scholarly journals Risk factors and prevalence of dilated cardiomyopathy in Sub Sahara Africa: a systematic review article (Preprint)

2020 ◽  
Author(s):  
Linda Van Laake ◽  
Lulu Said Fundikira ◽  
Pilly Chillo ◽  
David G Paulo ◽  
Reuben Kato Mutagaywa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Preventive Measures ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reference Manager ◽  
Sub Saharan

BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to 5.9 of 100,000 of estimated mortality of the global population although underdiagnosis is significant. In sub Saharan Africa, studies show that cardiomyopathy constitutes 21.4% of cases with heart failure and comes second only to hypertensive heart disease. However, there is paucity of data in the region regarding the different types of cardiomyopathies. It has been noted that presence of non-modifiable cardiovascular risk factors such as family history, age, ethnicity, gender as well as modifiable risk factors such as hypertension, diabetes, tobacco use, physical inactivity, poor nutrition, excessive alcohol consumption, high cholesterol and obesity increase the probability of developing cardiovascular disease. OBJECTIVE The review will focus on available literature in sub- Saharan Africa on prevalence of dilated cardiomyopathy (DCM) and associated risk factors in patients with DCM. It will identify gaps in knowledge regarding DCM and establish a foundation for preventive measures through reduction of the risk factors. This will be the first review that focuses solely on DCM while updating available data from previous reviews on cardiomyopathies in sub Saharan Africa. METHODS The review will consider all studies, qualitative and quantitative, which involve patients with a diagnosis of dilated cardiomyopathy as well as risk factors encountered in such patients in sub Saharan Africa. Both hospital based and community based studies will be included. Indexed articles in Medline and Embase will be searched. Full copies of articles identified by the search, and considered to meet the inclusion criteria, based on their title, abstract and subject descriptors, will be obtained for data synthesis. Bibliographic searches will also be considered for data collection based on their titles. The collected data will be organized in Mendeley reference manager and later on uploaded to Rayyan web application for systematic reviews articles to allow adequate sorting. Two reviewers will independently select articles against the inclusion criteria. Discrepancies in reviewer selections will be resolved by a third author (arbitrator) prior to selected articles being retrieved. RESULTS Interventions to be documented will include those related to screening and control of risk factors that may lead to DCM, and presence of assessment strategies in patients suspected with DCM. The primary outcome will be the number of cases with different etiologies of DCM. Secondary outcomes will be the number of hospitalizations, mortality due to heart failure, incidence of sudden cardiac death, proportion of participants on heart failure medications, proportion of participants with implantable cardioverter defibrillator placements, number of cases with left ventricular assist device and number of heart transplants in patients with DCM. CONCLUSIONS The review will give an update on the status of DCM in sub Sahara Africa and identify gaps that need to be addressed in order to improve preventive measures as well as management of this condition.

Abstract 65: Anemia-related Heart Failure in Sub-saharan African Sickle Cell Disease Patients

2017 ◽  
Vol 121 (suppl_1) ◽  
Author(s):  
Adebayo C Atanda ◽  
Yahya Aliyu ◽  
Oluwafunmilayo Atanda ◽  
Aliyu Babadoko ◽  
Aisha Suleiman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Hemoglobin Level ◽  
Sub Saharan Africa ◽  
Cell Disease ◽  
Jet Velocity ◽  
Sub Saharan

Introduction: Anemia has been implicated in heart failure. Existing literatures, involving predominantly African-Americans, suggests that Sickle Cell Disease (SCD) maybe linked to various cardiovascular complications including pulmonary hypertension and left venticular dysfunction. Peculiarly, our study involves exclusively Sub-Saharan population. Method: We conducted a cross sectional observational study of 208 hydroxyurea-naive consecutive SCD patients aged 10-52 years at steady state and 94 healthy non-matched controls who were studied in an out patient clinic in Sub-Saharan Africa. SCD patients were required to have electrophoretic or liquid chromatography documentation of major sickling phenotypes. Control group was required to have non-sickling phenotypes. Cardiac measurements were performed with TransThoracic Echo according to American Society of Echocardiography guidelines. Hemoglobin level was also obtained. Results: Hemoglobin level in SCD group (8.5+/- 1.5) was significant (P<0.001) compared to control (13.8+/- 1.7). Although SCD group had significantly higher values of left ventricular (LV) size, there was no qualitative evidence of LV dysfunction. SCD group had higher values of Ejection Fraction but not statistically significant. There was no evidence of LV wall stiffening to impair proper filling in SCD group, with the ratio of early to late ventricular filling velocities, E/A ratio elevated (1.7+/-0.4 compared to 1.6+/- 0.4; P=0.010). Right ventricular systolic pressure was determined using the formula of 4x Tricuspid Reugurgitant jet (TRV) square as an indirect measurement of Pulmonary arterial systolic pressure. SCD patients had significantly higher mean±SD values for tricuspid regurgitant jet velocity than did the controls (2.1±0.6 vs. 1.8±0.5; p= 0.001). Within the SCD group, there was no clear pattern of worsening diastolic function with increased TRV. Furthermore, E/A had a significant positive relationship with jet velocity in bivariate analysis (R=0.20; P=0.013). Conclusions: We were unable to demonstrate existence of anemia-associated left ventricular dysfunction in Sub-Saharan African with SCD. Further studies is required to highlight the reason behind this finding.

scholarly journals Analysis of Risk Factors for Acute Heart Failure in Patients with Dilated Cardiomyopathy and Persistent Severe Functional Mitral Regurgitation Despite Cardiac Resynchronization Therapy

2020 ◽  
pp. 35-39
Author(s):  
R. V. Buriak ◽  
K. V. Rudenko ◽  
O. A. Krykunov
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mitral Regurgitation ◽  
Cardiac Resynchronization Therapy ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Functional Mitral Regurgitation ◽  
Reverse Remodeling ◽  
Resynchronization Therapy

Congestive heart failure resulting from non-ischemic dilated cardiomyopathy (DCM) with secondary functional mitral regurgitation (FMR) is associated with poor prognosis. Medical treatment results in a 1-year survival of 52% to 87% and a 5-year survival of 22% to 54%, with highest survivals observed in more recent years, probably reflecting improvements in medical therapy. Non-surgical interventions involve cardiac resynchronization therapy. In addition to medical treatment, cardiac resynchronization therapy (CRT) should be considered in patients with New York Heart Association (NYHA) class II– IV HF, left ventricular ejection fraction (LVEF) =35%, normal sinus rhythm and left bundle branch block with QRS >150 ms. In these patients, CRT can also facilitate left ventricular (LV) reverse remodeling and reduce associated FMR. The aim of this study was to investigate the features of symptomatology and to analyze the risk factors for acute heart failure (AHF) in patients with DCM and persistent severe functional mitral regurgitation despite CRT and optimal guideline-directed medical therapy (GDMT). Materials and methods. After providing informed consent, 144 patients with severe FMR were involved in the study. Concomitant tricuspid valve regurgitation was registered in 142 (98.6%) cases. The median LVEF was 27.0 (23.0-31.6)%. 40 (27.8%) patients had a permanent form of atrial fibrillation, and 24 (16.7%) patients had a first-degree atrioventricular node block. The median NT-proBNP was 2600 (2133-3200) pg/ml, indicating the presence of severe chronic heart failure. Results. The median term after CRT device implantation was 36 (3.5-60) months. A comparative analysis between DCM patients with and without CRT revealed statistically significant differences between clinical characteristics, namely: age (p=0.020), lower heart rate (p=0.004), lower hemoglobin (p=0.017), higher erythrocyte sedimentation rate (ESR) (p=0.000) and more frequent AHF at the hospital stage (p=0.030). The incidence of AHF at the hospital stage was 13.8% in patients with CRT and 3.5% in those without CRT. The calculated odds ratio of AHF was 4.44 (95% confidence interval (CI) 1.039-18.971), and the relative risk of AHF was 3.966 (95% CI 1.054-14.915). Discussion. FMR has been reported to persist in about 20% to 25% of CRT patients and, in an additional 10% to 15%, it may actually worsen after CRT. In this subset of CRT non-responders, reduced reverse remodeling, increased morbidity, and increased mortality have been reported compared with CRT patients in whom FMR was significantly reduced or abolished. Conclusions. The results of our study demonstrate that severe functional mitral regurgitation despite cardiac resynchronization therapy in patients with dilated cardiomyopathy is a significant risk factor for AHF and subsequent hospitalizations for heart failure.

scholarly journals Title: Risk factors and prevalence of dilated cardiomyopathy in Sub Saharan Africa: protocol for a systematic review article (Preprint)

10.2196/18229 ◽  
2020 ◽  
Author(s):  
Lulu Said Fundikira ◽  
Pilly Chillo ◽  
Linda Van Laake ◽  
Reuben Kato Mutagaywa ◽  
Amand Floriaan Schmidt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Dilated Cardiomyopathy ◽  
Review Article ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals The natural history of myocardial disease in dialysis patients.

1991 ◽  
Vol 2 (1) ◽  
pp. 2-12 ◽  
Author(s):  
P S Parfrey ◽  
J D Harnett ◽  
P E Barre
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Natural History ◽  
Ischemic Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Dialysis Patients

Among dialysis patients, only 23% have a normal echocardiogram, about 10% have recurrent or chronic congestive heart failure, and 17% have asymptomatic ischemic heart disease. The predisposing factors for congestive heart failure are dilated cardiomyopathy, hypertrophic hyperkinetic disease, and ischemic heart disease. Dilated cardiomyopathy, a disorder of systolic function, includes among its risk factors age, hyperparathyroidism, and smoking. Hypertrophic disease results in diastolic dysfunction, and its predictors include age, hypertension, aluminum accumulation, anemia, and, perhaps, hyperparathyroidism. Ischemic heart disease is due to the presence of coronary artery disease and also to nonatherosclerotic disease caused by the reduction in coronary vasodilator reserve and altered myocardial oxygen delivery and use. The clinical outcome of congestive heart failure is comparable to that of nonrenal patients with medically refractory heart failure. Left ventricular hypertrophy is an important independent determinant of survival. A subset have hyperkinetic disease with severe hypertrophy and have a bad survival, as low as 43% have a 2-yr survival after the first admission to hospital with cardiac failure. The prognosis for those with dilated cardiomyopathy is less severe but is worse than those with normal echocardiogram. The survival of patients with symptomatic ischemic heart disease was little different from that of patients without symptoms, suggesting that the underlying cardiomyopathies had an adverse impact on survival independent of ischemic disease. Much research needs to be undertaken on the risk factors, natural history, and therapy of the various types of cardiac disease prevalent in dialysis patients.

scholarly journals Heart Failure in Sub-Saharan Africa

2018 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Joseph Gallagher ◽  
Kenneth McDonald ◽  
Mark Ledwidge ◽  
Chris J Watson ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Sub Saharan Africa ◽  
Essential Medicines ◽  
Endomyocardial Fibrosis ◽  
Technical Expertise ◽  
Significant Issue ◽  
Access To Essential Medicines ◽  
Sub Saharan ◽  
Rheumatic Heart

Heart failure is a growing problem in sub-Saharan Africa. This arises as the prevalence of risk factors for cardiovascular disease rises, life expectancy increases and causes of heart failure more common in Africa, such as rheumatic heart disease and endomyocardial fibrosis, continue to be a significant issue. Lack of access to diagnostics is an issue with the expense and technical expertise required for echocardiography limiting access. Biomarker strategies may play a role here. Access to essential medicines is also limited and requires a renewed focus by the international community to ensure that appropriate medications are readily available, similar to that which has been implemented for HIV and malaria.

scholarly journals Cardiometabolic Risk Factors and Preclinical Target Organ Damage Among Adults in Ghana: Findings From a National Study

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Jie Li ◽  
Isaac Kofi Owusu ◽  
Qingshan Geng ◽  
Aba Ankomaba Folson ◽  
Zhichao Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Sub Saharan Africa ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Sub Saharan ◽  
Artery Disease

Background Although sub‐Saharan Africa has a high prevalence of cardiovascular diseases (CVDs), there remains a lack of systematic and comprehensive assessment of risk factors and early CVD outcomes in adults in sub‐Saharan Africa. Methods and Results Using a stratified multistage random sampling method, we recruited 1106 men and women, aged >18 years, from the general population in Ghana to participate in a national health survey from 2016 to 2017. In Ghanaian adults, the age‐standardized prevalence of known CVD risk factors was 15.1% (95% CI, 12.9%–17.3%) for obesity, 6.8% (95% CI, 5.1%–8.5%) for diabetes mellitus, 26.1% (95% CI, 22.9%–29.4%) for hypertension, and 9.3% (95% CI, 7.1%–11.5%) for hyperuricemia. In addition, 10.1% (95% CI, 7.0%–13.2%) of adults had peripheral artery disease, 8.3% (95% CI, 6.7%–10.0%) had carotid thickening, 4.1% (95% CI, 2.9%–5.2%) had left ventricular hypertrophy, and 2.5% (95% CI, 1.5%–3.4%) had chronic kidney disease. Three CVD risk factors appeared to play prominent roles in the development of target organ damage, including obesity for peripheral artery disease (odds ratio [OR], 2.22; 95% CI, 1.35–3.63), hypertension for carotid thickening (OR, 1.92; 95% CI, 1.22–3.08), and left ventricular hypertrophy (OR, 5.28; 95% CI, 2.55–12.11) and hyperuricemia for chronic kidney disease (OR, 5.49; 95% CI, 2.84–10.65). Conclusions This comprehensive health survey characterized the baseline conditions of a national cohort of adults while confirming the prevalence of CVD risk factors, and early CVD outcomes have reached epidemic proportions in Ghana. The distinct patterns of risk factors in the development of target organ damage present important challenges and opportunities for interventions to improve cardiometabolic health among adults in Ghana.

scholarly journals Rarity of Heart Failure in a Traditional African Population. A Rural Community Based Study

2016 ◽  
Vol 8 ◽  
Author(s):  
Basil Nwaneri Okeahialam ◽  
Hadiza Abigail Agbo ◽  
Chikaike Ogbonna ◽  
Evelyn Chuhwak ◽  
Ikechukwu Isiguzoro
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Secondary Analysis ◽  
The Elderly ◽  
Sub Saharan Africa ◽  
Rural Nigeria ◽  
African Community ◽  
Sub Saharan

<p>BACKGROUND: Heart failure (HF) is common globally and increases with age. Among Caucasians it affects mainly the elderly, but the middle-aged in Africa. Statistics are usually hospital based, missing those in the population unable to present in hospital for various reasons. Population statistics of HF for sub-Saharan Africa are hardly available. This was to assess the population prevalence of HF in a rural sub-Sahara African community and get a truer picture of HF morbidity.</p><p>METHODS: Secondary analysis of data from a population study of cardiovascular disease risk factors in rural Nigeria; on self-reported HF as part of general history, physical examination and related laboratory investigations</p><p> RESULTS: Of the 840 subjects, 231 were men; 8 (0.95%) of whom were in HF (2M, 6F); and aged between 50 to 90 years. All the men were above 65 years while 2 of the women were less than 65 years. Four were hypertensive, 3 had hypertension and diabetes; while 1 the oldest had neither. They all denied tobacco and alcohol use. Most of the affected women were multiparous.</p><p>CONCLUSION: HF is infrequent in rural Nigeria with a prevalence of 0.95%. Hypertension was a prominent risk factor, with co-morbid diabetes. The absence of tobacco /alcohol history, anaemia and low rate of kidney disease confirms that a constellation of risk factors is required for HF among hypertensives. The earlier presentation and greater involvement of women (in the background of multiparity) supports the notion that repeated pregnancy and child-birth place higher disease burden of hearts of women.</p>

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Heart ◽  
2019 ◽  
pp. heartjnl-2018-314436
Author(s):  
Miguel Cainzos-Achirica ◽  
Emili Vela ◽  
Montse Cleries ◽  
Usama Bilal ◽  
Josepa Mauri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Universal Access ◽  
South Asians ◽  
Local Population ◽  
Sub Saharan Africa ◽  
Cvd Risk ◽  
Sub Saharan

ObjectiveTo describe the prevalence and incidence of cardiovascular risk factors, established cardiovascular disease (CVD) and cardiovascular medication use, among immigrant individuals of diverse national origins living in Catalonia (Spain), a region receiving large groups of immigrants from all around the world, and with universal access to healthcare.MethodsWe conducted a population-based analysis including >6 million adult individuals living in Catalonia, using the local administrative healthcare databases. Immigrants were classified in 6 World Bank geographic areas: Latin America/Caribbean, North Africa/Middle East, sub-Saharan Africa, East Asia and South Asia. Prevalence calculations were set as of 31 December 2017.ResultsImmigrant groups were younger than the local population; despite this, the prevalence of CVD risk factors and of established CVD was very high in some immigrant subgroups compared with local individuals. South Asians had the highest prevalence of diabetes, and of hyperlipidemia among adults aged <55 years; hypertension was highly prevalent among sub-Saharan Africans, and obesity was most common among women of African and South Asian ancestry. In this context, South Asians had the highest prevalence of coronary heart disease across all groups, and of heart failure among women. Heart failure was also highly prevalent in African women.ConclusionsThe high prevalence of risk factors and established CVD among South Asians and sub-Saharan Africans stresses the need for tailored, aggressive health promotion interventions. These are likely to be beneficial in Catalonia, and in countries receiving similar migratory fluxes, as well as in their countries of origin.

scholarly journals Paediatric dilated cardiomyopathy in Khartoum state, Sudan: a prospective study

2021 ◽  
Vol 5 (1) ◽  
pp. e000970
Author(s):  
Osama Hafiz Elshazali ◽  
Ekhlas Abdalla
Keyword(s):  
Dilated Cardiomyopathy ◽  
Failure To Thrive ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Middle Income ◽  
Sub Saharan ◽  
A Prospective Study

BackgroundDilated cardiomyopathy (DCM) is a disease of the heart muscle that affects ventricular function; it is a debilitating disease that can lead to heart failure and death in children. There is a lack of good epidemiological data about paediatric DCM in Sudan or in sub-Saharan Africa.ObjectiveTo study the incidence, causes and outcome of DCM among children in Sudan.MethodsA prospective cross-sectional study that was conducted in three paediatric hospitals in Khartoum state, Sudan over the period of 6 months.ResultsDuring the study period, 55 children were seen with the diagnosis of DCM; The female: male ratio was 1.9:1. The incidence of DCM in Khartoum state was found to be 1.4 cases per 100 000 children per year, 10 children (18 %) were diagnosed in the first year of their life. Twenty-seven children (49 %) showed evidence of failure to thrive, being below the fifth percentile for weight. The most common cause of DCM was found to be postviral in 27 children (49%), followed by Idiopathic in 25 children (45%). The most common presentation was the shortness of breath in 53 children (97%), on echocardiography 26 children (47 %) showed evidence of severe left ventricular impairment and 23 children (42%) showed moderate ventricular impairment. Regarding the outcome, 8 children (15%) recovered, the condition of 11 children (20%) remained static and there were 36 deaths (65%).ConclusionThe incidence of DCM in Sudanese children was found to high with a higher mortality compared with middle-income and high-income countries; Improvement in the entire health system is needed to tackle this condition.

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