 0.452;overall p = 0.005) were explained by fruits

关键词： Diet Behavior Insulin Resistance Hypertension Black Sub-Saharan Africans

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Atherosclerotic Cardiovascular Disease Short-Term Risk Estimate among Civilian Licensed Aircrew

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World Journal of Cardiovascular Diseases 2019年第2期9卷 92-108页

作者： Nathan B.Buila jean-marc B.Bantu Gilbert K.Kabanda Pascal m.Bayauli Aliocha N.Nkodila Francois B.Lepira Symphorien m.Ditu jean-rene m’buyamba-kabangu Division of Cardiology and Hypertension Kinshasa School of MedicineUniversity of KinshasaKinshasaDR Congo Civil Aviation Authority KinshasaDR Congo Departments of Cardiology Chirec ClinicsBrusselsBelgium Division of Endocrinology and metabolic Diseases Kinshasa School of MedicineUniversity of KinshasaKinshasaDR Congo Centre médical Cite des Aveugles KinshasaDR Congo Division of Nephrology Kinshasa School of MedicineUniversity of KinshasaKinshasaDR Congo

Background: Flight and cabin crew are known to be at increased risk for atherosclerotic cardiovascular disease (ASCVD). However, ASCVD risks have not yet been compared in flight and cabin crew in low resource settings like sub-Saharan Africa. Objectives: To assess absolute ASCVD risk estimate and its clinical correlates among flight and cabin crew. methods: From June 1st 2015 to December 30th 2015, 379 consecutive aviation navigants (Flight crew: 62.5%, pilots: 46.2%, women: 29.6%, Caucasians 23.2%) were enrolled in a cross-sectional survey of ASCVD risk estimate using the Framingham tools. They underwent a physical examination for either initial or renewal medical certificate Class 1 or 2 including blood chemistry, ECG, and echocardiogram as per International Civil Aviation Organization (ICAO) and Civil Aviation Authority (CAA-DRC) medical regulations. We modeled the risk of moderate and high ASCVD estimate in a stepwise logistic regression. Results: Low, moderate and high ASCVD risk estimates were observed respectively in 248 (65.4%), 64 (16.9%), and 67 (17.7%) navigants. moderate and high ASCVD risk estimates predominated among flight than cabin crew (23.6% vs. 5.6%;p 0.0001 and 28.3% vs. null;p 0.001), low ASCVD risk estimate among cabin than flight crew (94.4% vs. 48.1%;p ≤ 0.001). Low ASCVD risk?estimates.

关键词： Cardiovascular Risk Aircrew Frequency Clinical Correlates

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True Resistant Hypertension among Treated Hypertensive Black Patients.A Clinical-Based Cross-Sectional Study

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World Journal of Cardiovascular Diseases 2020年第5期10卷 278-293页

作者： Diane Kiese Kuntonda Francois Bompeka Lepira Yves Lubenga jean Robert Risassi makulo Aliocha Nkodila Noel Otshudi Tresor mvunzi Dominique mupepe Georges Ngoyi Fabien Kintoki Eulhetere Vita Kintoki jean rene m’buyamba-kabangu Division of Cardiology University of Kinshasa HospitalKinshasa School of MedicineUniversity of KinshasaKinshasaThe Democratic Republic of the Congo Division of Nephrology-Dialysis and Hypertension University of Kinshasa HospitalKinshasa School of MedicineUniversity of KinshasaKinshasaThe Democratic Republic of the Congo Centre medical Cite des Aveugles mont Ngafula KinshasaThe Democratic Republic of the Congo

Background and Objective: 24-h ambulatory blood pressure monitoring (ABPm) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates of tRH among patients with clinically suspected RH. methods: medical records of treated hypertensive patients referred in four healthcare centers for BP control evaluation by 24-h ABPm were reviewed to assess the prevalence of tRH. Inclusion criteria were age ≥ 18 years, clinical diagnosis of RH. Data on demographic, clinical, laboratory, 2D-echocardiography and 24-h ABPm parameters were retrieved from patient’s medical records. True RH (tRH) was defined as office blood pressure (BP) ≥ 140/90 mmHg and 24-h ambulatory BP ≥ 130/80 mmHg. Simple and multiple linear regression analyses were used to assess factors associated with systolic BP (SBP) as a proxy of RH among patients with tRH. P 0.05 defined the level of statistical significance. Results: Of 636 patients referred for BP control evaluation by 24-h ABPm, 75 (11.7%) had suspected RH by office BP measurements. After 24-h ABPm, pseudo or apparent RH (aRH) and tRH were observed in 15 (2.3%) and 60 (9.4%) patients, respectively. BmI (p = 0.007) and blood glucose (p = 0.024) were positively associated with SBP whereas a negative association was observed with eGFR (p = 0.022) among tRH hypertensive patients in multiple regression analysis. Conclusion: True RH was a common finding among patients with clinical RH and associated with obesity and silent target organ, especially kidney dysfunction. The present study highlights the diagnostic and prognostic importance of 24-h ABPm among patients with clinical RH.

关键词： True Resistant Hypertension 24-h ABPm Prevalence Determinants Black Africans

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Exclusive Fibula Osteosynthesis for Treating Open Fractures Gustillo I-III B of the Distal Half of the Leg Bones in a Resources-Limited Setting

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Open Journal of Orthopedics 2023年第3期13卷 108-121页

作者： Georges Kuyigwa Toha Paul munguakonkwa Budema Ona Longombe Ahuka Akinja Bitum Uwonda jean marie Vianney kabangu Tshimbila Department of Surgery Provincial General Reference Hospital of Bukavu Bukavu Democratic Republic of the Congo Faculty of medicine Université Catholique de Bukavu Bukavu Democratic Republic of the Congo Faculty of medicine Université de Kisangani Kisangani Democratic Republic of the Congo Faculty of medicine Université de Mbuji Mayi Mbuji Mayi Democratic Republic of the Congo

Introduction: management of open leg bones fractures is a challenging health issue for the surgeon, particularly true in resource-limited settings. In this study, we evaluate exclusive fibular osteosynthesis in the treatment of open fractures of the distal half of the leg bones as a therapeutic option in our context. methods: This is a prospective, experimental, multicenter study of 30 open fractures of the distal half of the leg bones treated with exclusive fibula osteosynthesis, conducted in 3 hospitals in the DRC from January 1, 2013 to September 30, 2016. Results: The age range of 20 to 40 years grouped 22 (73.4%) patients, the sex ratio was 1:1 and the unemployed were the most involved with 16 (53.3%) cases. The Gustilo II, I, III B and III A types represented 40%, 33.3%, 20% and 6.7%, respectively. The fractures were located in the distal third in 12 (40%) cases, in the middle third in 11 (36.7%) cases, and in both malleoli in 7 cases (23.3%). Osteosynthesis of the fibula by screw plate was applied in 22 (73.3%) patients and pinning in 8 (26.7%). Satisfactory reduction of the tibial fracture site was achieved in 29 (96.7%) cases and 100% bone healing was achieved within an average of 10 weeks. Four (13.3%) loss of alignment, 1 (3.3%) infection, 1 (3.3%) skin necrosis and 2 (6.7%) ankle stiffness complicated our fractures. Conclusion: Exclusive osteosynthesis of the fibula as a common technique for fractures of the distal half of the leg bones allowed us to reduce, immobilize and consolidate the tibial fracture in the required time and to preserve the mobility of the ankle.

关键词： Fibular Exclusive Osteosynthesis Open Tibial Fractures Resources Limited Settings Tibial Fracture Consolidation

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