Cardiovascular Journal of Africa最新文献

Background: Prolonged Tp-Te interval is strongly associated with fatal ventricular arrhythmias and mortality. This association has been demonstrated in various diseases. However, the current literature does not give any information on Tp-Te interval in cardiac amyloid light-chain (AL) amyloidosis.

Methods: We retrospectively screened 116 cardiac AL amyloidosis patients and 35 patients were included in the study. Demographic, laboratory, 12-lead electrocardiographic (QTc, Tp-Te V1-V6) and transthoracic echocardiographic data of the patients were analysed and compared with 35 healthy controls.

Results: QTc and Tp-Te V2-V5 were significantly prolonged in the cardiac AL amyloidosis group (p < 0.05). Also, there was a positive and statistically significant correlation between the parameters of QTc and Tp-Te V3-V6, and also between the parameters of interventricular septum thickness at enddiastole and Tp-Te V2-V5.

Conclusion: We present the first strong evidence of prolonged Tp-Te intervals in patients with cardiac AL amyloidosis. There may also be a relationship between prolonged Tp-Te interval and the development of arrhythmia in this patient group, as in some other groups. There is a need for prospective studies examining the relationship of prolonged Tp-Te interval with arrhythmias and its prognostic significance in cardiac AL amyloidosis.

Objective: With the widespread administration of the BioNTech mRNA-based COVID-19 vaccine, there is a need to evaluate its potential effects on cardiovascular health, particularly its association with myocardial infarction (MI). This study aimed to investigate the relationship between BioNTech vaccination and MI, as well as its impact on clinical and angiographic parameters.

Methods: A retrospective analysis was conducted at the Eskisehir Osmangazi University, Eskisehir City Hospital, between April 2020 and May 2023 on a cohort of 1 151 patients hospitalised with MI. The patients were stratified into a BioNTech+ (vaccinated) and a BioNTech- (unvaccinated) groups. Medical records were reviewed for demographic information, clinical data and angiographic findings. Statistical analyses were performed, including logistic regression models adjusting for potential confounders.

Results: The BioNTech- group had a higher mean number of percutaneous transluminal coronary angioplasty procedures and stents compared to the BioNTech+ group. Haematological parameters and lipid profiles showed some discrepancies between the two groups. The BioNTech- group had higher white blood cell and platelet counts, while also exhibiting a higher mean low-density lipoprotein cholesterol level. The prevalence of co-morbidities and cardiovascular risk factors differed between the groups.

Conclusion: This study found associations between the BioNTech vaccination and clinical and angiographic parameters in patients with MI.

Introduction: The aim of this study was to investigate the effects of ellagic, vanillic and rosmarinic acid on reperfusion-related kidney damage, developed in an experimental lower-extremity ischaemia/reperfusion (I/R) model.

Methods: Forty-eight female Sprague-Dawley rats were divided into six groups. A median laparotomy and dissection were performed. In the I/R group, 60 minutes of ischaemia followed by 120 minutes of reperfusion was achieved. In addition one group was given 100 mg/kg ellagic acid, one group was given 12 mg/kg vanillic acid, one group was given 50 mg/kg rosmarinic acid and one group was given all three drugs 15 minutes before clamp removal. Bilateral kidney and blood samples were taken in all groups.

Results: Tubular epithelial degeneration, necrosis of the tubule epithelium and vessel wall thickening were significantly higher in the I/R group. Some parameters in the groups that were given drugs were found to be lower than in the I/R group and close to that of the control group. Total oxidant status (TOS) and oxidative stress index (OSI) were significantly higher and total antioxidant status (TAS) was significantly lower in the I/R group. Although not statistically significant in the groups given drugs, TAS was higher, and TOS and OSI were lower than in the I/R group.

Conclusion: The antioxidant effect of ellagic, vanillic and rosmarinic acid administration may have beneficial effects on renal damage after reperfusion in acute lower-extremity ischaemia. This study is expected to provide information for future clinical trials.

Objective: The growing incidence of diabetes and the increasing life expectancy of the diabetic population worldwide has increased the number of diabetic vascular complications occurring in cardiology practice. As current treatment and prevention methods are less effective in this patient group, there is a need for new treatment methods in this area. Exercise, which reduces metabolic and vascular problems associated with diabetes, often becomes impossible, especially in advanced-stage patients who need exercise the most. Since exercise and flow-mediated dilation (FMD) are effective by stimulating mechanotransduction mechanisms on the endothelium, it can be expected that the same mechanisms could also be stimulated by direct vibration.

Methods: In order to test this hypothesis, in this study, a group of 20 type 2 diabetes patients (11 males, age 56.80 ± 11.05 years and diagnosed for 15.35 ± 8.61 years) were examined via the application of FMD and vibration-mediated dilation (VMD). We performed vibration for five minutes with 20-Hz frequency and 3-mm vertical amplitude, to the same side forearm, with a 30-minute interval. Using a 10-MHz linear echo probe, brachial artery diameter and flow velocities were recorded for 10 minutes before and at two-minute intervals after the FMD and VMD applications. Then brachial artery flow and resistance were calculated at each stage.

Results: In the first minute after FMD and VMD applications, brachial artery diameter and flow velocities increased significantly, and vascular resistance decreased significantly. None of the corresponding FMD or VMD parameters in the first minute was different. The artery diameters in the first minute after FMD and VMD were increased by 6.04 ± 5.29 and 5.49 ± 5.21%, respectively. At the tenth minute, these values decreased to 1.73 ± 3.21 and 2.05 ± 3.31%. In the FMD series, all parameters except brachial artery diameter returned to their baseline values after the fourth minute. After VMD, all parameters also decreased after the first minute, but the recovery was much slower. At each stage after the first minute, the VMD averages were higher than the baseline value and their corresponding FMD values.

Conclusion: The results of this study indicated that vibration may be a powerful, long-lasting and feasible treatment option in patients with peripheral perfusion failure, developed due to diabetic macro- and microvascular complications.

Objective: The aim of this study was to describe the profile and outcomes of pregnancies in women with pulmonary hypertension in South Africa.

Methods: A retrospective study was undertaken at a state-subsidised hospital. Data were analysed using SPSS. Descriptive statistics were used to summarise categorical variables. Central tendency and dispersion of data were measured using means and standard deviations for normally distributed variables and medians and interquartile ranges for skewed variables. A p-value less than 0.05 was considered statistically significant.

Results: Of a cohort of 185 women, 86.3% had pulmonary hypertension secondary to left heart disease. The median age of the cohort was 28 years (interquartile range 23-33) with 37.8% being HIV infected and 59% having mild pulmonary hypertension. Frequencies of deaths, intensive care unit admissions and cardiac failure events increased with increasing severity of pulmonary hypertension (p < 0.001). Women with more severe pulmonary hypertension had higher rates of preterm births (p < 0.001).

Conclusion: Adverse pregnancy outcomes were concentrated in women with moderate-to-severe pulmonary hypertension.

Aim: The aim of this study was to explore the association between serum lipoprotein-associated phospholipase A₂ (Lp-PLA₂) level and acute coronary syndrome (ACS), and to analyse the correlations of Lp-PLA₂ concentration with high-sensitivity C-reactive protein (hs-CRP) level, body mass index (BMI), triglyceride (TG), troponin I (TNI), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels, and severity of coronary artery disease.

Methods: A total of 75 patients were divided into an unstable angina (UA) group (n = 54) and an acute myocardial infarction (AMI) group (n = 21). Another 72 subjects with normal coronary angiography results were selected as a control group. The levels of hs-CRP, TG, LDL-C, HDL-C and TNI were determined. Serum Lp-PLA₂ concentration was measured by enhanced immunoturbidimetry. The Gensini score was obtained based on coronary angiography results.

Results: The serum Lp-PLA₂ concentration significantly increased in the AMI and UA groups compared with that of the control group (p < 0.05). Compared with the UA group, the AMI group had significantly increased levels of hs-CRP and TNI and higher Gensini score (p < 0.05). The UA group had increased levels of hs-CRP and higher Gensini score compared with those of the control group (p < 0.05), while the two groups had similar TNI levels (p > 0.05). Using serum Lp-PLA₂ concentration as the dependent variable, and hs-CRP, TG, LDL-C, HDL-C, TNI and Gensini score as independent variables, the analysis results showed that Lp-PLA₂ concentration was positively correlated with BMI and hs-CRP, LDL-C and TNI levels.

Conclusions: There was a positive correlation between Lp-PLA₂ concentration and LDL-C level, therefore plasma LDL-C level should be controlled to prevent ACS.

Objective: Recent studies suggest that increased red blood cell distribution width may be associated with increased risk of atrial fibrillation. This study aimed to evaluate the relationship between pre-operative and postoperative erythrocyte distribution volume, postoperative atrial fibrillation and related adverse events in patients undergoing isolated coronary artery bypass surgery.

Methods: A total of 790 patients (611 males, mean age 58.3 ± 6.2 years) in pre-operative sinus rhythm, who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass at the same centre and by the same surgical team between January 2015 and December 2021, were enrolled retrospectively. Two groups were created, group 1 (n = 183) and group 2 (n = 607), with regard to the occurrence of atrial fibrillation in the early postoperative period or not, respectively. Clinical and demographic data, biochemical and complete blood count parameters, and intra-operative and postoperative data of the patients were recorded. Univariate and subsequent multivariate logistic regression analysis was done to determine significant clinical factors and independent predictors of postoperative atrial fibrillation.

Results: Among the patients, 182 (23.2%) developed atrial fibrillation during the 72 hours postoperatively. Pre-operative and postoperative first-, third- and seventh-day red blood cell distribution volume (p = 0.0001), C-reactive protein (p = 0.0001) and erythrocyte sedimentation rate (p = 0.0001) were significantly increased in group 1. Multivariate logistic regression analysis showed elevated pre-operative and postoperative first-, thirdand seventh-day red blood cell distribution volume, erythrocyte sedimentation rate and C-reactive protein as independent predictors of early postoperative atrial fibrillation.

Conclusions: Pre-operative and postoperative red blood cell distribution volume was found to be an independent predictor of atrial fibrillation and associated adverse events in the early postoperative period of isolated coronary artery bypass grafting.

Background: Heart disease remains a leading cause of morbidity and mortality, particularly in low- and middle-income countries. Access to diagnostic modalities is limited in these settings. Limited echocardiographic studies performed by non-cardiologists can increase access, improve diagnosis and allow for earlier medical therapy.

Methods: Two internal medicine residents at a tertiary-level hospital in Ghana were trained to perform limited echocardiographic studies. Each trainee performed 50 echocardiograms and interpreted 20 studies across three predetermined timepoints. Interpretation was compared to expert interpretation.

Results: Agreement improved over time. At the final evaluation, there was high agreement across all aspects: left ventricular structure (70%, kappa 0.52, p = 0.01), left ventricular function (80%, kappa 0.65, p = 0.004), right ventricular structure (90%, kappa 0.71, p = 0.002), right ventricular function (100%, kappa 1.00, p < 0.001), and presence of effusion (100%, kappa 1.00, p < 0.001).

Conclusions: Non-cardiologists can be trained in focused echocardiography using handheld machines. Such training can increase access to diagnostic capabilities in resource-limited settings.

Malposition of a catheter is found in approximately 7% of cases after central venous catheterisation. This may result in haemorrhage, venous thrombosis and functional impairment, depending on the injury to the vessel wall. Uncomplicated catheterisation, easy aspiration of blood and monitoring of catheterisation do not guarantee correct placement of the catheter. In our rare case series, we share our experience of four cases of malposition into the left internal mammary vein (LIMV) that we experienced in a three-year period. The thinness and fragility of the vessel wall, particularly, increases the probability of complications in malposition into the LIMV. Administration of a catheter through the right jugular vein is associated with the lowest incidence of malposition. Performing the procedure under the guidance of ultrasonography (USG) and confirmation of the catheter position after puncture using one of the USG techniques will minimise the probability of malposition. In addition, a lung X-ray should immediately be taken, and venography and fluoroscopy should be considered in the presence of suspicion.