Cardiovascular Journal of Africa最新文献

{"title":"Clinical and echocardiographic characteristics of patients who developed adverse events following Benzathine penicillin G injection for secondary prophylaxis of rheumatic heart disease: a cross-sectional study from three university hospitals in Ethiopia.","authors":"Abraha Hailu Weldegerima, Dejuma Yadeta, Marta Yemane, Gabriele Wehr, Christian Leuner, Samuel Berhane, Abadi Leul, Tadesse Dukessa, Abraham Haileamlak","doi":"10.5830/CVJA-2025-080","DOIUrl":"10.5830/CVJA-2025-080","url":null,"abstract":"<p><strong>Background: </strong>Intramuscular (IM) Benzathine penicillin G administration (BPG) is essential to prevent the progression of acute rheumatic fever (RF) to rheumatic heart disease (RHD). Fatal adverse events during BPG administration have been reported. This study aimed to characterise the clinical features and outcomes of RHD patients who developed adverse events with BPG administration for RHD prophylaxis in Ethiopia.</p><p><strong>Methods: </strong>Charts of Patients who received BPG for secondary prophylaxis of RHD and had fatal adverse events were reviewed. An online survey was also used to collect data on adverse events during BPG injection. The study was done in Ethiopia at Ayder, Tikur Anbessa, and Jimma University Hospital from January 1, 2017, to May 30, 2023. Data were collected using a structured questionnaire. Demographic, clinical, and echocardiographic features were documented and analysed.</p><p><strong>Results: </strong>All five chart review cases were female. Four of them had fatal adverse events. Four of them were aged > 18 years. All had clinical evidence of heart failure (HF) and echocardiographically advanced RHD, including severe tricuspid regurgitation (TR) and moderate to severe pulmonary hypertension (PHTN). Case 1 was 24 years old with severe mitral stenosis (MS). Case 2 was 19 years old with severe mitral regurgitation (MR). Case 3 was 14 years old with moderate to severe aortic regurgitation (AR) and moderate to severe MR. Case 4 was 43 years old with severe MS and moderate MR. Case 5 was 16 years old with moderate-severe MS, severe MR and atrial fibrillation. Four had received BPG before the event with no previous adverse reaction. None of our cases met the Level 1 Brighton criteria consistent with anaphylaxis. There were four deaths, three skin rashes, and one anaphylactic shock reported from the six RHD cases from the online survey.</p><p><strong>Conclusion: </strong>We hypothesise that the coexistence of severe valve lesions with concomitant advanced HF may be an essential risk factor in BPG injection-related deaths rather than the presence of severe valve lesions alone. Heart failure and a failure of the compensatory mechanisms in BPG injection-related adverse circulatory reactions in advanced RHD with HF could be one of the major causes of these deaths. According to the literature, we recommend that patients with advanced RHD receive special attention regarding secondary BPG prophylaxis. For the introduction of less painful BPG injection, like the subcutaneous technique, further research is needed.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"590-600"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257247","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":"Prevalence of occlusive myocardial infarction in patients diagnosed with non-ST-elevation myocardial infarction at a single private facility in Cape Town, South Africa.","authors":"Elmari Schoeman, Ibrahim D'Andrea, Willem Stassen","doi":"10.5830/CVJA-2025-074","DOIUrl":"10.5830/CVJA-2025-074","url":null,"abstract":"<p><strong>Background: </strong>ST-elevation myocardial infarction (STEMI) is associated with acute coronary occlusion, while non-ST-elevation myocardial infarction (NSTEMI) is often associated with partial occlusion. However, 25.5% of NSTEMIs involve complete occlusion, impacting mortality and major adverse cardiovascular events (MACE).¹ The occlusive myocardial infarction (OMI) vs. non-occlusive myocardial infarction (NOMI) paradigm aims to improve acute myocardial infarction (AMI) identification.^2-5.</p><p><strong>Objectives: </strong>To examine OMI prevalence among NSTEMIs in a Cape Town emergency centre in 2019 and evaluate cardiac troponin I (cTnI) levels, angiography rates, thrombolysis in myocardial infarction (TIMI) flow grades, and door-to-angiogram times.</p><p><strong>Methods: </strong>A retrospective cross-sectional study of 31 NSTEMI patients using descriptive statistics, Chi-square tests, and Mann-Whitney U tests.</p><p><strong>Results: </strong>OMI was identified in 83.9% (n = 26) of NSTEMIs. Significant cTnI levels (median 1450 ng/L, p = 0.001) and a median door-to-angiogram time of 34 hours were observed.</p><p><strong>Conclusions: </strong>The high OMI prevalence underscores the need for revised diagnostic and management strategies. Further multi-centre research is needed to validate findings and evaluate whether early OMI identification improves outcomes.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"530-537"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257414","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 train-the-trainer curriculum to scale up artificial intelligence-supported echocardiography for rheumatic heart disease screening in a public health care system.","authors":"Doreen Nakagaayi, Jafesi Pulle, Jenifer Atala, Linda M Oyella, Sarah de Loizaga, Neema W Minja, Nicholas J Ollberding, Ndate Fall, Miriam Nakitto, Rachel Sarnacki, Joselyn Rwebembera, Emmy Okello, Andrea Beaton, Craig Sable","doi":"10.5830/CVJA-2025-077","DOIUrl":"10.5830/CVJA-2025-077","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to test a train-the-trainer model for scaling up echocardiographic screening for rheumatic heart disease (RHD).</p><p><strong>Methods: </strong>This was a two-phased, prospective, pilot cohort study conducted in Lira, Uganda. In phase one, four nurse centres underwent a three-day training on echocardiographic screening for RHD. Thereafter, nurses integrated screening of patients aged 5-40 years into their routine clinic workflow. Echocardiograms were uploaded to a cloud-based server for review by an expert, who served as the gold standard for interpretation. In phase two, 12 nurses were trained by trainees included in phase one.</p><p><strong>Results: </strong>A total of 16 nurses (four in phase one and 12 in phase two) were recruited. All nurses achieved the target of acquiring 100 echocardiograms, resulting in a total of 1620 screening echocardiograms (n = 406 in phase one and n = 1214 in phase two).Over 95% of the studies were of diagnostic quality. There were 44/1473 (3%) screen-positive participants, 40 with RHD. There was a decline in sensitivity from 70% to 50% (p = 0.33) and an increase in specificity from 86% to 94% (p < 0.0001) between phases one and two. All four cases of moderate/severe RHD were correctly identified. In phase one, 56 cases were incorrectly classified as left ventricular dysfunction using the auto ejection fraction function; this option was omitted for phase two.</p><p><strong>Conclusion: </strong>This pilot study showed that utilising a train-the-trainer model to implement echocardiographic screening for RHD into primary health care in a low-resource setting is feasible.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"560-569"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257625","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 prognostic nutritional index with poor outcomes in coronary artery bypass grafting.","authors":"Şebnem Albeyoğlu, Nehir Selçuk, Aykan Atambay","doi":"10.5830/CVJA-2025-065","DOIUrl":"10.5830/CVJA-2025-065","url":null,"abstract":"<p><strong>Background: </strong>The Prognostic Nutritional Index (PNI) is a tool that combines serum albumin levels and lymphocyte count to assess a patient's nutritional and immune status. Malnutrition, often undetected in coronary bypass (CABG) patients may cause increased morbidity and mortality. PNI is a potential preoperative marker to identify high-risk patients who may benefit from nutritional support.</p><p><strong>Aim: </strong>To investigate the association between the prognostic nutritional index (PNI) and 30-daymortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).</p><p><strong>Methods: </strong>Consecutive patients aged 60 years or older who underwent coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) at a single institute between 2021 and 2022 were included in the study. The Prognostic Nutritional Index (PNI) was calculated for each patient, and comparisons were made between those with and without mortality and morbidity. Multivariate analysis was conducted out to investigate the association between PNI and both mortality and morbidity.</p><p><strong>Results: </strong>A total of 435 patients were included in the study. The mean age was 68.61 ± 5.16 years, and 114 patients (26.2%) were female. The mean EuroSCORE II was 1.71 ± 0.93, and the mean PNI was 50.65 ± 6.33. Patients who experienced mortality or morbidity had significantly lower PNI scores compared to those who did not.</p><p><strong>Conclusions: </strong>Lower PNI values were associated with increased postoperative mortality and morbidity in patients over 60 years old undergoing CABG with CPB.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"456-461"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257229","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":"11-Year follow-up of percutaneous pulmonary valve implantation (PPVI) in central South Africa.","authors":"Dhesan N Pillay, Stephen C Brown, Daniël G Buys","doi":"10.5830/CVJA-2025-071","DOIUrl":"10.5830/CVJA-2025-071","url":null,"abstract":"<p><strong>Background: </strong>Excellent mid-term outcomes are well-established for percutaneous pulmonary valve implantation (PPVI) in treating right ventricular outflow tract (RVOT) dysfunction. Despite this success, long-term data assessing PPVI performance are limited, especially within middle- to low-income country contexts.</p><p><strong>Objective: </strong>To report on the patient characteristics and long-term outcomes after PPVI.</p><p><strong>Methods: </strong>This retrospective study describes outcomes for 31 PPVI patients treated from 2012 to 2023 at the paediatric cardiology department, Universitas Academic Hospital, Bloemfontein, South Africa.</p><p><strong>Results: </strong>The predominant underlying diagnosis was tetralogy of Fallot (n = 20, 64.5%). The primary indications for PPVI were pulmonary insufficiency (PI) (n = 15, 48.4%), followed by mixed PI and right ventricular outflow tract (RVOT) stenosis (n = 10, 32.3%), and isolated pulmonary/RVOT stenosis (n = 6, 19.4%). Most implants (n = 22, 71%) were placed within homograft conduits. One early death occurred during the study period, yielding a procedural mortality rate of 3.2%. At 10 years, Kaplan-Meier estimated valve survival was 77%, freedom from stent fracture was 85.3%, and freedom from infective endocarditis (IE) was 81%. The annualised incidence of IE was 1.9%.</p><p><strong>Conclusions: </strong>These findings contribute long-term data on PPVI outcomes from a middle-income country setting. The results demonstrate favourable durability and performance, appearing comparable to surgical pulmonary valve replacement benchmarks. However, IE remains a significant long-term complication, underscoring the potential importance of implementing and adhering to stringent prophylactic protocols.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"506-513"},"PeriodicalIF":0.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257708","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 correlation between blood volume of inferior vena cava and deep vein thrombosis of the lower extremities.","authors":"Li Zhang, Zhoupeng Wu","doi":"10.5830/CVJA-2025-070","DOIUrl":"10.5830/CVJA-2025-070","url":null,"abstract":"<p><strong>Objective: </strong>To explore the correlation between deep vein thrombosis and blood volume of inferior vena cava blood volume in the lower extremities through ultrasound.</p><p><strong>Methods: </strong>A total of 149 patients with lower extremity deep vein thrombosis (DVT) developed after surgical treatment in West China Hospital from January 2023-March 2024 were enrolled, and they were classified into grade I,II, III, IV according to the classification of deep vein thrombosis, the blood volume of the inferior vena cava in four groups was examined and evaluated, and the correlation between the blood volume of the inferior vena cava and the grade of deep vein thrombosis of the lower extremity was analysed.</p><p><strong>Results: </strong>There was a statistically significant difference in venous blood volume between the four groups (F = 14.568, p < 0.05). Pearson correlation analysis showed that venous blood volume was positively correlated with lower extremity deep vein thrombosis grade (r = 0.392, p < 0.05).</p><p><strong>Conclusion: </strong>Venous blood volume was found to inversely influence the extent of venous stasis in the lower extremities, suggesting its potential utility as an indicator for the risk of developing deep vein thrombosis.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"499-501"},"PeriodicalIF":0.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257586","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 rare case of splenic hematoma after percutaneous drainage of splenic abscess with infective endocarditis.","authors":"Xuejie Li, Jiaying Chen, Zhuling Fan","doi":"10.5830/CVJA-2025-061","DOIUrl":"10.5830/CVJA-2025-061","url":null,"abstract":"<p><p>Infective endocarditis with splenic abscesses remains a complex and unusual clinical scenario. We present a rare case of splenic hematoma caused by percutaneous drainage of splenic abscess with infective endocarditis. After antibiotic therapy, mitral valve replacement combined with splenectomy was performed simultaneously. When infective endocarditis is complicated with splenic abscess, splenectomy rather than percutaneous drainage of the splenic abscess is preferred to lower the risk of splenic haemorrhage and eradicate the source of infection. The order of surgery is controversial and should be considered according to the patient's general condition.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"449-451"},"PeriodicalIF":0.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257699","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 role of inflammatory markers in predicting acute kidney injury after coronary artery bypass surgery: platelet-lymphocyte and neutrophil-lymphocyte ratios.","authors":"Huseyin Gemalmaz, Yıldırım Gultekin, Alper Selim Kocaoglu, İbrahim Cagri Kaya, Merih Ozbayburtlu, Abdurrahman Demirel","doi":"10.5830/CVJA-2025-079","DOIUrl":"10.5830/CVJA-2025-079","url":null,"abstract":"<p><strong>Purpose: </strong>Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) surgery is a major complication. We investigated the association between platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), which are associated with inflammation, with the development of AKI according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria.</p><p><strong>Methods: </strong>We retrospectively evaluated 96 patients who underwent CABG surgery between October 11, 2022 and July 31, 2024. Patients were divided into two groups: postoperative acute kidney injury (AKI) (n = 32) and non-AKI (n = 64). The diagnosis of AKI was based on changes in serum creatinine level according to KDIGO 2012 criteria.</p><p><strong>Results: </strong>In patients who had developed acute kidney injury, several inflammatory markers were significantly increased. Preoperative PLR and NLR values were significantly higher in the AKI group when presented as median (interquartile range) (PLR: 145.8 [98.5 - 183.1] vs 118.4 [89.7 - 147.1], p = 0.018; and NLR: 3.8 [2.5 - 5.1] vs 2.9 [2.0 - 3.8], p = 0.009). The CRP/albumin ratio was significantly higher in the AKI group (0.21 [0.14 - 0.32] vs 0.14 [0.09 - 0.22], p = 0.008). ROC analysis showed moderate discriminative ability for both markers, with AUC values of 0.728 (95% CI: 0.627 - 0.829) for PLR and 0.692 (95% CI: 0.588 - 0.796) for NLR. Multivariate analysis identified preoperative PLR > 132.5 as an independent predictor of AKI (OR: 2.41, 95% CI: 1.02 - 5.68, p = 0.044).</p><p><strong>Conclusions: </strong>Our findings suggest that elevated PLR and NLR values are associated with increased risk of AKI after CABG surgery. The preoperative PLR ratio with a cut-off value of 132.5 and other inflammatory ratios can be used as independent predictors of post-CABG AKI. We suggest that these easily accessible markers may provide valuable information regarding the risk of AKI development following CABG.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"580-589"},"PeriodicalIF":0.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257575","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 relationship between coronary complexity and triglyceride glucose index in stable coronary artery disease.","authors":"Oguz Kilic, Damla Yalcinkaya Oner, Fatma Ozpamuk Karadeniz, Emine Altuntas, Ercan Erdogan","doi":"10.5830/CVJA-2025-064","DOIUrl":"10.5830/CVJA-2025-064","url":null,"abstract":"<p><strong>Aim: </strong>Coronary artery disease (CAD) is an important health problem and accurate prognostic evaluations are critical. We aimed to investigate the association between the triglyceride glucose (TyG) index and coronary complexity in stable CAD patients.</p><p><strong>Methods: </strong>We retrospectively enrolled 247 stable CAD patients. The patient group was classified into two groups; group 1: SYNTAX 0, group 2: SYNTAX ≥1. TyG index levels were analysed in these groups.</p><p><strong>Results: </strong>A total of 247 patients were included in the study. Group 1 included 106 patients and, group 2 included 141 patients. Mean age was 68.9 ± 10.6 and 52.2% was male. TyG index was statistically significantly higher in group 2 (p < 0.001).Correlation analysis showed a strong correlation between the TyG index and SYNTAX score (r = 0.303, p < 0.001).</p><p><strong>Conclusion: </strong>It was observed that high TyG index values increased the complexity of lesions in coronary arteries. The TyG index may be used to determine the prognosis of patients.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"462-466"},"PeriodicalIF":0.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257578","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":"Cutaneous rupture of infected carotid artery pseudoaneurysm following neck dissection and radiotherapy for thyroid cancer.","authors":"Kübra Gözaçık Karakoç, Tamer Cebe","doi":"10.5830/CVJA-2025-062","DOIUrl":"10.5830/CVJA-2025-062","url":null,"abstract":"<p><p>We report a case of a 72-year-old man with advanced thyroid cancer who presented with massive neck bleeding from a ruptured infected pseudoaneurysm of the left common carotid artery, following radical neck dissection and radiotherapy. Due to active haemorrhage, tissue infection, and haemodynamic instability, endovascular treatment was contraindicated. Emergency surgical ligation of the left common and internal carotid arteries was performed. Postoperative infection control was achieved with broad-spectrum antibiotics and wound care. The patient recovered without neurological deficits. Prompt recognition and surgical intervention can be lifesaving in infected carotid pseudoaneurysm rupture.</p>","PeriodicalId":9434,"journal":{"name":"Cardiovascular Journal of Africa","volume":"36 4","pages":"452-455"},"PeriodicalIF":0.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257488","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}