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outcome of Patients with Lower Limbs Deep Vein Thrombosis at the University Hospital of Brazzaville (The Republic of the Congo)

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World Journal of Cardiovascular Diseases 2023年第12期13卷 845-853页

作者： stéphane méo ikama Eric Gibrel Kimbally Kaky Jospin makani Fresnel Ngoma mabondzo Thibaut Naïbe Gankama Bijou moualengue Suzy Gisèle Kimbally Kaky Department of Cardiologye University Hospital Center of Brazzaville Brazzaville Congo Faculty of Health Sciences Marien NGOUABI University of Brazzaville Brazzaville Congo Department of Radiology University Hospital Center of Brazzaville Brazzaville Congo

The aim of this study was to describe the characteristics of patients with deep vein thrombosis (DVT) of the pelvic limbs at the time of diagnosis, and their course after hospitalization, in order to improve the management of DVT in our context. This was a descriptive longitudinal study, based on cases of deep vein thrombosis recorded between 1 January 2015 and 30 September 2018, in the cardiology and internal medicine department of the Brazzaville University Hospital Centre. During the study period, 4678 patients were hospitalized, including 52 with DVT. Thirty-three were reassessed. The frequency of DVT was 1.1% and the average hospitalization rate was 13.9 cases/year. The 33 patients were divided into 20 women and 13 men (sex ratio: 0.65). The mean age of the patients was 51.4 ± 17.8 years (extremes: 16 and 85 years). The main aetiological factors were cancer (19.1%), sickle cell disease (3%) and HIV immunosuppression (3%). The predominant risk factors were: prolonged immobilization (42.9%), pregnancy, long travel and obesity in the same number of cases (n = 3, i.e. 14.2%). The DVT involved the left pelvic limb in 75.8% of cases. Anticoagulants were administered in all patients, and compression stockings were worn in 97% of cases. The mean time to re-evaluation was 10.9 ± 9.4 months (extremes: three and 35 months). The mean measurements of the limb where the thrombosis had occurred at diagnosis and reassessment showed a significant difference. Venous Doppler showed compressible veins (60.6%), varicosities (36.3%), incompressible veins (30.3%) and thrombus (21.2%). Complications were: post-phlebitic disease (42.4%), death (21.2%), pulmonary embolism (18.2%), recurrence (18.2%). The DVT remains relatively rare, and its conventional therapeutic management is satisfactory. Systematic venous Doppler ultrasound reassessment should enable patients at risk of recurrence to be identified.

关键词： Deep Vein Thrombosis Reassessment Complications Congo

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The Erectile Dysfunction among Congolese Hypertensive Patients

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World Journal of Cardiovascular Diseases 2018年第10期8卷 481-488页

作者： stéphane méo ikama odzebe-Anani Sévérin Bernice mesmer Nsitou melvin Atipo-ondongo Jospin makani Thierry Raoul Gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville Congo Department of Urology University Hospital Center of Brazzaville Brazzaville Congo

The authors conducted an analytical cross-sectional study over a period of 3 months among hypertensive patients, in order to determine the frequency of the erectile dysfunction (ED), and to identify the predictive factors. It included treated hypertensive patients, presenting an ED, defined as the incapacity to obtain or maintain an erection sufficient for satisfactory sexual activity. on 265 hypertensive patients, 172 (65%) presented an ED. The average age was 58.2 ± 9.7 years. The associated cardiovascular risk factors were overweight/obesity in 99 cases (37.4%), sedentariness in 90 cases (34%), diabetes mellitus in 50 cases (19%), dyslipidemia in 12 cases (4.5%), and tobacco addiction in 6 cases (2.3%). Arterial hypertension (HTN), old of 6.7 ± 5.8 years, was treated by bitherapy in 129 cases (48.7%), and tritherapy in 102 cases (38.5%). The principal therapeutic classes used were ACE inhibitors/ARBs in 213 cases (81%), calcium antagonists in 205 cases (78%), thiazides in 137 cases (52.1%), and beta-blockers in 82 cases (31%). ED, severe in 124 cases (72%), and moderate in 48 cases (28%), consisted of a difficulty to maintain the erection in 78 cases (45.3%), to obtain the erection in 30 cases (17.4%), and the two partners in 64 cases (37.2%). In multivariate analysis, only the age, seniority of HTN, and the existence of diabetes mellitus were the predictive factors of ED. The early and effective assumption of responsibility of the AHT, as well as other cardiovascular risk factors whose diabetes, would make it possible to reduce the frequency of it, thus improving quality of life of the hypertensive patients.

关键词： Arterial Hypertension Erectile Dysfunction Frequency Predictive Factors Congo

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Left Ventricular Hypertrophy and Predictive Factors among Congolese Hypertensive Patients

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World Journal of Cardiovascular Diseases 2018年第12期8卷 569-577页

作者： stéphane méo ikama Bernice mesmer Nsitou Jospin makani Louis Igor ondze-Kafata Bertrand Fikhaem Ellenga-mbolla Thierry Raoul Gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo

A cross-sectional study of hypertensive patients was carried out in Brazzaville between January 2011 and December 2013.?The objectives of the present study are to determine the different types of left ventricular hypertrophy (LVH)?and to identify the predictive factors of LVH. It included 556 hypertensive patients with LVH, characterized by left ventricular mass index (LVmI) > 135 g/m2?in men, and > 111 g/m2?in women. Patients’ sociodemographic data and echocardiographic parameters were gathered and analyzed. There were 342 males (61.5%) and 214 females (38.5%),?with?mean age 53.5 ± 11.5 years. The indications of the test were hypertension initial evaluation in 402 cases (72.3%), investigation of ischemic stroke in 62 cases (11.2%), heart failure in 58 cases (10.4%), dyspnea and chest pain in respectively 22 and 12 cases. Hypertension, old of 5.2 ± 4.5 years, was associated with overweight/obesity in 408 cases (73.4%), physical inactivity in 325 cases (58.5%), hypertension family history in 274 cases (49.3%), diabetes mellitus in 76 cases (13.7%), dyslipidemia in 63 cases (11.3%), tobacco use in 9 cases (1.6%). The prevalence of LVH was 49.4% and consisted into concentric LVH in 470 cases (84.5%), eccentric LVH in 70 cases (12.6%), and in 16 cases (2.9%),?it was a concentric left ventricular remodeling. Age, male gender, seniority of hypertension and treatment were predictive factors of LVH. The latter is the most predominant abnormality in the echocardiographic profile of Congolese hypertensive patients. Efficient management on hypertension will lead to reducing its morbidity and mortality.

关键词： Arterial Hypertension Left Ventricular Hypertrophy Predictive Factors Congo

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Epidemiological and Prognostic Aspects of Anemia during Heart Failure in Brazzaville (The Republic of the Congo)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 396-403页

作者： stéphane méo ikama Joffode mobet memougame Thibaut oko Jospin Jospin makani Lydie ocini Ngolet Bijou moualengue Eric Gibrel Kimbally Kaky Thibaut Gankama Suzy Gisèle Kimbally Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Hematology Laboratory University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Clinical Hematology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo

To improve the management of patients with heart failure and anemia at the University Hospital of Brazzaville, a cross-sectional study of patients diagnosed with heart failure condition (left or global heart failure) was conducted over a period of nine months from January 1 to September 30, 2017. A total of 171 patients were included during the study period. study participants were divided into two groups: Group A included patients with an additional anemic condition (n = 57) and Group NA patients without anemia (n = 114). Anemia was defined as a hemoglobin rate of or men and or women. All eligible patients admitted to the Department of Cardiology were included in the study. The frequency of anemia was 33.3%, with a mean hemoglobin level of 9.4 ± 1.5 g/dL. men accounted for 46.9% of cases (n = 79) and women 53.8% (n = 92). The mean age of eligible patients was 57.5 ± 16.5 years. of these, 46.2% (n = 75) had a secondary educational level and 53.8% (n = 92) had a low socioeconomic status. Heart failure was global in 153 cases (89.5%). Patients were on NYHA III-IV functional class in 112 cases (65.5%), with a statistically significant difference between anemic and non-anemic patients (p = 0.0001). The main underlying heart diseases were dilated cardiomyopathy (75.1%), hypertensive heart disease (10.5%), ischemic heart disease (6.5%), and valvular disease (4.7%). The comparison between the two groups (A and NA) showed a longer hospital length of stay (18.4 ± 8.9 versus 12.9 ± 7.6 days;p = 0.00001) and a higher mortality rate (4 versus 2 deaths). The re-hospitalization rate was more important in group A (n = 4) than in group NA (n = 1). Anemia is a common condition in patients with heart failure. It worsens the clinical features and prognosis.

关键词： Anemia Heart Failure Frequency Prognosis The Republic of the Congo

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Epidemiological, Clinical and Etiological Profile of Rhythmic Emergencies at the University Hospital of Brazzaville, Republic of Congo

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World Journal of Cardiovascular Diseases 2022年第6期12卷 342-352页

作者： Suzy Gisèle Kimbally-Kaky Thibaut Naïbe Gankama Eric Gibrel Kimbally-Kaky Jospin Karel makani Bijou moualengue stéphane méo ikama Soodougoua Baragou Thierry Raoul Alexis Gombet Department of Cardiology and Internal medicine University Hospital of Brazzaville Brazzaville Republic of Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of Congo Sylvanus olympio University Hospital Lomé Togo Faculty of Health Sciences Lomé Togo Department of Emergency University Hospital of Brazzaville Brazzaville Republic of Congo

objectives: To describe the epidemiological, clinical and etiological aspects of rhythmic emergencies at the University Hospital of Brazzaville. Patients and methods: This was a retrospective descriptive study conducted in the cardiology and internal medicine department of the University Hospital of Brazzaville from January 1, 2014 to June 30, 2016. Were included, all patients admitted for a severe rhythm disorder diagnosed on the surface electrocardiogram. Rhythmic emergency was defined as a severe rhythm disorder of abrupt onset and required rapid management. Data entry and analysis were performed with Epi Info software version 3.5.1. Results: During the study period, 2269 patients were hospitalized, including 138 for a rhythmic emergency. The frequency of rhythmic emergencies was 6.1%. The patients were divided into 76 women and 62 men (sex ratio = 0.81). The mean age of the patients was 63.1 ± 16.9 years (extremes: 17 and 91 years). The socio-economic level was low for 103 patients (74.6%), medium for 26 (17.7%), and high for nine (6.6%). The average time to consultation was 13.7 ± 12.3 days. on admission, the signs were: heart failure (103 cases;74.6%) including 22 acute cases;dyspnea (94 cases;68%);palpitations (38 cases;27.5%);functional impotence (13 cases;9.4%);collapse (nine cases;6.5%);chest pain (two cases;1.4%). The type of rhythmic emergency was: rapid atrial fibrillation (103 cases;74.6%), ventricular tachycardia (14 cases;10.1%), junctional tachycardia (10 cases;7.2%), rapid atrial flutter (10 cases;7.2%), tachysystole (one case;0.7%). The context of occurrence was: hypokalemia (8 cases;5.8%), drunkenness (two cases;1.4%), acute gastroenteritis (one case;0.7%). Cardiovascular risk factors were: hypertension (62 cases;45.2%), smoking (17 cases;12.1%), dyslipidemia (12 cases;8.7%), diabetes (11 cases;8%), obesity (10 cases;7.2%). Underlying heart disease was: dilated cardiomyopathy (40 cases;29%), hypertensive cardiomyopathy (26 cases;18.8%), valvulopa

关键词： Cardiac Rhythm Disorders Atrial Fibrillation Dilated Cardiomyopathy Brazzaville

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Aetiologic Factors of Anemia During Heart Failure in Brazzaville (The Republic of the Congo)

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World Journal of Cardiovascular Diseases 2023年第9期13卷 605-612页

作者： stéphane méo ikama Joffode mobet memougame Jospin makani Thibaut oko Eric Gibrel Kimbally Kaky Lydie ocini Ngolet Bijou moualengue Thibaut Gankama Suzy Gisèle Kimbally Kaky Department of Cardiology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Hematology Laboratory University Hospital Center of Brazzaville Brazzaville The Republic of the Congo Department of Clinical Hematology University Hospital Center of Brazzaville Brazzaville The Republic of the Congo

To contribute to improving the management of patients with heart failure and anemia in Brazzaville, a prospective and descriptive study was conducted in the University Hospital of Brazzaville for nine months (January 1st to September 30, 2017). Included 57 patients hospitalized for left or global heart failure and presenting anemia. Anemia was defined by an haemoglobin level men and omen. Proportionings of the reticulocytes rate, serum iron, ferritin, erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP), electrophoresis of proteins, and evaluation of renal function by glomerular filtration rate (GFR), as well as the treatments of heart failure, and the auxiliary therapeutic ones, in particular the antithrombotic drugs, allowed aetiologic research. They were 20 men (35%) and 37 women (65%), old on average of 59 ± 17 years. The average rate of haemoglobin was 11.4 ± 1.4 g/dL. Heart failure was de novo in 24 cases (42.1%), old in 33 cases (57.9%);it was global in 54 cases (94.7%).The maintenance treatment associated diuretics in 32 cases (97%), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in 31 cases (94%), beta-blockers in two cases (6.1%), digoxin in four cases (12.1%), aspirin in five cases (15.1%) and anti-vitamin K in four cases (12.1%). Anemia was microcytic hypochromic in 30 cases (52.6%), normocytic normochromic in 20 cases (35.1%), and macrocytic normochromic in one case (1.7%). The main aetiologic factors were hemodilution in 46 cases (80.7%), renal insufficiency in 30 cases (52.3%), inflammation in 29 cases (50.8%), and iron deficiency in one case (1.7%). The HIV serology, carried out in 11 cases, was negative. Anemia is a frequent comorbidity among heart failure patients. Aetiologic research remains difficult in our context, and its often multifactorial origin.

关键词： Anemia Heart Failure Aetiologies Congo

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Global Cardiovascular Risk of the HIV Positive Patients Receiving Antiretroviral Therapy in Brazzaville

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World Journal of Cardiovascular Diseases 2019年第8期9卷 553-561页

作者： stéphane méo ikama Franck Ekoba-otende Jospin makani Amélia Bokilo Bienvenu ossibi-Ibara Louis Igor ondze-Kafata Bertrand Fikhaem Ellenga-mbolla Thierry Raoul Gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo National Centre of Blood Transfusion Brazzaville Congo Department of Infectious Diseases Brazzaville University Hospital Center Brazzaville Congo

A cross-sectional, descriptive and analytical study was conducted from January to August 2015 at the Brazzaville Ambulatory Treatment Center and at?the National Blood Transfusion Center. The objective was to contribute to improving?the care of people living with HIV under antiretroviral therapy by assessing their global cardiovascular risk (CVR). The variables studied focused on the epidemiological, clinical and biological aspects. The global CVR was assessed?by the Framingham and WHo/ISH scores. There were 135 HIV-positive subjects,?including 64 treated patients and 71 untreated HIV+ subjects. The subjects were divided into 83 men (61.5%) and 52 women (38.5%), with an average age of 42.6 ± 2.9 old years. The subjects were single people (62.2%), of a secondary educational level (63.7%), and civil servants (32.6%). The main risk factors found were dyslipidaemia (60%), obesity (36%), smoking (12.6%), hypertension (5.9%), diabetes (0.7%). The metabolic syndrome was found in seven cases (11.3%). The global CVR according to the score of Framingham, initially moderated at 17.2%, and mean at 1.5% within treated patients, was mean at 9.4% and high at 1.6% of the subjects respectively at the sixth month of treatment (p CVR under antiretroviral therapy. Preventive actions are highly recommended.

关键词： HIV Infection Antiretroviral Therapy metabolic Disorders Global Cardiovascular Risk Congo

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Hyperuricemia and Associated Factors during Arterial Hypertension in Brazzaville (Congo)

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World Journal of Cardiovascular Diseases 2019年第3期9卷 236-244页

作者： stéphane méo ikama Amorce Rolles matingou Jospin makani Norbert Lamini Nsounda Solange Flore mongo-Ngamami Bertrand Fikhaem Ellenga-mbolla Louis Igor ondze-Kafata Thierry Raoul Gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo Department of Rhumatolology Brazzaville University Hospital Center Brazzaville Congo

A longitudinal analytical and comparative study including outpatients was carried between June 1st?and December 31st?2017. The objectives were to determine the hyperuricemia frequency during arterial hypertension, to identify associated factors, and to evaluate its impact on the blood pressure control. We have included, hypertensive patients having a minimum blood test including at least an uricemia. They were divided into two groups according to?whether they have presented a?hyperuricemia (HU) or a normouricemia (NU).?Among?these 202 patients included, 61 (30.2%) presented a hyperuricemia.?The mean age in HU group was 54.6 ± 11.6 years vs 53.6 ± 11 years for NU group (p = 0.573). Following cardiovascular risk factors were more found in the HU group than NU group: overweight/obesity (68.8% vs 46.1%;p = 0.003), metabolic syndrome (42.6% vs 39%;p = 0.021). Diuretics were used in 72.1% of patients in HU group vs 47.5% in NU group (p = 0.002).?Bitherapy was used in 56% of the patients of HU group vs 69% in the NU group (p = 0.295), and the quadritherapy?in 8% and 1% of the patients respectively (p = 0.049). Blood pressure was not controlled in 68.8% of HU group vs 48.9% in the NU group (p = 0.014). In multivariate analysis after logistic regression, factors associated with hyperuricemia were: glucose intolerance or diabetes (p = 0.004;oR = 1.35) and uncontrolled blood pressure (p = 0.006;oR = 2.51). This preliminary study showed that hyperuricemia is commonly found in hypertensive patients and has negative impact on blood pressure control.

关键词： Hypertension Hyperuricemia Frequency Blood Pressure Control Congo

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Atrial Fibrillation during Cerebral Infarction in Brazzaville: Frequency and Predictive Factors

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World Journal of Cardiovascular Diseases 2019年第12期9卷 891-898页

作者： stéphane méo ikama Yann Luiz Ngouabi Ghislain mpandzou Paul macaire ossou-Nguiet Jospin makani Thibault Gankama Christian Kouala-Landa Louis Igor ondze-Kafata Bertrand Fikhaem Ellenga-mbolla Thierry Raoul Gombet Suzy Gisèle Kimbally-Kaky Department of Cardiology Brazzaville University Hospital Center Brazzaville Congo Department of Neurology Brazzaville University Hospital Center Brazzaville Congo

In order to contribute to the improvement of brain infarction management in Brazzaville, a cross-sectional and analytical study with prospective data collection was conducted in the cardiology and neurology departments of the Brazzaville University Hospital, from February 1 to July 31, 2018. It included patients hospitalized for cerebral infarction confirmed with imaging, and having done an etiological assessment with at least one electrocardiogram at rest and one of long duration. Among these 138 patients included, 11 had atrial fibrillation, equaling?a frequency of 7.9%. The mean age of AF patients was 71 ± 8.8 years. The cardiovascular risk factors found were hypertension in eight cases (72.7%), diabetes in five cases (45.5%), abdominal obesity in four cases (36.4%). AF was permanent in 10 cases (91%), and paroxysmal in one case (9%). It was valvular in three cases (27.3%) and non-valvular in eight cases (72.7%). The cardiopathy involved was hypertensive in seven cases (63.6%), ischemic and valvular in two cases each. The CHA2DS2-VASc score, calculated in eight patients, was an average of 2.2, and ≥2 in more than 80% of patients;HAS-BLED score of 2.4 on average was ≥?3 in more than 72% of patients. Digoxin was prescribed in seven cases (63.6%) and an anti-vitamin K in eight cases (72.7%). In multivariate analysis, age (oR = 20.10, p = 0.023), arterial hypertension (oR = 23.82, p = 0.011), and dyslipidemia (oR = 2.03, p = 0.032) were the predictive factors found. AF is infrequent during brain infarction in Brazzaville. This systematic research raises the problem of age in our context.

关键词： Atrial Fibrillation Cerebral Infarction Frequency Predictive Factors Congo

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Peri-Annular and Septal Abscesses in Infectious Endocarditis. About 3 Cases observed at the University Hospital of Brazzaville

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World Journal of Cardiovascular Diseases 2022年第2期12卷 94-110页

作者： Solange Flore mongo Ngamami Armel Landry Batchi-Bouyou Trésor mavie Eouolo Ndona Christian michel Kouala Landa Eric Gibrel Kimbally Kaky Jean Joseph Ekwa Sima Bertrand Fikahem Ellenga mbolla méo stéphane ikama Department of Cardiology University Hospital of Brazzaville Brazzaville Republic of the Congo Department of Doctoral studies Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Infectious endocarditis (IE) is a relatively rare but serious condition. We report 3 cases of infectious endocarditis complicated by peri-annular and/or septal abscess. The patients aged 24, 25 and 28 were all male. Global heart failure was observed in 2 cases. Atrioventricular block was noted in 2 cases (complete syncopation: 1 time;2nd degree mobitz 2 1 time). Transthoracic echocardiography made it possible to diagnose abscess in all cases (aortic and septal peri-annulus: once, septal only: twice). The aortic insufficiency was grade 2 in all cases, mitral insufficiency grade 2 in 1. The front door was found once, with a dental location. Blood cultures were negative in all cases. A bi-probabilistic antibiotic therapy made it possible to control the infectious process in all the patients. Cardiac surgery, indicated in all cases, was performed in 1 case, consisting of flattening the abscesses and then placing a pacemaker in the patient with complete syncopal atrioventricular block. The outcome of all patients was favorable. Return to permanent sinus rhythm, associated with complete left bundle branch block, was noted at the 4th year of development in the pacemaker wearer. The other 2 patients are still awaiting medical evacuation.

关键词： Infectious Endocarditis Peri-Annular and Septal Abscess Echocardiography Treatment

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