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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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Thrombolysis in Pulmonary Embolia at the Cardiology Department of Aristide le Dantec Cardiology Department

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World Journal of Cardiovascular Diseases 2024年第9期14卷 521-538页

作者： Joseph Salvador Mingou Marguerite Téning Diouf fatou aw Simon Antoine Sarr Khadim Rassoul Diop Malick Bodian Mouhamadou Bamba Ndiaye Maboury Diao Abdoul Kane Cardiology Department Aristide le Dantec Hospital Dakar Senegal Cardiology Department Dalal Jam Hospital Dakar Senegal

Introduction: Venous thromboembolic disease is the 3rd most common cardiovascular pathology. Acute pulmonary embolism constitutes its most serious presentation and a major cause of mortality, morbidity and hospitalization in Africa and Senegal. The objectives of this work were to study the epidemiological profile of pulmonary embolisms and to evaluate the practice of thrombolysis in patients in a cardiological setting. Methodology: A retrospective, descriptive study was carried out in the Cardiology department of the Aristide le Dantec Hospital (HALD) over the period from August 2011 to December 2019 in patients hospitalized in the cardiology department for pulmonary embolism confirmed by CT angiography and/or with thrombi on cardiac ultrasound and who had also benefited from thrombolysis. Results: Thirty-one patients with pulmonary embolism were thrombolyzed. There was a predominance of the female gender with an average age of 45.97 years. Risk factors were dominated by age (61.29%) followed by obesity (32.26%) and prolonged immobilization (22.5%). The functional signs were dominated by dyspnea (77.42%) followed by chest pain (51.62%) and cough (35.48%). The physical signs were dominated by right heart failure in 22.5% of cases, pulmonary condensation syndrome in 19.35%, and inflammatory large leg in 12.9% of cases. Echocardiography and chest CT angiography were the means of diagnosis. Nine of our patients presented with an intracardiac mass. Thrombotic treatment was administered in all patients. The average length of hospitalization was 12.32 days and in-hospital mortality was 32.26%. Conclusion: Pulmonary embolism does exist in our regions and is responsible for heavy mortality. Rapid and efficient support is essential. Prevention remains the corner-stone in the fight against this pathology.

关键词： Pulmonary Embolism Thrombolysis Senegal

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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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Ankle-Brachial Index in Systemic Lupus Erythematosus:A Senegalese Case-Control Study

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World Journal of Cardiovascular Diseases 2019年第12期9卷 958-968页

作者： Baidy Sy Kane Maimouna Sow fatou aw Abdourahmane Samba Ahmed Tall Lemrabott awa Cheikh Ndao Souhaibou Ndongo Mouhamadou Bamba Ndiaye Maboury Diao Abdoulaye Pouye Department of Internal Medicine Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Department of Cardiology Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Biochemistry Laboratory Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Department of Nephrology Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal

Systemic lupus erythematosus (SLE) is associated with accelerated atherosclerosis and increasing cardiovascular risk which is recognized as a major cause of morbidity and death. Whether subclinical atherosclerosis has been evaluated by several methods, there are very limited data about Ankle-Brachial Index (ABI) in patients with systemic lupus erythematosus. The aim of the present study was to compare this index, between SLE patients and controls. We conducted a case-control study in the Department of Internal Medicine of our institution during the period from August 1, 2017 to December 31, 2018. We included 100 subjects, including 50 SLE patients and 50 control cases. This included 44 women and 6 men in patients with an identical distribution in controls. The mean age was 33.5 ± 11.3 years for cases and 33.3 ± 11.3 years (p-value: 0.93) for controls subjects. There was higher frequency of cardiovascular risk factors such as dyslipidemia (p-value at 0.009), low level of serum HDL-cholesterol (p-value??0.001), hypertriglyceridemia (p-value at 0.000) and hyperuricemia (p-value at 0.000) in patients with SLE. Overweight/obesity was higher in controls subjects (p-value at 0.028). There was no statistically significant difference in the frequency of diabetes-mellitus, smoking and high blood pressure. The abnormally ABI was recorded in 19 patients with SLE (38%) and 8 controls (16%) with a p-value: 0.01 and odds ratio: 3.22. Eight patients (16%) and four controls (8%) had low ABI without significant difference (p-value: 0.11 but odds-ratio at 2.98). Eleven patients with SLE (22%) and five controls (10%) had high ABI (p-value: 0.05 and odds-ratio: 3.24). In patients with SLE only disease activity (cSLEDAI) at the inclusion of the study was correlated?to abnormal ABI.?Conclusion:?This study showed an increasing prevalence of abnormal ABI in black African patients with SLE compared to controls with a correlation between disease activity and abnormal ABI.

关键词： Systemic Lupus Erythematosus Subclinical Atherosclerosis Peripheral Arterial Disease Ankle-Brachial Index Africa South of the Sahara

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Performance of Cardiovascular Risk Equations versus Vascular Ultrasound in Systemic Lupus Erythematosus in a Black African Population

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World Journal of Cardiovascular Diseases 2021年第11期11卷 523-532页

作者： Sow Maïmouna Kane Baïdy Sy Diouf Marguerite Téning aw fatou Ndao awa Cheikh Samba Abdourahmane Ndiaye Mouhamadou Bamba Ndongo Souhaibou Diao Maboury Pouye Abdoulaye Internal Medecine Department of Aristide Le Dantec Teaching Hospital of Dakar Senegal Cardiology Department of Aristide Le Dantec Teaching Hospital of Dakar Senegal Biochemial Department of Aristide Le Dantec Teaching Hospital of Dakar Senegal Internal Medecine Department of Dalal Jamm Hospital of Dakar Senegal

Introduction: Cardiovascular risk is increased in systemic lupus erythematosus. Cardiovascular events are the first cause of death in lupus after five years duration. Prevention of cardiovascular events needs a good evaluation of the risk. In this work, we tried to evaluate the performance of conventional and adjusted forms of cardiovascular risk equations to predict high risk in lupus patients, in comparison with carotid ultrasound. Method: We realized a cross-sectional study during the period from 24 August 2017 to 22 November 2018. Consenting patient meeting the 1997 American college of Rheumatology criteria of systemic lupus erythematosus were recruited. The clinical characteristics and the treatment data were informed. Traditional cardiovascular risk factors were also investigated, and the assessment of cardiovascular risk was performed by Framingham and SCORE equations and their modified forms (multiplication by a factor of 1.5). Carotid ultrasound was used to detect atherosclerosis by measuring intima media thickness and searching for carotid plaques. In last, we compared cardiovascular risk levels by equations to results of carotid ultrasound. Statistical analysis and data collection were performed using SPSS 23.0 software. Results: Forty-nine patients with a sex ratio of 0.13 and a mean age of 33.5 (±11.3) years were enrolled. More than half of patients had dyslipidemia. More than 80% of the population were at lo

关键词： Cardiovascular Risk Equations Carotid Ultrasound Systemic Lupus Erythematosus

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Study of the Right Heart of High-Level African Adult Athletes: Electrocardiographic and Echocardiographic Aspects

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World Journal of Cardiovascular Diseases 2018年第7期8卷 360-369页

作者： Simon Antoine Sarr Joseph Salvador Mingou Hamidy Hassal Mhoussine fatou aw Malick Bodian Mouhamadou Bamba Ndiaye Alassane Mbaye Adama Kane Maboury Diao Abdoul Kane Serigne Abdou Ba 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

Despite the growing interest in athlete’s right ventricle and various work carried out, many uncertainties are remaining. The interest of this work resides in the determination of the particularity in right heart of the black athlete subject. We conducted a prospective study from August to October 2016 in the cardiology department of Aristide Le Dantec University Hospital in Dakar. The included patients were divided according to the sporting practice as enduring, resistant and non-athletes. The parameters studied were electrocardiographic (atrial or ventricular hypertrophies), echocardiographic: dimensions of the right cavities, systolic and diastolic functions of the right ventricle. We included 58 subjects: 38 athletes including 28 endurance and 10 resistance and 20 non-athletes. The average age of the endurance athletes was 21.9 ± 3, 75 years, 26.30 ± 4.64 in resistance ones and 24.10 ± 1.89 in the non-athletic group. Two cases of first-degree atrioventricular block were recorded in athletes. On the echocardiographic point, the atrium surfaces, as well as the transverse diameter, were greater in athletes, especially in the endurance group. The mean diameters of the admission chamber and those of the right ventricular flush chamber were larger in the group of endurance athletes. It was the same for the annular and sagittal basal mean diameters of the RV as well as the RV/LV ratio. The anterior wall of the right ventricle was larger in athletes compared to non-athletes. The vena cava was greater in athletes, the pulmonary arterial pressure higher in resistance ones.

关键词： Right Ventricle Black African Athletes Dilation Endurance

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Cardiac MRI: Luxury or Necessity, beyond the Electrocardiogram and Biology in the Management of Acute Coronary Syndrome in Young Patients? About 2 Cases Reports in Sub-Saharan Environment

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World Journal of Cardiovascular Diseases 2018年第2期8卷 102-110页

作者： Simon Antoine Sarr Kana Babaka fatou aw Malick Bodian Joseph Mingou Mouhamadou Bamba Ndiaye Mor Beye Amalia Owona Babacar Mbengue Adama Kane Maboury Diao Serigne Abdou Ba Cardiology Department Teaching Hospital Aristide Le Dantec Dakar Sénégal Radiology Department Hospital Principal Dakar Sénégal

Introduction: Precordial pain is a common reason for admission in cardiology, and has many causes. Acute myocarditis in its pseudo-infarctoid form is sometimes difficult to differentiate from myocardial infarction. Cardiac magnetic resonance imaging (MRI) helps to differentiate these two disease entities. We report the respective cases of two young patients, one presenting with myocarditis whilst the other with myocardial infarction. Case Report: We present the cases of two patients. The first who had a recent history of febrile syndrome is a 23-year-old who stopped smoking 3 months prior to presentation whilst the second is a 22-year-old professional footballer with a history of stress with no other cardiovascular risk factors. They were respectively admitted in our emergency department for a constrictive, intense chest pain. Physical examination was normal. The chest pain in both patients was associated with elevated cardiac markers, primary repolarisation abnormalities on ECG, wall motion abnormalities as well as left ventricular systolic dysfunction on transthoracic echocardiography. Coronary angiograms were normal in both patients. In the first patient, MRI concluded with an acute myocarditis with apical akinesia extending to the anterior wall, a T2 hypersignal indicative of myocardial edema, and uptake of a nodular heterogeneous contrast without affecting the sub-endocardial layers on the late enhancement sequences. In the second patient, MRI showed an appearance consistent with acute extensive infarction in the antero-apical region with severe hypokinesia and late quasi-transmural enhancement, impairment of the anterior papillary muscle of the mitral valve and a reduced left ventricular ejection fraction at 33%. In addition to analgesics, the first patient was treated with perindopril and bisoprolol, and the second patient received antithrombotic and anticoagulant treatment. There was clinical improvement in both patients. Conclusion: Cardiac MRI is a useful

关键词： MRI Myocardial Infarction Myocarditis Young Patient

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Clinical Management and Long-Term Follow-Up of Patients with Peripartum Cardiomyopathy: A Prospective Registry Study

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Open Journal of Epidemiology 2023年第3期13卷 167-177页

作者： fatou aw Simon Antoine Sarr Joseph Salvador Mingou Mohamed M. C. B. O. Leye Malick Bodian Mouhammadou Bamba Ndiaye Abdoul Kane Maboury Diao Adama Faye Department of Cardiology University Hospital Center Aristide Le Dantec Dakar Senegal Medical Department Cheikh Anta Diop University Dakar Senegal Training and Research in Health Sciences Unit University of Thies Thies Senegal Institute of Health and Development Department of Public Health and Research Support (CHU Fann) Dakar Senegal

Introduction: Peripartum cardiomyopathy (PPCM) is a rare pathology in Western countries but is common in Africa. Its progression is highly variable, left ventricular function improves in almost one-third to one-half of patients. In sub-Saharan Africa, there are few prospective cohort studies. We aimed to describe the long-term evolutionary aspects of this pathology in a sub-Saharan African country, so we developed a PPCM registry;here, we present the first results after 2 years of follow-up. Methodology: This work was performed at the cardiology clinic of the Aristide Le Dantec Teaching Hospital of Dakar from January 01, 2017, to January 01, 2021, for a total duration of 4 years. This was an observational, longitudinal prospective study including patients admitted for peripartum cardiomyopathy. Results: During our study, 5372 patients were admitted to the cardiology clinic. Considering the inclusion criteria, 79 patients were consecutively recruited. The mean age was 30.5 ± 6.7 years, ranging from 18 to 42 years. Half of the patients came from rural areas (56.3%), and 78.2% of patients had a low socioeconomic status. Multiparity and twin pregnancies were noted in 72.8% and 20% of the patients, respectively. A total of 91% of patients had advanced NYHA stage 4 heart failure, and 3 patients had cardiogenic shock. Left ventricular dilatation was found in 52 patients, and severe left ventricular systolic dysfunction was found in 50 patients (90.9%). During hospitalization, 19 patients (34.5%) had complications. The evolution in the hospital was favourable in 45 patients (81.8%). The global mortality rate was 7.3% at 2 years. In multivariate analysis, fewer patients with a dilated left ventricle, a severe alteration of the LVEF and an advanced age progressed towards remission. Conclusion: The long-term evolution of PPCM is very variable. Despite a good rate of remission, progression to end-stage heart failure and death is not negligible in cases of advanced maternal age

关键词： Peripartum Cardiomyopathy Pregnancy Cardiovascular Disease Senegal

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