Cardiovascular Journal of Africa最新文献

{"title":"Dual antiplatelet therapy is an effective treatment method after coronary artery endarterectomy: a single-centre retrospective study.","authors":"Yalçın Günerhan, Mehmet Işık, Serkan Yıldırım, Ali Vasfi Ağlarcı, Ali Demiray, Yüksel Dereli","doi":"10.5830/CVJA-2025-102","DOIUrl":"https://doi.org/10.5830/CVJA-2025-102","url":null,"abstract":"<p><strong>Aim: </strong>It was aimed to investigate the patients who underwent coronary artery bypass grafting with coronary endarterectomy (CABG-CE) and postoperative dual antiplatelet therapy (DAPT) in terms of acute coronary syndrome, mortality and morbidity in the early period.</p><p><strong>Method: </strong>Ninety-nine patients who underwent endarterectomy during CABG between 2022 and 2024 were included in the study. DAPT was applied after surgery. Preoperative and postoperative electrocardiogram (ECG), echocardiography (Echo), ejection fraction (EF) changes, operative time, postoperative first 30-day mortality, and length of stay in the intensive care unit (ICU) were investigated.</p><p><strong>Result: </strong>The left anterior descending (LAD) coronary artery endarterectomy rate was 38.4%. Among those who underwent LAD endarterectomy, eight had ECG changes in favour of myocardial infarction (MI), eight had postoperative arrhythmia, and two had mortality. The right coronary artery (RCA) endarterectomy rate was 38.4%. Of these cases, two had ECG changes, nine had postoperative arrhythmia, and two hadmortality. The circumflex artery (CX) endarterectomy rate was 12.1%. Of these, three had ECG changes, five had postoperative arrhythmia, and two had mortality. Although the bypass numbers were equal, the cross-clamping time was longer in patients who underwent LAD endarterectomy than in those who underwent RCA or CX endarterectomy. The postoperative blood replacement requirement was 1.6 ± 1.4 units. The mean length of stay in the ICU was 4.0 ± 4.5 days.</p><p><strong>Conclusions: </strong>DAPT is an effective treatment method after CABG-CE surgery, especially for patients with diabetes mellitus (DM) and coronary artery disease and diffuse, long-segment, calcified plaque.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 2","pages":"158-164"},"PeriodicalIF":0.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of <i>ACE</i> I/D and ACE (rs4343) polymorphism with MACE development in hypertensive patients.","authors":"Alija Baig, Syed M M Shah, Asif Jan, Malik Faisal, Aiman Begum, Aftab Ullah, Haseenullah Shah","doi":"10.5830/CVJA-2026-006","DOIUrl":"10.5830/CVJA-2026-006","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. The angiotensin-converting enzyme (<i>ACE</i>) insertion/deletion (I/D) and ACE rs4343 polymorphism have been considered important and extensively studied for their association with cardiovascular conditions. This study investigates the association of this variant with the development of major adverse cardiovascular events (MACE) in hypertensive patients of Khyber Pakhtunkhwa, Pakistan.</p><p><strong>Methods: </strong>This prospective cohort study, conducted over two years (2022-2023), included 429 adult patients (aged 30-70 years) with cardiovascular risk factors or established cardiovascular disease. Baseline demographic, clinical, and laboratory data were collected. Blood samples were analysed for <i>ACE</i> I/D and ACE (rs4343) polymorphism using polymerase chain reaction (PCR). Participants were followed up for 12 months to monitor MACE occurrence. The study protocol was approved by the institutional ethics committee. Data were analysed using SPSS software for relevant descriptive and inferential statistics.</p><p><strong>Results: </strong>Mean age of the patients was 60.4 years, with 51.3% being male. <i>ACE</i> ID (heterozygous) variant was the most prevalent (67.6%), followed by the II (Insertion) (28%), and the DD (deletion) (4.4%). Significant associations were observed between the ID genotype and specific cardiovascular parameters, particularly ejection fraction (p = 0.019) and pulmonary arterial hypertension (p = 0.008). Most participants (69.2%) had hypertension for over 10 years, and 78.1% were aware of their condition. Genotypes and allele frequencies were also found to be considerably Non-contrasting between the case and control groups for ACE (rs4343).</p><p><strong>Conclusion: </strong>The findings demonstrate significant associations between <i>ACE</i> I/D polymorphism and cardiovascular events in patients with hypertension. The rs4343 variant carries no significant affinity for hyperactive ACE, which causes MACE in the subjects of this study.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 2","pages":"139-145"},"PeriodicalIF":0.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges and interventional management of left isomerism in heterotaxy syndrome with a lower extremity arteriovenous malformation: a case report.","authors":"Defne Şahin, Temel Fatih Yılmaz, Can Yılmaz Yozgat, Ahmet Akcay, Mehmet Nuri Belge, Hüseyin Toprak","doi":"10.5830/CVJA-2026-002","DOIUrl":"https://doi.org/10.5830/CVJA-2026-002","url":null,"abstract":"","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 2","pages":"146-148"},"PeriodicalIF":0.7,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of patients, caregivers and health care practitioners on heart failure management: a narrative review with lessons for Ghana.","authors":"Aba A Folson, Florence Koryo Akumiah","doi":"10.5830/CVJA-2025-100","DOIUrl":"10.5830/CVJA-2025-100","url":null,"abstract":"<p><p>Heart failure is a worldwide pandemic that has seen major advancements in pharmacotherapeutic and device care therapies over the past decade contributing significantly to holistic, evidence-based care. The perspectives of patients with heart failure, their caregivers and healthcare practitioners on current heart failure management, remain unexplored in Africa. These perspectives, where studied, have provided invaluable information on, communication, readmission, decision-making in heart failure, mental and psychosocial stress and cost implications of optimal heart failure care. It is believed that lessons from what has been documented may serve as a guide for further studies in this area in Ghana and Africa. This literature review highlights other aspects of heart failure management relevant to patients, their caregivers and healthcare practitioners and which need to be further studied in our setting, guiding evidence-based but population-specific heart failure care.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"124-138"},"PeriodicalIF":0.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical Embolization of an Intravenous Catheter Fragment through Patent Foramen Ovale: A Rare Case of Acute Limb Ischaemia.","authors":"Kübra Gözaçık Karakoç","doi":"10.5830/CVJA-2025-108","DOIUrl":"https://doi.org/10.5830/CVJA-2025-108","url":null,"abstract":"<p><strong>Background: </strong>Paradoxical embolism occurs when venous materials traverse through a patent foramen ovale (PFO) into arterial circulation. Catheter fragment embolisation represents an unusual cause of systemic arterial occlusion with significant morbidity.</p><p><strong>Case presentation: </strong>An 83-year-old female presented with sudden-onset pain, coldness, and cyanosis of the right lower extremity 15 days after pacemaker implantation requiring intravenous catheterisation. Physical examination revealed absent popliteal and distal pulses. Vascular imaging confirmed acute arterial occlusion. During surgical embolectomy, a 20G pink-coded intravenous catheter fragment (32 mm) was unexpectedly retrieved. Postoperative echocardiography identified a PFO. The patient improved with antithrombotic therapy following revascularisation.</p><p><strong>Conclusion: </strong>This case demonstrates paradoxical embolisation of catheter fragments through a PFO following intravenous catheterisation. Venous-to-arterial paradoxical embolisation should be considered in unexpected arterial occlusions. Meticulous monitoring of catheter integrity and systematic PFO evaluation are critical in preventing these rare but potentially life-threatening complications.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"116-119"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- and inter-rater reproducibility of the echocardiographic data of the Nigerian UPRIGHT-HTM trial participants.","authors":"Babangida S Chori, Dong-Yan Zhang, Samuel E Antia, Ojonoma Ajanya, Collins N Ugwu, Chidiebere V Ugwueze, Arinze F Obasi, Olugbenga O Abiodun, Muhammad N Shehu, Bushra M Sanni, Sanusi Garba, Yu-Ling Yu, De-Wei An, Katarzyna Stolarz-Skrzypek, Marek Rajzer, Dries S Martens, Tim S Nawrot, Jan A Staessen, Godsent C Isiguzo, Augustine N Odili","doi":"10.5830/CVJA-2025-114","DOIUrl":"10.5830/CVJA-2025-114","url":null,"abstract":"<p><strong>Background: </strong>Echocardiography is the guideline- recommended tool for risk stratification in asymptomatic high-risk patients, but its reproducibility in sub-Saharan Africa remains largely undocumented. This study assessed the intra- and inter-rater repeatability of the risk-carrying echocardiographic traits among 42 patients enrolled in the UPRIGHT-HTM trial at three Nigerian sites.</p><p><strong>Methods: </strong>The echocardiographic images (168 for intra- and 84 for inter-rater agreement) were acquired according to current recommendations and blindly analysed by randomising the order of the digitised images. The study focused on left ventricular mass (LVM) index to body surface area of height 2.7 and ejection fraction (EF) and left ventricular diastolic dysfunction (LVDD). Repeatability was assessed by the Bland and Altman approach, the coefficient of variation (CV), the intra-class correlation coefficient (ICC) and Cohen's κ statistic. The current findings were compared with a systematic literature review of 27 publications.</p><p><strong>Results: </strong>LVM showed a slight but significant intra-rater bias, but no inter-rater bias. CVs for LVM were approximately 30%, ICCs ranged from 0.74 to 0.84, and κ statistics for LV hypertrophy (LVH) varied from 0.49 to 0.64. For EF, intra- and inter-rater CVs ranged from 13.0% to 14.5%, ICCs from 0.60 to 0.69, and statistics were 0.71 and 0.53, respectively. LVDD reproducibility was moderate, with κ values around 0.50. These findings were consistent with most of the reviewed literature.</p><p><strong>Conclusion: </strong>The risk-carrying echocardiographic traits were obtained with moderate repeatability in three Nigerian tertiary referral centres. As data quality augments with expertise, these findings call for a Nigerian training programme in echocardiography with certification.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"86-101"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Medium and Long-Term Effects of COVID-19 on the Non-Dipper Blood Pressure Pattern.","authors":"Ozan Oğuz, Ali Can Özkan, Mehmet Akif Erdöl, Çağrı Yayla, Adnan Burak Akçay, Ahmet Göktuğ Ertem","doi":"10.5830/CVJA-2025-097","DOIUrl":"https://doi.org/10.5830/CVJA-2025-097","url":null,"abstract":"<p><strong>Objectives: </strong>Although the COVID-19 pandemic has ended, its long-term cardiovascular effects remain unclear. This study evaluated persistent changes in blood pressure (BP) patterns among recovered COVID-19 patients.</p><p><strong>Methods: </strong>Data from 50 COVID-19 (+) and 42 COVID-19 (-) patients recruited between January 2020-March 2021 were retrospectively analysed. Ambulatory BP monitoring was performed between January 2023-February 2024. The primary endpoint was the prevalence of the non-dipper BP pattern.</p><p><strong>Results: </strong>Hypertension was present in 18 (36.0%) COVID-19 (+) and 16 (38.1%) COVID-19 (-) patients. COVID-19 (+) patients had lower daytime systolic BP (121.62 ± 11.65 vs. 133.36 ± 15.56 mmHg; p < 0.001) and nighttime systolic BP (109.3 ± 11.00 vs. 122.86 ± 14.96 mmHg; p < 0.001), with similar trends in diastolic BP. Non-dipper BP was more frequent in COVID-19 (+) patients (36.0% vs. 11.9%; p = 0.008).</p><p><strong>Conclusion: </strong>COVID-19 may promote the non-dipper BP pattern, highlighting the need for long-term monitoring and early cardiovascular risk management.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"102-107"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram model for predicting risk of lower extremity deep venous thrombosis in patients after heart valve replacement.","authors":"Ayu Sun, Hanjun Zhang, Tiansheng Tang, Dafa Zhang","doi":"10.5830/CVJA-2025-110","DOIUrl":"https://doi.org/10.5830/CVJA-2025-110","url":null,"abstract":"<p><p>We aimed to construct and validate a nomogram model for predicting the risk of lower extremity deep venous thrombosis (DVT) in patients after heart valve replacement. The data of patients hospitalised for heart valve replacement between January 2021 and March 2024 were retrospectively analysed. The independent risk factors for postoperative DVT were screened through univariate and multivariate logistic regression analyses, based on which a prediction model was established. The results of univariate analysis indicated that smoking history, history of alcohol intake, operation time, intraoperative blood loss, postoperative bed rest time, postoperative DVT screening time, postoperative DVT screening result, D-dimer level, postoperative pain score, postoperative hospitalisation time, postoperative complication, pulmonary infection, cardiac insufficiency, platelet count, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and international normalised ratio (INR) were associated with the occurrence of postoperative DVT (P < 0.05). The AUC, optimal cutoff value, sensitivity, and specificity reached 0.884 (95% CI: 0.817-1.000), 0.825, 0.853, and 0.756 respectively in the validation group. A risk prediction model applicable to DVT in patients undergoing heart valve replacement was successfully constructed, with satisfactory predictive efficiency.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"108-115"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombus in the Common Carotid Artery Caused by Penetrating Injury with a Bull Horn: A Case Report.","authors":"Çeber Mehmet, Karaman Kayihan","doi":"10.5830/CVJA-2025-103","DOIUrl":"https://doi.org/10.5830/CVJA-2025-103","url":null,"abstract":"<p><p>A 40-year-old man was brought to the emergency department after being gored in the neck by a bull. His general condition and vital signs were stable. No neurological deficit was detected. There was no significant bleeding in the wound area. The patient's left carotid pulse could be palpated. Despite the presence of mild symptoms, computed tomography angiography (CTA), followed by Doppler ultrasound (US), was used for further evaluation. CTA revealed an intimal tear and a filling defect consistent with thrombus in the lumen of the distal part of the left common carotid artery (CCA). US demonstrated that the bull's horn caused intimal tears in both the anterior and posterior walls, with the thrombus originating from the posterior wall. Given these findings, surgical exploration was preferred due to the risk of complications related to the endovascular approach. Neck exploration confirmed the findings, revealing an approximately 2 cm haematoma on the distal segment of the left CCA, indicative of a circumferential intimal tear that caused thrombus formation within the lumen. An arteriotomy was performed at the haematoma site, and a clot approximately 15 mm in length was removed. After excision of the circular intimal tear, an end-to-end repair was performed using a synthetic vascular graft. The patient was discharged on postoperative day 5. Imaging methods such as Doppler US and CTA should be used to ensure early diagnosis and appropriate treatment of both blunt and penetrating trauma. Patients not evaluated with these imaging modalities may later present with stroke, haematoma, or pseudoaneurysm.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"120-123"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of the Endothelial Activation and Stress Index for No-Reflow in NSTEMI Patients Undergoing Percutaneous Coronary Intervention.","authors":"Muhammet Cihat Çelik, Macit Kalçık, Abdullah Sarıhan, Orhan Karayiğit, Mücahit Yetim, Lütfü Bekar, Yağmur Ceren Doğru Yılmaz, Yusuf Karavelioğlu","doi":"10.5830/CVJA-2025-101","DOIUrl":"10.5830/CVJA-2025-101","url":null,"abstract":"<p><strong>Background: </strong>The no-reflow phenomenon, defined as inadequate myocardial perfusion despite successful epicardial recanalisation, remains a major complication after PCI in NSTEMI. Endothelial dysfunction and microvascular injury are key mechanisms. The Endothelial Activation and Stress Index (EASIX), calculated as (LDH × creatinine) / platelet count, reflects systemic endothelial stress and may predict no-reflow.</p><p><strong>Methods: </strong>This retrospective, single-centre study included 543 NSTEMI patients who underwent urgent or early PCI between 2022 and 2024. Patients were divided into no-reflow (TIMI ≤ 2) and normal reflow (TIMI 3) groups. Logistic regression identified independent predictors; ROC analysis assessed predictive accuracy.</p><p><strong>Results: </strong>No-reflow occurred in 72 patients (13.3%). These patients had higher EASIX, glucose, creatinine, LDH, and hs-CRP levels, and lower LVEF. Multivariate analysis showed that elevated EASIX (OR 2.155, 95% CI 1.211-3.835, p = 0.009), reduced LVEF (OR 0.900, 95% CI 0.868-0.933, p < 0.001), and LAD involvement (OR1.854, 95% CI 1.115-4.711, p = 0.013) independently predicted no-reflow.</p><p><strong>Conclusions: </strong>Elevated EASIX, reduced LVEF, and LAD culprit lesion independently predict no-reflow in NSTEMI patients after PCI. EASIX, derived from routine tests, offers a simple and cost-effective tool for early identification of patients at high risk of microvascular obstruction.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"37 1","pages":"80-85"},"PeriodicalIF":0.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}