Nigerian Journal of Cardiology最新文献

{"title":"Short-term outcomes and their predictors among patients admitted with acute heart failure in a Nigerian Teaching Hospital","authors":"Muhammad Auwal Shehu, M. Sani, B. Okeahialam","doi":"10.4103/njc.njc_20_19","DOIUrl":"https://doi.org/10.4103/njc.njc_20_19","url":null,"abstract":"Background: Despite many recent advances in the evaluation and management of heart failure (HF), the development of symptomatic HF still carries a poor prognosis. A study of clinical characteristics of patients with acute heart failure (AHF) will provide appropriate clinical decisions with regard to treatment and patients' monitoring. This study therefore aimed to determine the clinical characteristics of patients admitted with AHF. The outcome measures are death, rehospitalization, or combined death/rehospitalization. Methods: It was a longitudinal study carried out on eligible AHF patients aged 18 years and above who were consecutively recruited. On presentation, all patients had history obtained and physical examination performed. Baseline blood chemistry, full blood count, electrocardiography, and echocardiography were carried out as well. Data on vital status and rehospitalization/death were recorded at 1 month, 3 months, and 6 months of follow-up periods. Results: A total of 120 patients were studied. Fifty-five percent of them were female, and the mean age was 49.88 ± 18.87 years. Of the 120 patients studied, 35 (29.2%) died, 21 (17.5%) were rehospitalized only once, and 2 (1.7%) were rehospitalized twice. Renal impairment (RI) was an independent predictor of both mortality from AHF (odds ratio [OR] = 2.875, 95% confidence interval [CI]: 1.207–6.874 and P = 0.012) and composite endpoint of death or rehospitalization (OR = 3.131, 95% CI: 1.326–7.890, and P = 0.009). Rehospitalization was significantly higher among diabetics (OR = 5.000, 95% CI: 1.604–15.586 and P = 0.006). Conclusion: AHF was associated with high mortality rate and composite endpoint of death or rehospitalization. RI and diabetes were the independent predictors of poor outcomes.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128468572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic exercise for hypertension: An update for exercise prescribers","authors":"Mubarak Muhammad, J. Nuhu, Tasneem M. Hassan, S. Baba, Mustapha I. Radda, Mubarak M. Mutawakkil, Majida A. Musa","doi":"10.4103/njc.njc_24_19","DOIUrl":"https://doi.org/10.4103/njc.njc_24_19","url":null,"abstract":"Hypertension (HTN) remains the most common noncommunicable disease that constitutes the greatest public health problem worldwide, with the management involving pharmacological and nonpharmacological means. Therapeutic exercise is an important first-line intervention for a number of chronic diseases and has been recommended both as a measure for prevention and as an adjunctive nonpharmacological intervention for HTN, however; exercise prescription to hypertensive patients is still low, especially among primary healthcare professionals. This study examined from evidence-based literature the various aspects of therapeutic exercise and HTN to successfully stimulate the integration of exercise for HTN management in clinical settings, especially at the primary healthcare level. The paper reviewed published articles on exercise and HTN on Google Scholar, PubMed, and ScienceDirect using search terms “exercise” and “hypertension.” Studies identified in this review were summarized to further enrich literature with data and provide an update to exercise prescribers on exercise and HTN. This study revealed and identified three key aspects that need to be strengthened for successful integration of exercise for HTN management in all clinical settings: adequate and routine pre-exercise screening and monitoring; well-informed prescription of therapeutic exercise by qualified exercise professionals; and sufficient knowledge about potential interaction between exercise and antihypertensive medications.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133795195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular diseases in Nigeria: What has happened in the past 20 years?","authors":"S. Ike, Chuka Onyema","doi":"10.4103/njc.njc_33_19","DOIUrl":"https://doi.org/10.4103/njc.njc_33_19","url":null,"abstract":"Cardiovascular diseases (CVDs) are a leading cause of death worldwide with an accelerated increase in CVD-related death in Nigeria and other low-income and middle-income countries. A review of the trend of presentation and management of CVDs in Nigeria over the past 20 years revealed a transition from high incidence of CVDs associated or resulting from poverty and malnutrition (such as rheumatic heart disease) initially to a fall in the prevalence of these poverty-related CVDs occurring subsequently at same time with a rising prevalence of other noncommunicable CVDs (such as hypertension and heart failure). Although some CVDs such as coronary heart disease and cardiomyopathies maintained a steady prevalence within the period in review, this trend was associated with changing availability of healthcare services in Nigeria, with better services and newer treatments becoming more available over time and increasing prevalence of CVD risk factors among Nigerians. Despite these, Nigeria is at a plateau now as a result of poor funding and support of the health sector. This has resulted in most health funding coming from donor agencies, religious bodies, philanthropists, and nongovernment organizations. For progress, there is a need for an increase focus in the health sector with increased funding and support from the government and all players. Increased awareness and education of the general population on the prevention and control of risk factors and training of health professionals on appropriate diagnosis and management of CVDs is advocated.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116478519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with interventional and definitive solutions for structural heart diseases in a resource-challenged setting","authors":"O. Ogunkunle, B. Adebayo, A. Famosaya, S. Omokhodion","doi":"10.4103/njc.njc_31_19","DOIUrl":"https://doi.org/10.4103/njc.njc_31_19","url":null,"abstract":"Background: The first case of open-heart surgery (OHS) in the University College Hospital, Ibadan, took place on December 19, 1978. Since then, various attempts have been made to provide definitive solutions for patients with structural cardiac diseases, but till now, no permanent regular service exists. We present our initial experience with interventional cardiology (IC) and OHS in a resource-challenged setting. The challenges encountered are discussed, and the solutions we have proffered with each situation are presented as we forge ahead toward achieving a more regular service for IC and OHS in our center. Results: In January 2016, eight children underwent diagnostic cardiac catheterization with a view to performing a possible corrective intervention. Two subsequently had device closure of patent ductus arteriosus – the first in the history of the hospital. Four patients (one with a large atrial septal defect (ASD), one severe pulmonary stenosis, one with a large ventricular septal defect (VSD), and one with Fallot's tetralogy) were deemed to be more suitable for OHS and were, therefore, deferred. The muscular VSD in another patient was thought to be too small to need intervention. The last patient, initially thought to have a coarctation of the aorta, was found to have normal cardiac anatomy. The patient with large ASD and VSD subsequently underwent successful total repair of his lesions in our facility. Conclusion: The successful outcome in the three patients has encouraged us to be optimistic that despite various resource challenges, it will soon be possible to establish a regular service for both IC and OHS in our center.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122685011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arrhythmia in people living with HIV/AIDS","authors":"Shailesh Singh, Katyayni Singh","doi":"10.4103/njc.njc_1_19","DOIUrl":"https://doi.org/10.4103/njc.njc_1_19","url":null,"abstract":"With improvement in longevity and therapy of HIV; acquired heart diseases are expected to become more and more prevalent. The electric abnormalities in HIV/AIDS are not very rare. These electrical abnormalities in HIV/ AIDS patients may result from the structural heart diseases because of accelerated atherosclerosis, or cardiac dilation as a sequela of myocarditis, or infective endocarditis or pericardial afflictions in HIV. These electrical disorders can present with a history of palpitations, missed beats or even sudden cardiac death. Both tachy- and bradyarrhythmia may be seen in people living with HIV/AIDS.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121503866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between ECG QRS voltage and left ventricular functions in patients with heart failure attending federal Medical Centre Nguru, Northeastern Nigeria","authors":"M. Baba, F. Buba, M. Talle, H. Umar, H. Abdul","doi":"10.4103/njc.njc_22_19","DOIUrl":"https://doi.org/10.4103/njc.njc_22_19","url":null,"abstract":"Introduction: Heart failure (HF) is a clinical syndrome characterized by typical symptoms (e.g., breathlessness, ankle swelling, and fatigue) that may be accompanied by signs (e.g. elevated jugular venous pressure, pulmonary crackles, and peripheral edema) caused by a structural and/or functional cardiac abnormality, resulting in a reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. Electrocardiogram (ECG) is a widely available tool; it is relatively inexpensive and simple to perform; and it yields an instant result. A normal ECG makes systolic dysfunction unlikely and is rare in patients with suspected heart failure. Low ECG voltage has been reported as a marker of the severity of HF and is a risk factor for adverse outcomes in patients with systolic HF at 1 year. However, the relationship between ECG QRS voltage and left ventricular function in patients with heart failure has not been evaluated. Therefore, the objective of this study is to determine the relationship between electrocardiographic QRS voltage and left ventricular function. Methodology: This was a prospective cross-sectional study conducted among inpatients with HF in the medical ward of the hospital. Results: Three hundred and sixty patients were recruited for the study, of which 19 had incomplete data and were excluded in the analysis. The remaining 341 subjects were analyzed comprising 215 female and 126 male with a mean age of 47.54 ± 18.85 years. Majority of patients with normal or high QRS voltage had HF with preserved ejection fraction (HFpEF), while those with low QRS voltage had HF with reduced ejection fraction (HFrEF). On the other hand, patients with high QRS voltage had impaired relaxation pattern of diastolic dysfunction, while those with low QRS voltage had a restrictive pattern of diastolic dysfunction. There was a positive and significant correlation between the QRS voltage and ejection fraction, fractional shortening, isovolumic left ventricular relaxation time, and left ventricular deceleration time, while a negative but not significant correlation was observed between electrocardiographic QRS voltage and transmitral E/A ratio. Majority of patients with normal QRS voltage had normal left ventricular geometry, while those with high QRS voltage predominantly had concentric left ventricular hypertrophy and those with low QRS voltage had eccentric left ventricular hypertrophy. Patients with concentric left ventricular hypertrophy had predominantly HFpEF and impaired relaxation pattern of diastolic dysfunction, while those with eccentric left ventricular hypertrophy had HFrEF and restrictive pattern of diastolic dysfunction. Conclusion: HF patients with high QRS voltage had preserved left ventricular systolic function, impaired relaxation pattern of left ventricular diastolic dysfunction, and concentric left ventricular hypertrophy. While those with low QRS voltage predominantly had reduced left ventricular systolic function, restri","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115048020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dextrocardia with situs inversus in an adult Nigerian","authors":"Bonny Ejeh, Y. Ayoola, H. Okolie, S. Danbauchi","doi":"10.4103/njc.njc_2_19","DOIUrl":"https://doi.org/10.4103/njc.njc_2_19","url":null,"abstract":"Situs inversus with dextrocardia refers to complete inversion of the position of the thoracic and abdominal viscera. Dextrocardia occurs when the heart is located in the right side of the thoracic cavity with its base-to-apex axis directed to the right and inferiorly. It may be isolated or associated with cardiac or alimentary malformations. Our patient had dextrocardia with situs inversus. The patient is a 32-year-old woman that presented with recurrent respiratory symptoms but no cardiac symptoms. Dextrocardia with situs inversus was confirmed by chest radiograph, electrocardiography, and abdominal ultrasound. Echocardiography established atrioventricular great arteries and ventricular concordance with no valvular abnormalities.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122452232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of atherothrombosis or thrombophilia in acute retinal vein occlusion","authors":"Y. Boduroğlu, N. Son","doi":"10.4103/njc.njc_22_18","DOIUrl":"https://doi.org/10.4103/njc.njc_22_18","url":null,"abstract":"Retinal vein occlussion (RVO) is one of the retinal vascular disease which may occur due to atherosclerosis in elderly, but young patients may have connective tissue diseases (such as systemic lupus erythematosus [SLE]) or thrombophilia. Antiphospholipid antibodies (lupus anticoagulant [LA], anticardiolipin [anti-CL]) are well-known risk factors for thrombotic complications in SLE. We present a case of SLE with RVO. A 57-year-old woman was admitted with decreasing of visual acuity (VA) in the right eye. She did not have diabetes mellitus or hypertension. Malar rash was found in the face. The ophthalmoscopy and fluorescein angiography showed retinal hemorrhages. LA antibody and antinuclear antibodies were positive, and level of anti-CL was normal with high level of homocysteine. Because of detecting widespread capillary nonperfusion in her retina, VA did not change during follow-up after treatment. RVO in SLE patients has been described to be caused by thrombophilic conditions.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124861572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipid and apoprotein markers and carotid intima-media thickness among hypertensive Nigerians","authors":"M. Kuti, A. Adeoye, S. Agboola, Tolulope Olutosin Omilakin","doi":"10.4103/njc.njc_29_18","DOIUrl":"https://doi.org/10.4103/njc.njc_29_18","url":null,"abstract":"Context: Measurement of lipids and apoproteins are essential components aimed at reducing the global burden of atherosclerotic cardiovascular disease. Carotid intima-media thickness (CIMT) has been widely accepted as an index of subclinical atherosclerosis. A relationship between CIMT and the parameters of the traditional lipid profile has been described. Aim: Evaluation of the diagnostic character of lipid and apoprotein markers, which are cheap and easy to perform, in detecting a significant thickening of the carotid intima media in hypertensive persons. Subjects and Methods: Cross-sectional study of adult male hypertensive persons with fasting measurement of the traditional lipid profile and apoprotein B. CIMT of the common carotid artery was determined by ultrasound in all participants. Results: The mean CIMT was significantly higher among the hypertensive participants than normotensive controls. Age, systolic blood pressure, triglycerides, low-density lipoprotein-cholesterol (LDL-C), and Apo B were all significantly associated with CIMT. Hypertensive persons with CIMT ≥1.00 mm had significantly higher serum concentrations of total cholesterol (TC), LDL-C, and Apo B. The positive predictive value of a result (TC >200 mg/dL, LDL-C >130 mg/dL, and Apo B >100 mg/dL) was <50%, while that for a negative result (TC <200 mg/dL, LDL-C <130 mg/dL, and Apo B <100 mg/dL) approached or was equal to 100%. Conclusions: There is some relationship between dyslipidemia and significant thickness of the carotid intima media. The levels of TC, LDL-C, and Apo B in plasma, which are cheaper and easier to determine, may help in the selection of hypertensive persons to be offered CIMT assessment.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124639384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care monitoring of international normalized ratio among patients with mechanical valves in Jos, North-Central, Nigeria","authors":"Ishaya I Abok, Benjamin Andeyaba, T. Slusher, F. Bode‐Thomas","doi":"10.4103/njc.njc_39_17","DOIUrl":"https://doi.org/10.4103/njc.njc_39_17","url":null,"abstract":"Background: Rheumatic heart disease is the leading cause of acquired valvular heart disease in low- and middle-income countries and sometimes requires mechanical valve replacement. Postsurgical management of these patients is vital and includes lifelong anticoagulation with close monitoring. This study aims to report our experience with anticoagulation monitoring of patients with mechanical heart valves using a handheld portable device. Patients and Methods: This retrospective review involved 12 patients that were enrolled in the anticoagulation clinic (AC) of a local nongovernmental organization, at different times between 2003 and 2012. Patients' sociodemographic variables, international normalized ratio (INR) assay results, and clinical status were routinely entered into a register and were retrieved for the present review. Results: The 12 patients comprised three males and nine females and were resident between 3.7 and 300 km from the AC. Their age ranged from 7 to 26 years (mean 14.1 ± 3.3 years, median 13 years) at the time of enrollment into the AC. Seven hundred and ninety-four INR assays were done during the period under review (mean 12.2 ± 5.4 INR assays per patient per year). Of the 794 assays, 38.5% were within target (INR levels between 2.5 and 3.5 or between 2.0 and 3.0 for patients with mechanical valves at the mitral and aortic positions, respectively) 35.7% were below the target range, and 25.7% were above the target range. Conclusion: Our experience with point-of-care INR testing in a clinic setting suggests that adopting this approach could improve the quality of anticoagulation monitoring by increasing patients' access to the device, the frequency of assays per patient, and, ultimately, the number of within-target INR assays.","PeriodicalId":228906,"journal":{"name":"Nigerian Journal of Cardiology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132384297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}