Abdominal Aorta Screening During Routine Transthoracic Echocardiography in Zanzibar, Tanzania: The Zanzibar Heart Survey.

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Global Heart Pub Date : 2025-05-30 eCollection Date: 2025-01-01 DOI:10.5334/gh.1432

Abukar Mohamed Ali, Khamis Mustafa Khamis, Ghirmay Andemichael, Muhiddin Abdi Mahmoud, Victor Aboyans, Sahrai Saeed

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引用次数: 0

Abstract

Background and objectives: Abdominal aortic (AA) aneurysms (AAA) are often incidental findings and preceded by a long period of subclinical growth in diameter. Patients may present with life-threatening complications. Therefore, screening programmes for AAA in primary care are proposed in several European countries, and opportunistic AAA screening during echocardiography is also advocated. However, data on the interest of such an approach in the sub-Saharan African population are unknown.

Methods: In 2022, a total of 189 patients with cardiac symptoms visiting the Mnazi Mmoja Referral Hospital (MMH) in Zanzibar underwent standard transthoracic echocardiography (TTE). Demographics and clinical data were recorded. AA diameter was routinely assessed in 137 patients. AA was measured by the leading-edge-to-leading-edge method from a longitudinal plane, and AAA was defined as an AA diameter of ≥3.0 cm. SPSS version 29.0 was used for data analysis. The prevalence of AAA was estimated as the number of AAA cases divided by the number of all screened subjects. Correlates of AA diameter were tested in univariate and multivariate linear regression analyses.

Results: AA could be visualized in 128 (93.4%) patients (43% of men and 57% of women). The mean age was 54.4 ± 15.9 years. The mean AA diameter was 2.1 ± 0.3 cm in the entire study population and was significantly greater in men than women (2.2 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.005) and in individuals aged ≥60 years than those aged <60 years (2.3 ± 0.3 vs 2.1 ± 0.3 cm, p = 0.003). The prevalence of AAA was 1.6%. In a multivariate linear regression analysis, higher age, male gender, atrial fibrillation and left ventricular (LV) mass were independent correlates of greater AA diameter, adjusted for clinic systolic blood pressure, ascending aortic diameter and LV ejection fraction (multiple R² = 0.38, p < 0.001).

Conclusions: Abdominal aorta screening during routine TTE is feasible in Africa. Patients in Zanzibar have relatively smaller abdominal aorta diameters with a 1.6% prevalence of AAA. Abdominal aorta screening by routine echocardiography may be beneficial, provided that access to care and vascular surgery facility/expertise with appropriate follow-up is available for patients with AAA identified during screening.

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在坦桑尼亚桑给巴尔的常规经胸超声心动图中进行腹主动脉筛查：桑给巴尔心脏调查。

背景和目的：腹主动脉瘤（AA）通常是偶然发现的，并且在其发生之前有很长一段时间的亚临床直径增长。患者可能出现危及生命的并发症。因此，一些欧洲国家在初级保健中提出了AAA筛查方案，并提倡在超声心动图中进行机会性AAA筛查。然而，关于这种方法在撒哈拉以南非洲人口中的兴趣的数据是未知的。方法：2022年，共有189名到桑给巴尔Mnazi Mmoja转诊医院（MMH）就诊的有心脏症状的患者接受了标准的经胸超声心动图（TTE）检查。记录人口统计学和临床数据。对137例患者的AA直径进行常规评估。AA采用前缘-前缘法从纵向平面测量，AA直径≥3.0 cm定义为AAA。采用SPSS 29.0版本进行数据分析。AAA患病率估计为AAA病例数除以所有筛查对象的数量。用单因素和多因素线性回归分析检验AA直径的相关系数。结果：128例（93.4%）患者可见AA，其中男性43%，女性57%。平均年龄54.4±15.9岁。整个研究人群的平均AA直径为2.1±0.3 cm，男性明显大于女性（2.2±0.3 vs 2.1±0.3 cm, p = 0.005），年龄≥60岁的个体AA直径明显大于年龄R2 = 0.38, p < 0.001)。结论：腹主动脉筛查在非洲是可行的。桑给巴尔的患者腹主动脉直径相对较小，AAA患病率为1.6%。常规超声心动图腹主动脉筛查可能是有益的，前提是在筛查过程中发现的AAA患者能够获得护理和血管手术设施/专业知识，并进行适当的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Global Heart Medicine-Cardiology and Cardiovascular Medicine

CiteScore

5.70

自引率

5.40%

发文量

审稿时长

5 weeks

期刊介绍： Global Heart offers a forum for dialogue and education on research, developments, trends, solutions and public health programs related to the prevention and control of cardiovascular diseases (CVDs) worldwide, with a special focus on low- and middle-income countries (LMICs). Manuscripts should address not only the extent or epidemiology of the problem, but also describe interventions to effectively control and prevent CVDs and the underlying factors. The emphasis should be on approaches applicable in settings with limited resources. Economic evaluations of successful interventions are particularly welcome. We will also consider negative findings if important. While reports of hospital or clinic-based treatments are not excluded, particularly if they have broad implications for cost-effective disease control or prevention, we give priority to papers addressing community-based activities. We encourage submissions on cardiovascular surveillance and health policies, professional education, ethical issues and technological innovations related to prevention. Global Heart is particularly interested in publishing data from updated national or regional demographic health surveys, World Health Organization or Global Burden of Disease data, large clinical disease databases or registries. Systematic reviews or meta-analyses on globally relevant topics are welcome. We will also consider clinical research that has special relevance to LMICs, e.g. using validated instruments to assess health-related quality-of-life in patients from LMICs, innovative diagnostic-therapeutic applications, real-world effectiveness clinical trials, research methods (innovative methodologic papers, with emphasis on low-cost research methods or novel application of methods in low resource settings), and papers pertaining to cardiovascular health promotion and policy (quantitative evaluation of health programs.