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Comparison of the Performance of Three Commonly Used Electrocardiographic Indexes for the Diagnosis of Left Ventricular Hypertrophy in Black Hypertensive Patients with Reduced Kidney function managed at a Tertiary Healthcare Hospital: A Post-Hoc Analysis

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World Journal of Cardiovascular Diseases 2017年第4期7卷 105-118页

作者： f.B.Lepira C.m.B.mpembe f.I.N.mbutiwi J.R.makulo P.K.Kayembe f.m.kajingulu E.V.Kintoki J.R.m’buyamba-Kabangu Division of Nephrology University Hospital of KinshasaDemocratic Republic of the Congo Division of Cardiology University of Kinshasa HospitalDemocratic Republic of the Congo Division of Epidemiology and Biostatistics University of KikwitDemocratic Republic of the Congo Division of Epidemiology and Biostatistics Kinshasa School of Public HealthDemocratic Republic of the Congo

Background: Reduced kidney function in blacks is associated with an increased frequency of left ventricular hypertrophy. Given the unavailability of echocardiography in most developing countries, the diagnostic performance of current ECG indexes needs to be evaluated. Objective: To compare the diagnostic performance of 3 commonly used ECG indexes (Sokolow-Lyon, Cornell voltage and Cornell product) in black hypertensive patients. methods: Electrocardiography and echocardiography estimated left ventricular mass of 155 consecutive hypertensive patients who participated from January 2012 to January 2013 to an echocardiographic cross-sectional study of left ventricular structure was analyzed to compare Cornell voltage and Cornell product indexes with Sokolow-Lyon voltage index as a reference. Reduced kidney function was defined as eGfR 2. ROC curves in relation to LVH diagnosis were used to estimate the sensitivities and specificities of each index. P Results: The sensitivity and specificity were 43% and 85%, 23% and 77% and 26% and 77% for Sokolow-Lyon, Cornell voltage and Cornell product indexes, respectively. However, Sokolow-Lyon index (AUC;95% CI: 0.64;0.50 - 0.78) showed better performance than Cornell voltage (0.42;0.25 - 0.59) and Cornell product (0.43;0.28 - 0.59). Sokolow-Lyon index cut-point ≥ 37 mm corresponded to the highest Youden index (39.4% of sensitivity and 92.3% of specificity). Conclusion: Although the overall performance of the 3 ECG indexes versus echocardiography was low, Sokolow-Lyon index performed better than the two other indexes in diagnosing LVH.

关键词： Performance ECG Indexes Reduced Kidney function Black Africans

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The Atherogenic Dyslipidemia Ratio Log (Tg)/Hdl-C Was Not Associated with Urinary Albumin Excretion Rate (Uaer) and Increased Cardiovascular Risk in Black Patients with Type 2 Diabetes

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World Journal of Cardiovascular Diseases 2016年第1期6卷 14-20页

作者： m. f. kajingulu B. f. Lepira I. N. f. mbutiwi J. R. R. makulo E. Bieleli m. N. Nseka Division of Nephrology University of Kinshasa Democratic Republic of Congo faculty of medicine University of Kikwit Democratic Republic of Congo Division of Diabetes and metabolic Diseases University of Kinshasa Hospital University of Kinshasa Democratic Republic of Congo

Objective: The objective is to assess the relationship of Log (TG)/HDL-c as surrogate estimate of atherogenic dyslipidemia with urinary albumin excretion rate and cardiovascular risk among black patients with type 2 diabetes. Patients and methods: A post-hoc analysis of data from 181 type 2 diabetes patients enrolled in a cross-sectional study of urinary albumin excretion rate seen at a tertiary healthcare. microalbuminuria and macroalbuminuria were defined as ACR 30 - 299.9 mg/g and ACR ≥ 300 mg/g, respectively. Quartiles of Log (TG)/HDL-c were used as surrogate estimates of atherogenic dyslipidemia. Cardiovascular risk was assessed using WHO chart for estimation of CV risk in low and middle income countries. Comparisons across Log (TG)/HDL-c quartiles were performed using one way ANOVA and Chi square for trend as appropriate. P fined the level of statistical significance. Results: A high prevalence (69%) of atherogenic dyslipidemia (AD) was observed in the present case series of Black Africans with type 2 diabetes. Average total cholesterol levels showed significant (p = 0.010) trends towards lower values across quartiles of Log (TG)/ HDL-c. No significant trends were observed for average UAER and cardiovascular risk across quartiles of Log (TG)/HDL-c. Conclusion: Log (TG)/HDL-c as a surrogate estimate of atherogenic failed to predict cardiovascular risk in the present case series of black patients with type 2 diabetes.

关键词： Log (TG)/HDL-C Cardiovascular Risk Type 2 Diabetes Black Africans

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Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa,the Democratic Republic of the Congo

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World Journal of Cardiovascular Diseases 2019年第9期9卷 665-680页

作者： Josée K.Tshituta francois B.Lepira francois P.kajingulu Jean Robert R.makulo Ernest K.Sumaili Pierre Z.Akilimali Aliocha N.Nkodila freddy m.mbuyi Angele I.masewu Stephane mutombo Eric B.Amisi Jean Pierre m.Ilunga Wilfrid B.mbombo Patrick m.mukuna Adolphe m.Kilembe Department of Anesthesiology and Reanimation University of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo Division of Nephrology Department of Internal MedicineUniversity of Kinshasa HospitalKinshasaThe Democratic Republic of the Congo Department of Epidemiology&Biostatistics Kinshasa School of Public HealthUniversity of Kinshasa School of MedicineKinshasaThe Democratic Republic of the Congo Centre medical cite des Aveugles KinshasaThe Democratic Republic of the Congo

BACKGROUND AND AIm: Although admission hyperglycemia has been reported to be associated with unfavorable outcomes in acute stroke, little is known about this association in sub-Saharan Africa. Therefore, the aim of the present study was to assess the prognostic significance of admission hyperglycemia in the acute phase of stroke in Congolese patients. mETHODS: In a multicenter prospective cohort study, consecutive patients with acute stroke were examined in 5 Emergency Rooms or Intensive Care Units of Kinshasa between July 15th, 2017 and march 15th, 2018. The severity of stroke was assessed at admission using the Glasgow Coma Scale. Stress hyperglycemia was defined as random blood glucose levels at admission > 140 mg/dL in patients without known type 2 diabetes mellitus (T2Dm). The endpoint was 10-day all-cause in-hospital mortality. Survival (time-to-death) curves were built using the Kaplan meier methods. Cox proportional analysis was used to identify predictors of 10-day all-cause in-hospital mortality. The predictive performance of blood glucose level to predict 10-day all-cause in-hospital mortality was assessed using ROC curve analysis. RESULTS: Out of 194 patients (mean age 58.7 ± 13.1 years;64% males, 74.7% light to moderate stroke severity;63.4% ischemic stroke) enrolled, 106 (54.6%) had admission hyperglycemia with 77 (72.6%) having stress hyperglycemia. Ninety four deaths (48.5%);mortality rate of 6 deaths per 100 person-days (95%CI 2.7 - 9.3) occurred during a median follow up time 6 (5 - 7) days equivalent to 1542 person-days. Independent predictors of 10-day all-cause in-hospital mortality were admission hyperglycemia regardless of diabetes status (aHR 3.77;95%CI 1.92 - 7.42;p f mechanical ventilation (aHR 1.97;95%CI 1.05 - 3.70;p = 0.034). Blood glucose concentrations (AUC 0.743;95%CI 0.672 - 0.814) had a better predictive performance for 10-day all-cause in-hospital mortality with an optimal value of 154 m

关键词： Admission Hyperglycemia Stroke Prognostic Significance Black Africans

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