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Effect of Cardiac Rehabilitation on Physical Capacity of Heart Failure Patients in Senegal

World Journal of Cardiovascular Diseases 2024年第8期14卷 447-458页

作者： Ngoné Diaba Gaye aliou alassane ngaidé Joseph Mingou Fatou Aw Mame Madjiguène Ka Aimé Mbaye Sy Zakaria Naji Lamrani Abdoul Kane Department of Cardiac Rehabilitation Ibra Mamadou Wane Medical Center Dakar Senegal Department of Cardiology Dalal Jam Hospital Guediawaye Senegal Department of Cardiology Idrissa Pouye General Hospital Dakar Senegal School of Medicine Cheikh Anta Diop University Dakar Senegal Department of Cardiology Principal Hospital of Dakar (HPD) Dakar Senegal.

Background: Heart failure is a chronic and severe condition that often results from various heart diseases. Cardiac rehabilitation (CR) is currently a crucial component in managing this condition. The aim was to assess the effects of cardiac rehabilitation on physical capacity of heart failure patients. Methods: This was a cross-sectional study conducted from February 1, 2021, to June 30, 2023. We included all patients with heart failure who underwent cardiac rehabilitation. Data analysis was performed using SPSS software version 24.0, with a significance level set at p Results: The study included 87 heart failure patients, with a male-to-female ratio of 1.8. Mean age was 57.10 years (±11.75). Coronary artery disease was the primary cause of heart failure, accounting for 75.9% of cases. Atrial fibrillation was present in 4.7% of cases. Following cardiac rehabilitation, Left Ventricular Ejection Fraction increased from 40.15% to 49.48% (p = 0.001). Resting heart rate decreased significantly from 81.4 bpm to 68.3 bpm (p = 0.000), and the number of METS increased from 4.3 to 6.57 (+56.8%;p = 0.000). The mean distance covered in the 6-minute walk test significantly increased from 337.8 meters to 522.7 meters (p = 0.000), reflecting a gain of 183.5 meters. Moreover, the increase in the number of METS was more pronounced in females (p = 0.001), non-obese individuals (p = 0.000), non-diabetics (p = 0.001), non-sedentary individuals (p = 0.000), and non-smokers (p = 0.000). The study reported a low readmissions rate of 2.2% and a mortality rate of 1.1%. Conclusion: Our study demonstrates that cardiac rehabilitation is beneficial for black African heart failure patients, resulting in significant improvements in symptoms, physical and capacity.

关键词： Cardiac Rehabilitation Chronic Heart Failure Physical Capacity Senegal

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Totally Occluded Coarctation of the Aorta in a Young Adult

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World Journal of Cardiovascular Diseases 2024年第4期14卷 282-287页

作者： Marguerite Téning Diouf Mohamed Leye Joseph Salvator Mingou Aw Fatou Ndeye Faye Sy Aimé Mbaye Malick Bodian aliou alassane ngaidé Abdoul Kane Cardiology Dalal Jamm Hospital Dakar Senegal Training and Research in Health Sciences Unit University of Thi&#232s Thi&#232s Senegal Cardiology Department Hospital Aristide Le Dantec Dakar Senegal

We report the case of a 20-year-old female patient presenting with a totally occluded coarctation of the aorta. The patient was admitted for the evaluation of resistant grade III high blood pressure. The physical examination revealed a blood pressure gradient between the upper and lower limbs, absent femoral pulses, a diffuse continuous murmur over the chest, and hyperpulsatility of the carotid arteries and sternal notch. A transthoracic echocardiography outlined a narrowing in the caliber of the isthmic aorta without acceleration of flow or gradient. Thoracic CT angiography revealed a complete aortic coarctation with interruption of continuity between segment 3 and the descending aorta.

关键词： Coarctation of Aorta Complete Aortic Occlusion High Blood Pressure Adult

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Deep Vein Thrombosis of the Upper Limb: About 6 Cases Collected in Dakar

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World Journal of Cardiovascular Diseases 2020年第2期10卷 57-66页

作者： Mouhamadou Bamba Ndiaye Fatou Aw Marguerite Téning Diouf Joseph Salvador Mingou Simon Antoine Sarr Malick Bodiian aliou alassane ngaidé alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Department of Cardiology Aristide Le Dantec Hospital University Dakar Senegal Department of Cardiology HOGGY Dakar Senegal Departement of Cardiology Regional Hospital of Saint Louis Saint Louis Senegal Departement of Cardiology Dalal Jamm Hospital Dakar Senegal

Deep vein thrombosis of the upper limb is a rare location of venous thromboembolic disease. Data on this form of thrombosis are limited. We report six cases collected in Dakar. The sex ratio was 0.5 and the average age was 27.6 years with extremes of 17 and 39. Painful limb edema was the most constant sign and involved the non-dominant limb in almost all patients. Thrombosis occurred in a field of peripartum cardiomyopathy in two patients and SS sickle cell disease in one patient taking oral contraception. There was neither cancer nor venous catheter in medical history. The diagnosis was made by venous Doppler ultrasound in all patients. Subclavian involvement was the most common. The thrombophilia assessment, done for two patients, was normal. It was about exertion thrombosis on three (3) patients. All the patients had received antivitamin K treatment relaying a low molecular weight heparin. Venous limb compression was associated with anticoagulation for all patients. The treatment duration was six (6) months. There were no reports of pulmonary embolism or death. One patient presented a post-thrombotic syndrome.

关键词： Deep Vein Thrombosis Upper Limb Dakar

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Mitral Valve Abnormalities during Hypertrophic Cardiomyopathy: Study on a Cohort in Dakar

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World Journal of Cardiovascular Diseases 2023年第11期13卷 710-717页

作者： Simon Antoine Sarr Hicham Fassi-Fehri Marguerite Tening Diouf Youssou Diouf Fatou Aw Joseph Salvador Mingou Khadimu Rassoul Diop Serigne Mor Beye aliou alassane ngaidé Malick Bodian Mouhamadou Bamba Ndiaye alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Cardiology Unit Aristide Le Dantec Hospital Dakar Senegal Cardiology Unit Dalal Jamm Hospital Dakar Senegal UFR2S Saint Louis Saint-Louis Senegal Cardiology Unit Idrissa Pouye General Hospital Dakar Senegal

INTRODUCTION: Mitral valve abnormalities in hypertrophic cardiomyopathy (HCM) are becoming increasingly well defined, and their role in intra-ventricular obstruction is well defined. The aim of this study was to evaluate mitral valve abnormalities in patients with HCM. PATIENTS AND METHODS: We conducted a descriptive cross-sectional study from May 1 to July 1, 2022 in the Cardiology Department of Aristide Le Dantec Hospital. All patients with HCM aged at least 18 years old were included. The parameters studied concerned mainly the mitral valvular apparatus (papillary muscles abnormalities, leaflet length, mitral insufficiency). RESULTS: A total of 10 patients were included. Mean age was 58.3. On Doppler echocardiography, mean interventricular septal thickness was 20.6 mm. The mean maximum intra-ventricular gradient was 21.06 mmHg. Two patients had significant intraventricular obstruction. The mean length of the anterior mitral valve leaflet was 28.7 ± 3.55 mm, with extremes of 22 and 33 mm. The posterior mitral leaflet averaged 14.8 ± 3.16 mm. Nine (9) out of 10 patients had an elongated anterior valve leaflet. Elongation of the posterior leaflet was noted in 6 patients. With regard to papillary muscle position, 6 patients had an anterolateral ascending pillary muscle. These patients had a mean intra-ventricular gradient of 25 mmHg, compared with 16.5 mmHg in the others cases. We found no direct insertion on the mitral valve. Mitral insufficiency was noted in 9 patients, including 5 with mild insufficiency and 4 with moderate one. CONCLUSION: Mitral valve abnormalities in HCM appear to be frequent. They should be analyzed for a better diagnostic and therapeutic approach.

关键词： Hypertrophic Cardiomyopathy Mitral Valve Obstruction

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Epidemiology of Cardiovascular Mortality in Patients under 60 Years Old in a Cardiology Department in West Africa, Dakar-Senegal

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World Journal of Cardiovascular Diseases 2024年第8期14卷 502-514页

作者： aliou alassane ngaide Ngone Diaba Gaye Joseph Salvador Mingou Mame Diarra Sene Momar Dioum Mouhamadou Bamba Ndiaye alassane Mbaye Abdoul Kane Faculty of Medicine University Cheikh Anta Diop of Dakar Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Idrissa Pouye General Hospital Dakar Senegal Cardiology Department Fann Hospital Dakar Senegal

Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and va

关键词： Mortality Under 60 Years Cardiovascular Dakar

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Assessment of the Physical Capabilities of Heart Failure Patients before and after Cardiovascular Rehabilitation: A Study of 125 Patients from West Africa, Dakar, Senegal

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World Journal of Cardiovascular Diseases 2024年第8期14卷 490-501页

作者： aliou alassane ngaide Ngoné Diaba Gaye Joseph Salvador Mingou Mahugbe L. C. Houenassi Aminata Mbaye Aime Mbaye Sy Fatou Aw alassane Mbaye Abdoul Kane Faculty of Medicine Cheikh Anta Diop University Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Idrissa Pouye General Hospital Dakar Senegal

Background: Cardiac rehabilitation represents a critical therapeutic strategy for patients suffering from chronic heart failure. The physical capacity of patients with heart failure, assessed using the exercise test and the 6-minute walk test, is the measure of the patient’s overall functional ability to perform physical activities and tolerate exercise loads. The objective of this study was to assess the impact of cardiac rehabilitation on patients’ physical capabilities and to conduct a thorough comparison of data obtained via exercise testing and the 6-minute walk test before and after the rehabilitation programme. Methods: This was a descriptive and analytical cross-sectional study, conducted from 1 February 2021 to 31 June 2022. Included were heart failure patients who had participated in an outpatient cardiovascular rehabilitation programme. The collected data included anamnestic, clinical, paraclinical data, and the 6-minute walk test. Informed consent was obtained. Data analysis, word processing, and charting were performed using Microsoft Word 2016, Excel 2013, and Sphinx version 5.***.0.2. Data analysis was performed using SPSS (Statistical Package for Social Sciences) version 24.0. Any difference less than 0.05 was considered statistically significant. Results: In a Senegalese study, heart failure patients undergoing rehabilitation in a cardiac unit represented 45.59% of all cases, with a prevalence rate of 3.21%. The average participant was 57.97 years old, with those aged 61 to 70 forming the largest group (35.5%). The study noted a male predominance (sex ratio of 2.1) and identified dyslipidaemia (80.6%) and sedentarism (71%), as prevalent cardiovascular risk factors. All participants initially suffered from NYHA stage 2 or 3 dyspnoea, yet 80.65% showed no symptoms following rehabilitation. Significant improvements were recorded in resting heart rate (from 79 to 67 bpm), and the 6-minute walk test distance (from 328 m to 470 m). Enhanced exercise toleran

关键词： Cardiovascular Rehabilitation Heart Failure Physical Capabilities Quality of Life Improvement West Africa

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Screening of Myocardial Cardiotoxicity Induced by Anticancer Chemotherapy and the Importance of Global Longitudinal Strain

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World Journal of Cardiovascular Diseases 2024年第6期14卷 381-391页

作者： Marguerite Téning Diouf Fatou Aw Hussein Khadra Sophie Ba Doudou Diouf Michel Ngonar Sarr Joseph Salvador Mingou Malick Ndiaye Simon Antoine Sarr Momar Dioum aliou alassane ngaide Serigne Mor Beye Simon Manga Alain Affangla Youssou Diouf Khadimu Rassoul Diop Malick Bodian Mohamed Leye Mouhamadou Bamba Ndiaye alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Cardiology Department of the Dalal Jamm Hospital Dakar Senegal Cardiology Department Hospital Aristide Le Dantec Dakar Senegal Cardiology Department Hospital Fann Dakar Senegal UFR2S Saint Louis Saint Louis Senegal UFR Ziguinchor Ziguinchor Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Cardiology Department Hospital General Idrissa Pouye Dakar Senegal

Introduction: The improvement of survival in patients with cancer and the expansion of therapeutic options have led to the emergence of a new profile of cardiotoxicity, specifically associated with antimitotic agents. Our study aimed to assess the incidence of chemotherapy-induced myocardial toxicity in patients with cancer. Patients and Methods: We conducted a looking-forward longitudinal cohort study including all patients admitted to the Cardiology departments of Aristide le Dantec Hospital and Dalal Jamm National Hospital Centre for apre-chemotherapy check-up. The included patients did not undergo any pre-existing cardiopathy. Results: Over a period of two years ranging from January 2019 to December 2021, a total of 37 patients were included in the study. Notably, there was a female predominance (92%) with an average age of 49.7 years ± 13.69. Breast cancer accounted for 70% of the neoplasms. Laboratory findings revealed moderate anemia in 19 patients (51%). At inclusion, the left ventricle (LV) was of normal size (LV diastole at 44.46 ± 4.97 mm). The systolic function of the left ventricle was normal in all patients, with an average ejection fraction (EF) of 63.1% ± 5.80 and a mean global longitudinal strain (GLS) of −20.4% ± 2.58. The most commonly used agents were anthracyclines. During follow-up, 3 patients (8.1%) developed clinical symptoms of left heart failure, and LV dysfunction on echocardiography was observed in 5 (13.5%) patients, with a significant decrease in EF Conclusion: The incidence of cardiac toxicity is not negligible, hence the importance of early screening. Strain imaging is an essential tool that should be performed as part of the assessment before chemotherapy and re-evaluated during treatment.

关键词： Cancer Chemotherapy Global Longitudinal Strain Cardiotoxicity

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Management of High Complicated Genital Infections at the Aristide De Le Dantec Hospital: Apropos of Six Cases

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Open Journal of Obstetrics and Gynecology 2023年第11期13卷 1816-1830页

作者： aliou Cisse Mef Dieme Omar Gassama Youssoupha Toure An Coly alassane Diouf Dantec Hospital and University Center Dakar Senegal

Objective: To study the epidemiology, the diagnostic elements and the prognosis after laparotomy surgery, of complicated upper genital infections. Patients and method: This is a retrospective study of six cases of complicated upper genital infections collected over a period of 20 months in the Obstetrics and Gynecology department of the Aristide Hospital Center of LEDANTEC. Results: The average age of the patients was 37.67, in two patients;a hysterosalpingography had been performed less than seven days before the start of the symptoms, a notion of multiple sexual partners was noted in two patients. All patients presented with acute abdominal-pelvic pain associated with vomiting in three patients. An infectious syndrome was found in two patients, adnexal pain caused in four patients and signs of peritoneal irritation (guarding and umbilical tenderness) in three patients. Para-clinically, a biological inflammatory syndrome was found in all patients, including an elevation of C-reactive protein in all patients and hyperleukocytosis in four patients and an elevation of CA 125 in two patients. The cytobacteriological examination of the pus taken intraoperatively was positive in two patients, the isolated germs were Pseudomonas aeruginosa and Enterobacter cloacae. Pelvic ultrasound was performed in all patients and revealed a cystic adnexal mass in five cases, a pyosalpinx and peritoneal effusion in two cases. Abdominal & pelvic computed tomography was performed in four patients and revealed a lateral-uterine adnexal mass in two cases, pyosalpinx in two cases, uretero-hydronephrosis and peritoneal effusion in one case. An exploratory laparotomy was performed in each patient and confirmed the diagnosis of tuboovarian abscess, the presence of pelvic adhesion and purulent effusion in four patients, the presence of false membranes in two patients, pyometra and isolated bilateral pyosaplinx were found in one patient. Radical surgical treatment was associated with double proba

关键词： Tubo-Ovarian Abscess Pyometra Pyosalpinx

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Osler’s Subacute Infective Endocarditis on Rheumatic Heart: A Complicated Clinical Case That Reflects Four (4) Major Public Health Issues in Sub-Saharan Africa

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Case Reports in Clinical Medicine 2022年第12期11卷 507-519页

作者： Pêngd-Wendé Habib Boussé Traore aliou alassane ngaide aliou alassane ngaide Jean Augustin Diégane Tine alioune Kane Akouètè Jean Paul Degue alassane Mbaye Bouna Diack Abdoul Kane Cardiology Department Idrissa Pouye General Hospital Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop University Dakar Senegal Institute of Health and Development Public Health Service Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop Univer-sity Dakar Senegal Cardiology Department Dalal Jamm Hospital Faculty of Medicine Pharmacy and Dentistry Cheikh Anta Diop University Dakar Senegal

Endocarditis is an inflammation of the endocardium and its structures (valves), most often of infectious origin, described by William Osler in 1885. In the 21st century, infective endocarditis remains a reality in our countries. We report a complicated case of infective endocarditis (IE). This is a 53-year-old woman, obese and passive smoker who died on the 5th day of her hospitalization following an infective endocarditis (IE) with bacterial strains resistant to the usual antibiotics: daughter of acute lithiasic cholecystitis, mother of major mitral valve perforation, brain abscess, ischemic stroke and atrial fibrillation. All were responsible for septic shock and fatal coma. Surgical management of the infective endocarditis in the first hours of her admission could have improved her prognosis. To conclude, in addition to its interests and its clinical particularities, our present observation has highlighted major public health problems specific to our sub-Saharan African countries, namely: The problem of the double health burden, the problem of delays in seeking care, the problem of resistance to antibiotics and the problem of the insufficiency of reference health technical platforms.

关键词： Infective Endocarditis Rheumatic Heart Disease Cardiovascular Risk Factors Antibiotic Resistance Acute Lithiasis Cholecystitis Neurological Complications Delayed Consultation Senegal

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Impact of COVID-19 in the Hospital Activities of a Cardiology Department: Case of the General Hospital Idrissa Pouye in Dakar, Senegal in 2020

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Open Journal of Epidemiology 2022年第2期12卷 86-101页

作者： Pêngd-Wendé Habib Boussé Traore Jean Augustin Diégane Tine aliou alassane ngaide Joseph Salvador Mingou alassane Mbaye Bouna Diack Abdoul Kane Cardiology Department General Hospital Idrissa Pouye Dakar Senegal Institute of Health and Development Public Health Service Faculty of Medicine Pharmacy and Odontology Cheikh Anta Diop Uni-versity Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal

Introduction: In Senegal, at the end of 2020, there were a cumulative 18,728 confirmed cases of COVID-19 and 390 deaths. Patients with cardiovascular disease were the most affected by this morbidity and mortality. This is why we were given the objective of analyzing the effect of COVID-19 on the hospital activities of a cardiology service in Senegal. In this case that of the General Idrissa Pouye Hospital (HOGIP), by comparing admissions, deaths, average monthly length of stay and overall annual mortality of the service in 2020 with each of the four previous years. Methodology: This was a descriptive study from January 2016 to December 2020 by retrospective data collection. The collection ran from January 5, 2021 to March 30, 2021. Statistical analysis was performed with Rstudio 4.1.0 statistical analysis software. We expressed these variables as their absolute values and then we calculated the difference between the absolute value of 2020 and that of each of the previous years, both on a monthly and annual scale for each of the variables. Finally, we calculated the annual global mortality (each year from 2012 to 2020). Results: The total number of admissions in 2020 was significantly lower than in 2016 (-7.59%), 2017 (-8.78%) and 2018 (-2.16%). On the other hand, it was clearly higher than that of 2019 (+12.83%). A record in admissions was found during the month of December 2020 compared to 2016 (+64.70%), 2017 (+95.34%), 2018 (+127.02%) and 2019 (+127.02%). The average monthly length of stay in 2020 was less than or equal to those of 2016 (-7.62%), 2017 (-8.57%), 2018 (-3.03%) and 2019 (-0.00%). The total number of annual deaths in 2020 was significantly lower than in 2016 (-24.39%), 2017 (-27.06%), 2018 (-39.81%) and 2019 (-23.46%). Over the 5 years of our study, the year 2020 was the least lethal in service with an overall annual mortality of 9.79%. Conclusion: COVID-19 being a viral transmissible pathology with pulmonary tropism, its mortality is due to both re

关键词： Hospital COVID-19 Cardiology Senegal Impact

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