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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

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

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

Coronary Angioplasty in a Low Income Sub-Saharan Country: Situational Analysis

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World Journal of Cardiovascular Diseases 2018年第12期8卷 539-544页

作者： Mouhamed Cherif Mboup Djibril Marie Ba Modou Jobe Massamba Thiam khadidiatou dia Pape diadie Fall Hopital Principal de Dakar Dakar Senegal Military Hospital of Ouakam Dakar Senegal Clinique Du Golf Dakar Senegal

Introduction: Coronary angioplasty is not widely conducted in sub-Saharan Africa in general and Senegal in particular. The objective of this work was to describe the indications, techniques, results and difficulties of coronary angioplasty in Senegal. Patients and Methods: We prospectively included all patients who underwent coronary angioplasty between July 2012 and November 2014. We evaluated the clinical characteristics, techniques used, and the peri-procedural complications. Results: 110 coronary angioplasties were performed at the cardiac catheterisation unit of the Clinique du Golf in Dakar. The average age of patients was 60.41 ± 10.93 years. A male predominance was noted with a sex ratio of 6.3. Hypertension was found in 57% of patients. The principal indications for coronary angioplasty were for the management of acute coronary syndromes with or without ST elevation, in 29 and 39 patients respectively. The femoral artery was the puncture site in 104 patients. The lesions treated were type A/B1 or B2/C in 53 and 57 cases respectively. The success rates of coronary angioplasties and 30-day mortality were 91% and 0.9% respectively. Conclusion: In sub-Saharan Africa, Senegal in particular, the practice of coronary angioplasty is low. Indeed, many factors linked to socioeconomic status limit the development of coronary angioplasty in Senegal.

关键词： Coronary Angioplasty Acute Coronary Syndrome Interventional Cardiology

Double Compression of Left Atrium and Pulmonary Artery by a Huge Descending Aortic Aneurysm with Intramural Hematoma Mimicking Pulmonary Embolism: A Case Report

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World Journal of Cardiovascular Diseases 2019年第6期9卷 419-424页

作者： Djibril Marie BA Aminata diack Alain Affangla khadidiatou dia Mouhamed Cherif Mboup Mouhamed Leye Abdoul Kane Unit of Training and Research in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Cheikh Anta Diop University Dakar Senegal

Hemodynamic instability secondary to left atrial (LA) compression by an aortic aneurysm is a rare entity. We report?the case of a 43-year old woman with no previous diagnosis of congestive heart failure who was admitted for an initial diagnosis of pulmonary embolism (PE) based on shortness of breath, hypotension and D-Dimers?elevation. The electrocardiogram and blood counts were within normal limits. The chest X-ray revealed widening of the mediastinum. Transthoracic echocardiography demonstrated LA compression by a large descending thoracic aortic aneurysm. Left and right ventricle systolic functions were preserved. Chest angiography showed LA and left pulmonary artery (LPA) compression by a descending aortic aneurysm and an intramural hematoma with no evidence of PE evidence. Emergency surgery could not be done because of her financial status. She was treated medically and was discharged 1?week later with significant improvement. However she remained hypotensive.

关键词： Aortic Aneurysm Left Atrium Compression Pulmonary Artery Compression Intramural Hematoma Echocardiography

Conservative Approach Might Be the Strategy by Default in Stable Angina Patients: A Case Report

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World Journal of Cardiovascular Diseases 2020年第11期10卷 769-774页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Djibril Marie Ba khadidiatou dia Mouhamed Chérif Mboup Pape diadie Fall Department of Cardiology Hospital Principal Dakar Dakar Senegal

Management of stable angina is still a matter of debate. Whether a conservative or invasive approach is better remains unclear. Even though recent large-scale randomized trials depict the conservative strategy as safe and efficient. In this report, we present a case of a 53-year-old male patient with cardiovascular risk factors of hypertension and hypercholesterolemia. He complained about typical chest pain at exertion. The coronary angiogram (CA) revealed severe stenosis of the proximal left anterior descending artery (LAD) ostium. After heart team discussion, coronary artery bypass graft (CABG) was advocated. However, due to a lack of means, the CABG was postponed. Meanwhile, he was managed with guideline-based medical therapy. In addition, he exercised regularly and adopted a healthy diet. Evolution was favorable with excellent symptoms control. A regular follow-up was organized with his cardiologist. A new CA before an eventual CABG six years later showed a significant plaque volume regression of the proximal LAD. We decided to continue conservative management. The stress echocardiogram to assess symptoms and exercise tolerance was normal. Our patient was sent to surgery on top of optimal medical therapy even though angioplasty was a good indication and was feasible. However, while he was struggling to afford the CABG procedure, he adopted a very healthy lifestyle along with medical therapy. Six years later, the result of that approach was without appeal, suggesting and reinforcing the conservative management

关键词： Stable Angina Chronic Coronary Syndrome Conservative Treatment Case Report

Late diagnosis of Takayasu Disease in a 50-Year-Old African Black Woman with Repeated Episodes of Heart Failure: Seeing the Forest through the Trees—A Case Report

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World Journal of Cardiovascular Diseases 2020年第10期10卷 683-697页

作者： Djibril Marie BA Aminata diack Alain Affangla Serigne Cheikh Tidiane Ndao Madjiguene KA khadidiatou dia Mouhamed Cherif Mboup Mouhamed Leye Unit of Research and Training in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal

Background: First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure. Case Presentation: Here, we present the case of a 50-year sub-saharan female suffering from acute heart failure related to TAK. Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure. Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations. Conclusion: Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.

关键词： Takayasu Heart Failure Corticotherapy Pulseless Syndrome Sub-Saharan Black Female Case Report