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Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case

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World Journal of Cardiovascular Diseases 2023年第11期13卷 756-763页

作者： Khadidiatou Dia waly niang mboup Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Djibril Marie Ba Demba Ware Balde Mouhamed Cherif mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.

关键词： Lead Malposition Left Ventricle Lead Right Bundle Branch Block Ventricu-lar Pacing Transthoracic Echocardiography

Cardiac Resynchronization Therapy in Heart Failure in Sub-Saharan Africa Environment: Experience of the Principal Hospital of Dakar (Senegal)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 349-358页

作者： Khadidiatou Dia waly niang mboup Djibril Marie Ba Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Demba Ware Balde Mouhamed Cherif mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.

关键词： Cardiac Resynchronization Therapy CRT Heart Failure Biventricular Pacing Sub-Saharan Africa

MINOCA Resulting from Coronary Spasm Confirmed Angiographically without Ergonovine Stimulation: A Case Report

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World Journal of Cardiovascular Diseases 2022年第11期12卷 473-480页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguène Ka waly niang mboup Khadidiatou Dia Djibril Marie Ba Demba Waré Balde Mouhamed Chérif mboup Cardiology Department H&ocirc pital Principal Dakar Dakar Senegal Cardiology Department H&ocirc pital Militaire de Ouakam Dakar Senegal

Introduction: Myocardial infarction with nonobstructive coronary arteries disease (MINOCA) encompasses a heterogeneous group of disorders. Multimodality imaging is crucial to figure out the underlying mechanism. Coronary artery spasm is a common cause of MINOCA and might be difficult to identify. Case Presentation: A 43-year-old male with no cardiovascular risk factor presented with prolonged acute chest pain at 5 am that resolved spontaneously. On admission, he was asymptomatic and clinical findings were unremarkable. The electrocardiogram showed an anterolateral negative T wave. The troponin was positive. Coronary angiography (CA) revealed a moderate lesion of the proximal left anterior descending (LAD) coronary artery. He was treated with dual antiplatelet therapy, statin, and beta-blocker with a favourable hospital course. One week later, he presented chest pain recurrences with anterior ST-segment elevation. CA, without intra-radial nitrate, owing to a vasospasm suspicion, showed a sub-occlusion of the proximal LAD which resolved after intracoronary nitrates. Chest pain and ST-segment elevation then disappeared. He remained asymptomatic and was discharged on CCB (calcium channel blocker), long-acting nitrates dual antiplatelet and statin. Cardiac magnetic resonance (CMR) demonstrated an ejection fraction (EF) of 45% with anterior ischemia. Conclusion: Our case is about a common cause of MINOCA, namely coronary spasm, diagnosed by coronary angiogram without provocative test.

关键词： MINOCA Coronary Spasm Case Report

Atrial Fibrillation in Wolff Parkinson White Syndrome: About a Case in Senegal

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World Journal of Cardiovascular Diseases 2023年第1期13卷 1-6页

作者： waly niang mboup Khadidiatou Dia Mame Madjiguène Ka Serigne Cheikh Tidiane Ndao Demba Ware Balde Djibril Mari Ba Mouhamed Cherif mboup Adama Kane Department of Cardiology Principal Hospital of Dakar (HPD) Dakar Senegal Department of Cardiology Military Hospital of Ouakam (HMO) Dakar Senegal Department of Cardiology Aristide Le Dantec University Hospital Center Dakar Senegal

WOLFF PARKINSON and WHITE (WPW) syndrome is the most common form of pre-excitation. It is associated in some cases with atrial fibrillation with a high risk of sudden death. We report the case of a 64-year-old hypertensive woman with a history of ischemic stroke. She presented with hyperkinetic palpitations without hemodynamics instability on admission. The electrocardiogram recorded a complete tachyarrhythmia by pre-excitation atrial fibrillation, with a mean rate of 300 beats per minute. Electrophysiological investigation revealed an accessory pathway located at the ostium of the coronary sinus, which was successfully ablated by radiofrequency. A drug treatment based on flecaine 100 mg was introduced. The patient was asymptomatic after one month of outpatient follow-up.

关键词： Wolff Parkinson and White Atrial Fibrillation Senegal

Cardiovascular and Cerebrovascular Prognosis at 5 Years of Patients Who Presented with an Ischemic Stroke at Principal Hospital of Dakar

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World Journal of Cardiovascular Diseases 2022年第1期12卷 77-86页

作者： waly niang mboup Mame Madjiguène Ka Serigne Cheikh Tidiane Ndao Demba Ware Balde Djibril Mari Ba Khadidiatou Dia Pape Diadji Fall Mouhamed Cherif mboup Department of Cardiology Principal Hospital/Dakar (HPD) Dakar Senegal Department of Cardiology Military Hospital of Ouakam/Dakar (HMO) Dakar Senegal

Aims: To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. Methods: We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 2019 for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. Results: Overall, one hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%, with a sex ratio of 1.28. Patients’mean age was 66.33 ±13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0.6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke

关键词： Cardiovascular Cerebrovascular Prognosis Ischemic Stroke Dakar

Cardiac Rehabilitation in the Elderly

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World Journal of Cardiovascular Diseases 2023年第12期13卷 854-869页

作者： Aw Fatou Wiam Akif Mame Madjiguene Ka Aimee Mbaye Sy waly niang mboup Aliou Aalassane Ngaide Ccherif mboup Simon Antoine Sarr Josep Salvadou Mingou Marguerite Tening Diouf Khadim Rassoul Diop Momar Dioum Malick Bodian Mohamed Leye Alain Désiré Affangla Mouhammadou Bamba Ndiaye Alassane Mbaye Serigne Mor Beye Adama Kane Maboury Diao Abdoul Kane Department of Cardiology University Hospital Center Aristide Le Dantec Dakar Senegal Hopital Principal Dakar Senegal Hopital Dalal Jamm Dakar Senegal Hopital général Idrissa Pouye Dakar Senegal University Hospital Center Fann Dakar Senegal UFR de Thies Dakar Senegal UFR de Saint Louis Dakar Senegal Medical Department Cheikh Anta Diop University Dakar Senegal

Introduction: The purpose of cardiac rehabilitation is to improve the effects of aging and maintain a good quality of life for older individuals. This study aims to assess how cardiac rehabilitation affects the autonomy and quality of life of older adults. Patients and Method: This was a longitudinal, descriptive and comparative before-and-after cardiovascular rehabilitation study conducted over a two-year period from January 2019 to December 2021. This study was conducted at four cardiac rehabilitation units in Dakar: the Aristide Le Dantec Hospital (HALD), National Dalal Jamm Hospital, and the General Idrissa Pouye Hospital (HOGIP). We compared the degree of autonomy, dependence and quality of life of subjects aged over 65 before and after the cardiac rehabilitation program using the Katz index, the Lowton index and the SF12 quality-of-life questionnaire. Results: Over a two-year period, a total of 345 patients had benefited from a complete cardiovascular rehabilitation program in the four cardiovascular rehabilitation units in Dakar, and 86 patients, or 24.92% of the population, were at least 65 years old. The patients were predominantly male (sex ratio M/F = 4.73). The mean age was 70.35 ± 4.55 years for men and 69.27 ± 4.59 years for women. The main pathology motivating cardiac rehabilitation was ischemic heart disease, which was found in 73 patients (84.88%). Initial assessment revealed exertional dyspnea in 35 patients (40.69%), followed by residual exertional angina in 21 patients (4.41%). Mean functional capacity increased from 5.81 ± 2.38 Mets in pre-cardiac rehabilitation to 8.68 ± 2.28 Mets in post-cardiac rehabilitation (p < 0.001). The mean distance covered in the 6-minute walk test increased from 330.42 ± 170.50 m in pre-cardiac rehabilitation to 524 ± 98.54 m in post-cardiac rehabilitation (p = 0.119). The Lowton dependency index in pre-cardiac rehabilitation was 44.18% versus 36.04% in post-cardiac rehabilitation (p = 0.0156). The mental quality of

关键词： Cardiac Rehabilitation Elderly Dakar

Low Cost Equipment and Short Duration Program Are Not Barriers to Good Outcomes of Cardiac Rehabilitation in Senegalese Patients with Coronary Artery Disease

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World Journal of Cardiovascular Diseases 2021年第9期11卷 421-433页

作者： Mame Madjiguène Ka waly niang mboup Serigne Cheikh Tidiane Ndao Sènankpon Paterne Aymard Abadassi Djibril Marie Ba Khadidiatou Dia Pape Diadie Fall Mouhamed Chérif mboup Hô pital Principal de Dakar Dakar Senegal

Cardiac rehabilitation is still underused in Africa, despite its cost effectiveness widely demonstrated around the world. Aim: To evaluate the results of a cardiac rehabilitation program in the first Senegalese outpatient center in low resource context. Patients and Method: We carried out a prospective and interventional study. It compared on one hand a group of coronary patients at baseline and after 6 months of our rehabilitation program and on the other hand a control group of patients not enrolled in rehabilitation. Results: We included 70 patients (30 in the rehabilitation group and 40 in the control group). After rehabilitation, the functional capacity improved: 6.99 ± 2.9 Mets at M0 vs 8.8 ± 2.23 Mets at M6, p = 0.0001. Patients of intervention group significantly increased motivation to lifestyle changes and knowledge about their disease. We found better control at 6 months of hypertension (84.50% vs 33.70%, p = 0.003), diabetes (70.00% vs 26.70%, p = 0.0042), LDL cholesterol (33.00% vs 5.00%, p = 0.002) in the group “Rehabilitation”. Prevalence of psychosocial issues like anxiety and depression decreased in intervention group: 50.00% at M0 to 23.33% at M3 (p = 0.021), then 30.00% at M6 (p = 0.18). Return to work and resuming sexual activity were not significantly different. Conclusion: Comprehensive cardiac rehabilitation program, with low cost equipment in a short duration, could have real benefits in the management of coronary artery disease by reducing anxiety and depression, improving treatment compliance, control of cardiovascular risk factors, lifesty

关键词： Cardiac Rehabilitation Patient Education Cardiovascular Risks Factors Psy-chosocial Factors Coronary Artery Disease Africa

Frailty in People Living with Human Immunodeficiency Virus Aged 50 Years and Older: Prevalence and Predictors

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World Journal of AIDS 2024年第1期14卷 18-34页

作者： Alassane Ndiaye Ndèye Fatou Ngom Kiné Ndiaye Assiétou Gaye Elhadji Bara Diop Ahmadou mboup Houlèye Saou Bessoume Sy Ababacar niang Betty Fall Mame Awa Faye Outpatient Treatment Clinic (CTA) Dakar Senegal Medicine Department of Health and Sustainable Development/Research and Training Unit (UFRSDD) Alioune Diop University of Bambey Diourbel Senegal Health and Development Institute (ISED) Cheikh Anta Diop University Dakar Senegal Geriatrics and Gerontology Department Fann National Teaching Hospital Center Dakar Senegal

Introduction: Life expectancy improvement for people living with Human Immunodeficiency Virus (HIV) is coming up against the problems associated with aging and chronic diseases. Frailty is a concern affecting a growing number of patients, particularly the elderly in this population. Our study aimed to determine the prevalence of frailty and its predictors on people living with HIV aged 50 years and older followed at the Outpatient Treatment Clinic (CTA) in Dakar. Methodology: We conducted a cross-sectional study of descriptive and analytic purposes ranging from November 2022 to August 2023, in CTA, Dakar (Senegal). We included people living with HIV aged 50 years and older under antiretroviral therapy for at least 6 months (≥6 months). Frailty was considered according to Fried criteria with a score ≥3. To identify the predictors of frailty, we performed a multivariate logistic regression analysis using STATA software version 18. Results: We included 199 patients. The median age at the moment of the study was 58 years old [50 - 91] with a sex ratio (M/F) of 0.58. The most representative age group was that of [50 - 59] years (59.3%). HIV-1 profile was most common in 89.45%. The median duration under antiretroviral therapy was 180 months [6 - 284] and 94% of patients received a Tenofovir Disoproxil Fumarate (TDF)-containing regimen with 43% of them for at least 10 years. Viral load was undetectable (≤40 copies/ml) in 98% of cases. WHO Stage III was more common at inclusion and 55.78% had nadir TCD4+ Lymphocyte counts Conclusion: Our study confirms the high prevalence of frailty among older people living with HIV. Its prevention should consider the management of comorbidities and the implementation of non-pharmacological interventions such as nutrition.

关键词： Frailty HIV Senior Dakar

Acute Coronary Syndromes: Epidemiological, Clinical and Management Aspects in Thies (Senegal)

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World Journal of Cardiovascular Diseases 2023年第3期13卷 114-123页

作者： Désiré Alain Affangla Jean-Paul Degue Wally niang mboup Stéphanie Claudia Akanni Sheikh Mouhamadou B. M. Diop Malick Ndiaye Jean-Michel Amath Dione Hugues Elie Elame Ngwa Adamson Phiri Djibril Marie Ba Mohamed M. C. B. O. Leye Cardiac Unit Saint Jean de Dieu Hospital Thies Senegal Health Sciences Training and Research Unit University of Thies Thies Senegal

Purpose: To describe the epidemiological, clinical and management characteristics of acute coronary syndromes (ACS) in Thies, Senegal. Methods: This was a prospective study that included consecutively from October 1st, 2018 to March 03rd, 2019, patients aged 18 years or older admitted for an ACS at the DIABCARMET department of the Saint Jean de Dieu Hospital in Thies. Results: Of the 516 patients admitted, 29 had ACS, the prevalence was 5.62%. The average age of the patients was 64.2 ± 11.6 years. Nineteen patients (65.5%) were male and 10 (34.5%) were female, the sex ratio was 1.91. The number of direct admissions was 18 (62%) versus 11 patients (38%) referred. The mode of transport was a private vehicle in 19 patients (65.5%), an ambulance in 7 patients (24.1%) and public transport in 3 patients (10.3%). STEMI (ST segment elevation myocardial infarction) was the most common presentation observed in 19 patients (65.5%). Fifteen patients (51.7%) were admitted before the 12th hour. Of the 19 patients with STEMI, 11 (57.9%) had arrived in hospital before the 12th hour and 10 patients had streptokinase thrombolysis. No patients received primary PCI. Ten patients (34.5%) had heart failure and five patients (17.2%) died during hospitalization. Conclusion: Delayed consultation and high mortality characterize ACS in Thies. Prevention must be the rule.

关键词： ACS Myocardial Infarction Thrombolysis Thies Senegal