{"title":"Index of Abstracts SA Heart Congress 2021","authors":"Erika Dau","doi":"10.24170/18-3-4901","DOIUrl":"https://doi.org/10.24170/18-3-4901","url":null,"abstract":"","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78155805","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":"A comparison of coronary angiography and myocardial perfusion studies, using quantitative scoring systems","authors":"P. Premsagar, C. Aldous, T. Esterhuizen","doi":"10.24170/18-2-4883","DOIUrl":"https://doi.org/10.24170/18-2-4883","url":null,"abstract":"Background: Results of myocardial perfusion for screening coronary artery disease (CAD), and angiography for diagnosing CAD, can be quantified using summed difference score (SDS) and Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, respectively. \u0000Aim: The aim is to quantitatively compare myocardial perfusion studies with angiography amongst South African patients using scoring systems. \u0000Methods: SDS on myocardial perfusion and SYNTAX score on angiography were compared. Regional scores within each vessel (left anterior descending (LAD), circumflex and right coronary artery (RCA)) were also compared. Scores were further risk categorised and evaluated. \u0000Results: The weak correlation between SDS and SYNTAX score (rs=0.210, p=0.015), became slightly negative when SYNTAX scores were stratified into low and intermediate-high risk groups. Regionally, LAD had very slight positive correlation (rs=0.171, p=0.048), circumflex (rs=0.164, p=0.058), and RCA (rs=0.116, p=0.184) no correlation. Conversely, comparison of scores categories was signifi cant (p=0.001). \u0000Conclusions: Inherent differences in the design of 2 scoring systems that evaluate the LAD territory may explain these findings. These differences were dominance, regional blood flow distribution and significant luminal diameter reduction. This study highlights the need to interpret myocardial perfusion results contextually during CAD screening.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90608566","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}
Dike B. Ojji, Ojonojima Ajanya, Bolaji Abdullahi, N. Nwankwo, Anita Nnamonu, H. Oshaju, Moses Durotoluwa, T. Adedokun, F. Taiwo, Ginika Oguagha, I. Aondoyima, Alexander Etubi, P. Bassi
{"title":"Use of single pill anti-hypertensive combination medications in Cardiology Clinic of a Tertiary Health Institution in Nigeria","authors":"Dike B. Ojji, Ojonojima Ajanya, Bolaji Abdullahi, N. Nwankwo, Anita Nnamonu, H. Oshaju, Moses Durotoluwa, T. Adedokun, F. Taiwo, Ginika Oguagha, I. Aondoyima, Alexander Etubi, P. Bassi","doi":"10.24170/18-2-4880","DOIUrl":"https://doi.org/10.24170/18-2-4880","url":null,"abstract":"Background: Majority of patients with hypertension require 2 or more medications to provide adequate blood pressure (BP) control. In addition, contemporary guidelines on the management of hypertension favor the use of single-pill combinations (SPCs) as they simplify the treatment regimen and decrease the daily pill burden for patients, both of which are associated with improved adherence. In spite of this, there is a lack of data in sub-Saharan Africa on the frequency of use of SPC anti-hypertensive medications. \u0000Method: We prospectively collected detailed clinical data from 373 patients with primary diagnosis of hypertension attending the cardiology clinic of University of Abuja Teaching Hospital between 2016 and 2017. \u0000Results: Three hundred and seventy three patients with mean age of 50.6 ± 12.3 years and mean body mass index of 31.2 ± 6.5kg/m2 on anti-hypertensive treatment were evaluated. Baseline mean systolic and diastolic BPs were 161.1 ± 3.1mmHg and 95.4 ± 15.6mmHg respectively, while the mean pulse pressure was 56.6 ± 18.1mmHg. 212 (56.8%) where on SPCs, with 32.5% on angiotensin receptor blockers (ARBs) plus hydrochlorothiazide (HCTZ), 18.9% on angiotensin converting enzyme inhibitors (ACEIs) plus HCTZ, 9.9% on amlodipine (AML) plus ARB, 3.3% on AML plus ACEI, 3.8% on thiazide-like diuretic plus atenolol, 29.2% on HCTZ plus amiloride, and 2.4% on triple combination of AML+ARB+HCTZ. \u0000Conclusion: Our study has shown that over 50% of our patients were on SPC anti-hypertensive medications, with the most prescribed single pill combination being angiotensin receptor blocker plus thiazide diuretic.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"2011 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86319354","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":"The hidden continuum of HIVassociated cardiomyopathy: A focussed review with case reports","authors":"P. Robbertse, A. Doubell, J. Nachega, P. Herbst","doi":"10.24170/18-2-4885","DOIUrl":"https://doi.org/10.24170/18-2-4885","url":null,"abstract":"HIV-associated cardiomyopathy (HIVAC) is a poorly understood group of diseases with a poor prognosis once ventricular dysfunction is present. Cardiovascular magnetic resonance has revealed a previously unappreciated burden of asymptomatic myocardial abnormalities in people living with HIV, including abnormalities already present at the time of HIV diagnosis. These abnormalities include thickened, inflamed ventricles that bear resemblance to cases of symptomatic HIVAC that are reported on in this article. Our understanding and the significance of asymptomatic HIV-associated myocardial pathology will be explored as early disease on a continuum towards more advanced cardiomyopathy. The need for prospective research in persons naive to anti-retroviral therapy is emphasised as it may provide key findings to better understand this elusive disease process.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78328474","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":"The value of exercise stress testing in prediction of angiography amongst South African patients using quantitative scoring systems","authors":"P. Premsagar, C. Aldous, T. Esterhuizen","doi":"10.24170/18-2-4882","DOIUrl":"https://doi.org/10.24170/18-2-4882","url":null,"abstract":"Background: Accurate pre-test assessment of high risk patients may increase positive yield on angiography. Exercise stress testing (EST) prediction of angiography, may be evaluated by Duke Treadmill Score (DTS), and Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score, respectively. \u0000Aim: To investigate the value of EST in prediction of angiography amongst South African patients using quantitative scoring systems. \u0000Methods: The DTS and SYNTAX score were compared in patients with high risk pre-test assessments selected for angiography. Logistic regression modelling determined the odds ratio of abnormal angiograms using EST as a predictor. \u0000Results: Pre-test assessment of 525 suspected coronary artery disease patients, indicated angiography in 131 high risk individuals. The positive yield of abnormal angiograms was 58.0%, with no correlation between DTS and SYNTAX scores (Pearson’s correlation coefficient = 0.113, p=0.200). There was low predictive probability on receiver-operator-curve for DTS when compared to angiogram results (area under curve (AUC)=0.529, p=0.574), and SYNTAX categories (AUC=0.432, p=0.378). Chi-square tests had no significance between angiography and EST (all p-values >0.05). However DTS predicted abnormal angiograms with odds ratio of 1.92 when relevant cardiovascular risk factors (smoking, BMI, age) were added. \u0000Conclusion: Pre-test assessment of high risk patients represented a homogenous group with prevalent cardiovascular risk factors. However, the high risk group had no relationship between DTS and SYNTAX scores, indicating DTS alone discounts risk factors. Modelling accounted for DTS limitation by demonstrating an obese, elderly smoker with high risk category DTS is 1.92 times more likely to have an abnormal angiogram.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78853124","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}
Nicole A. Saacks, T. Spracklen, James M. Eales, G. Shaboodien, B. Keavney, L. Zühlke
{"title":"The genetics of congenital heart disease: The role of advanced genomic approaches","authors":"Nicole A. Saacks, T. Spracklen, James M. Eales, G. Shaboodien, B. Keavney, L. Zühlke","doi":"10.24170/18-2-4886","DOIUrl":"https://doi.org/10.24170/18-2-4886","url":null,"abstract":"As the leading non-infectious cause of paediatric morbidity and mortality worldwide, congenital heart disease (CHD) is a significant social and healthcare burden, especially in low- and lower-middle-income countries, including South Africa. The aetiology of CHD is poorly understood, though heritable genetic factors have been shown to contribute to the risk of CHD in individuals of European ancestry. In this review, we highlight the impact that advanced genomic approaches have had on the understanding of the role of genetics in CHD. We also summarise current knowledge of the genetics of CHD in Africa, and the challenges and opportunities for conducting genomic research in these populations. Chromosomal microarrays and next-generation sequencing platforms allow for high-throughput screening of patients for genetic mutations and show great potential for the identification of genetic causes of CHD. Advancing our understanding of the genetic architecture and risk factors associated with CHD in patients of African descent is the fi rst step towards improving CHD diagnosis and management. Therefore, exploring the genetics of CHD has the potential to improve the quality of life for children born with CHD in Africa, by enabling clinicians to identify familial inheritance patterns and predict recurrent risks and prognostic outcomes pre- and post-surgical intervention.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80739304","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 disease in sub-Saharan Africa","authors":"N. Ntusi","doi":"10.24170/18-2-4877","DOIUrl":"https://doi.org/10.24170/18-2-4877","url":null,"abstract":"Globally, non-communicable diseases (NCDs) are the leading cause of death, accounting for nearly three-quarters of all deaths, led by cardiovascular diseases (CVD) – with ischaemic heart disease (IHD) and stroke being the leading cause of global cardiovascular (CV) mortality and a major cause of CV morbidity and disability.(1) CVD is an important cause of premature mortality and rising healthcare costs in all regions of the world; and is driven by rapidly evolving cardiometabolic, behavioural, psychological, environmental, and social risk factors and determinants of health.(2) Consistent, comparable, and systematic analysis of trends and patterns in CVD are essential to guide public policy and provide benchmarks for decision-makers.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90255170","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":"Research integrity and societal trust in research","authors":"L. Horn, L. Bouter, S. Kleinert","doi":"10.24170/18-2-4879","DOIUrl":"https://doi.org/10.24170/18-2-4879","url":null,"abstract":"","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83150828","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":"Peri-operative outcomes of mitral valve surgery at Charlotte Maxeke Johannesburg Academic Hospital","authors":"Tebogo Tabane, T. Leonard, T. Kleyenstuber","doi":"10.24170/18-2-4884","DOIUrl":"https://doi.org/10.24170/18-2-4884","url":null,"abstract":"Background: The distribution and determinants of heart disease vary greatly between high-income countries and sub-Saharan Africa where rheumatic heart disease (RHD) is a major public health challenge. Studies from Africa report that RHD is the main cause of cardiovascular morbidity and mortality in the young. Data on mitral valve surgery outcomes in South Africa are limited. The aim of this study was to describe the peri-operative outcomes of patients that have undergone mitral valve surgery at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). \u0000Methods: All patients older than 18 years who underwent mitral valve surgery at CMJAH between 1 January 2015 and 31 December 2018 were retrospectively included. Cardiac intensive care records including anaesthesia charts were assessed to describe preoperative, intra-operative and post-operative data of each patient. Pre-operative data included patient demographics and comorbidities. Intra-operative data included aortic clamp and bypass times. Post-operative variables included outcomes such as sepsis, bleeding, re-operation, and the development of acute kidney injury (AKI). The pre-operative, intra-operative and post-operative outcomes were compared to determine the effect each variable had on post-operative mortality. \u0000Results: Two hundred and seventeen patients underwent mitral valve surgery at CMJAH between 1 January 2015 and 31 December 2018. Four patients’ records were incomplete. RHD was found to be the primary aetiology for mitral valve surgery at CMJAH with a mortality rate of 6.1%. Pre-operative findings that contributed to mortality were: EuroSCORE>2%, preoperative ventilation, dialysis dependence, pre-operative inotropic support, chronic obstructive pulmonary disease, congestive cardiac failure, renal insufficiency, low ejection fraction and New York Heart Association functional class ≥III. Post-operative findings that contributed to increased mortality were prolonged mechanical ventilation, pneumonia, re-operation, AKI, sepsis, bleeding, and transfusion. Increased aortic clamping and cardiopulmonary bypass times increased the risk of prolonged mechanical ventilation, re-operations, pacemaker implantations, AKI, and bleeding. \u0000Conclusions: RHD was found to be the primary aetiology for mitral valve surgery at CMJAH with a mortality of 6.1%. Pre-operative, intra-operative and post-operative predictors of outcomes in this study confirm observations made in other parts of the world.","PeriodicalId":55781,"journal":{"name":"SA Heart Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73503317","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}