Anomalies électrocardiographiques chez les patients hospitalisés pour COVID-19 à Fianarantsoa, Madagascar

Les anomalies électrocardiographiques sont l'expression d'une atteinte cardiovasculaire lors de la COVID-19. Les troubles du rythme et de la conduction cardiaque peuvent mettre en jeu le pronostic vital à court terme au cours de la COVID -19. Notre objectif principal est de décrire les anomalies électrocardiographiques et leurs fréquences chez les patients atteints de la COVID -19. L'objectif secondaire est de déterminer l'association entre ces anomalies électrocardiographiques et la gravité de la maladie. Méthodes : Il s'agit d'une étude rétrospective à visée descriptive des patients hospitalisés pour COVID-19 dans les centres de traitement COVID -19 de Fianarantsoa sur une période de 14 mois. Résultats : Nous avons retenu 101 patients. Le sex-ratio était de 1,06. La moyenne d'âge était de 59,81ans +/- 11,9. Tous les patients retenus avaient un électrocardiogramme à 12 dérivations et un test positif à la COVID-19. L'électrocardiogramme (ECG) était anormal chez 87 (86,1%) patients. Dans les formes graves et modérées de la maladie nous avons enregistré à l'ECG: 51 (50,5%) tachycardies sinusales, 13 (12,8%) blocs de branche incomplets droits, 13 (12,8%) profil S1Q3T3, 24 (23,7%) ondes Q pathologiques, 19 (18,8%) anomalies du segment ST. Dans les formes graves de la maladie nous avons enregistré à l'ECG: 2 (3,8%) bloc auriculoventriculaire complet (BAV complet), 7 (13,4%) blocs de branche gauche complet (BBG), 5 (9,6%) blocs de branche droit complet (BBD). La tachycardie sinusale avait une association significative avec la gravité de la maladie (p=0,002). Conclusion : Des anomalies électrocardiographiques ont été observées dans notre étude. La tachycardie sinusale était associée à la gravité de la maladie. Une surveillance rythmique, des explorations cardiaques plus pertinentes sont nécessaires pour une meilleure prise charge de la COVID-19

Association between serum lipid profile, body mass index and osteoporosis in postmenopausal Sudanese women

Background: Epidemiological observations suggest links between osteoporosis and the risk of acute cardiovascular events. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. The reduction of bone density and osteoporosis in postmenopausal women contributes to elevated lipid parameters and body mass index (BMI). Objective: To investigate the relationship between serum lipid profile, BMI and osteoporosis in postmenopausal women. Materials and Methods: A prospective analytical case control-study conducted in Khartoum north hospital at Khartoum city, capital of the Sudan from April 2017 to March 2018 after ethical approval obtained from the local Research Ethics Committee of Faculty of Medical Laboratories, Alzaeim Alazhary University on the committee meeting number (109) on Wednesday 15th February 2017. A written informed consent was obtained from all participants to participate in the study.Two hundred postmenopausal women were enrolled in the study. The age was studied in one hundred osteoporosis postmenopausal women as a case group and one hundred non-osteoporosis postmenopausal women as control group. The serum lipid profiles were estimated using spectrophotometers (Mandry) and BMI calculated using Quetelet index formula. The data were analysed using SPSS version 16. Results: The BMI, serum total cholesterol, triglyceride, HDL and LDL in case group respectively were (24.846±2.1647, 251.190±27.0135 mg/dl, 168.790 ±45.774 mg/dl, 50.620 ± 7.174 mg/dl, 166.868 ±28.978 mg/dl). While the BMI, serum total cholesterol, triglyceride, HDL and LDL in control group respectively were (25.378 ±3.8115, 187.990 ± 26.611 mg/dl, 139.360±20.290 mg/dl, 49.480 ±4.659 mg/dl, 111.667 ±28.0045 mg/dl). All serum lipid profiles significantly increased (p=0.000) in the case group compared to the control group, except serum HDL was insignificant different between the case and control group and also BMI was insignificant different between the case and control group. There was a positive Pearson's correlation between BMD and serum total cholesterol (r= 0.832, P<0.01), serum LDL (r = 0.782, P<0.01) and serum triglyceride (r = 0.72, P<0.01). Conclusions: Osteoporotic postmenopausal women had a significant increase in serum lipid profile and BMI. Moreover, we found a positive link between women with cardiovascular diseases and stroke

Pattern and Clinical Profile of Children with Complex Cardiac Anomaly at University of Nigeria Teaching Hospital; Ituku-Ozalla; Enugu State; Nigeria

Background: Complex congenital cardiac abnormalities are rare among children and contribute to mortality and morbidity. The prevalence and pattern of presentation vary from lace to place.Materials and Methods: The objective of this study was to determine the clinical profile and pattern of presentation of complex congenital cardiac malformations among children attending a tertiary hospital in Enugu State. A cross-sectional retrospective study in which a review of the records of children who attended the children outpatient clinic of University of Nigeria Teaching Hospital (UNTH); Ituku-Ozalla; Enugu State over a 5-year period (January 2007-June 2012) was undertaken. Results: Thirty one thousand seven hundred and ninety-five (31;795) children attended the outpatient clinic of the hospital over the study period; of these; 65 had cardiac diseases; from which 16 were found to have congenital complex cardiac abnormalities of various types; giving a prevalence of 0.05. Complex abnormalities seen in these children are Tricuspid atresia with various associations; cor triatriatum; single ventricle; and large ASD (atrio-septal defect) with complete AVCD; cor triatriatum sinistrum with cardiomyopathy; DORV (double outlet right ventricle) with left sided aorta; hypoplastic tricuspid valve with a PDA (patent ductus artriosus); TOF (tetralogy of fallot); prolapse of aortic valve; and pulmonary regurgitation. One of these complex cardiac anomalies presented with Turner's syndrome and another with VACTERAL association. Conclusions:The results of this study show that 0.05 of children who presented at cardiology clinic of a teaching hospital in Enugu State had congenital complex cardiac abnormalities and that the commonest forms seen were those with cor triatriatum and TOF

Cardiac Abnormalities of Sudanese Patients with Down's Syndrome and their Short-Term Outcome : Cardiovascular Topics

Background : Congential heart disease (CHD) is an important cause of morbidity and mortality in patients with Down's syndrome (DS). Methods : All patients with DS seen at the Sudan Heart Centre from July 2004 to November 2007 were included in the study. All patients were examined clinically and echocardiographically; and cardiac catheterisation was carried out in selected patients. All patients were prospectively followed up. Results : In the study period; 1 566 patients were evaluated forheart disease. Of these; 80 patients with DS were identified (5). Their ages ranged from 15 days to 18 years. Cardiac abnormalities included atrioventricular septal defect (AVSD) in 38 patients (48); with the complete form in 25; a partialform in seven; AVSD with intact atrial septum in one; and complex AVSD in four patients. In one patient there was AVSD with right atrioventricular valve malformation with severe valve regurgitation and functional pulmonary atresia. The other main lesions were ventricular septal defect (VSD) in 19 patients (23) and tetralogy of Fallot (TOF) in five (6). Cardiac catheterisation was done in four patients with AVSD to measure pulmonary pressures and resistance; and in one patient with patent ductus arteriosus for device closure. Ten percent of the patients had Eisenmenger's syndrome at the time of presentation. Only 15of patients who were in need of surgery were operated on ; all had an uneventful postoperative course and a good outcome at a mean follow-up period of one year. Conclusion : The pattern of CHD in Sudanese patients with DS was comparable with that in the literature; including the rare occurrence of AVSD with intact atrial septum. In addition; we described an unreported association with right atrioventricular valve malformation. Although there was a significant delay in diagnosis and surgery; surgical results and short-term follow up were good

Prevalence and Covariates of Electrocardiographic Left Ventricular Hypertrophy in Diabetic Patients in Tanzania : Cardiovascular Topics

Background : Left ventricular hypertrophy (LVH) has been demonstrated to be a powerful predictor of cardiovascular (CV) morbidity and mortality in diabetic as well as hypertensive patients. However; less is known about the prevalence of electrocardiographic LVH (ECG-LVH) and its relation to other CV risk factors in diabetic patients in sub-Saharan Africa. Therefore; the aim was to assess the prevalence of ECG-LVH in diabetic patients in Dar es Salaam; Tanzania; and its relation to other cardiovascular risk factors. Methods: Two hundred and thirty-seven consecutive patients attending the Muhimbili diabetic clinic were studied. ECGlvH was diagnosed by Sokolow-Lyon voltage and Cornell voltage-duration product criteria. Q waves; ST-segment deviation; T-wave abnormalities and intraventricular conduction defects were classified by the Minnesota codes. Blood pressure (BP); serum creatinine; cholesterol and triglyceride levels; and HbA1c and urinary albumin and creatinine concentrations were determined. Results: The prevalence of LVH in patients was 16by either ECG criteria; 12.2by Sokolow-Lyon and 5.1by Cornell product criteria. Patients with LVH had significantly higher systolic and mean BP and pulse pressure; and a higher prevalence of ST-segment abnormalities; T-wave inversion and albuminuria than those without LVH (all p 0.05). in multivariate logistic regression analysis; systolic BP was the only independent predictor of ECG-LVH. The prevalence of ECG-LVH increased by 15per 10 mmHg higher systolic BP [OR 1.151 (95CI 1.00921.314); p 0.05]. Clustering of cardiovascular risk factors differed significantly between type 1 and type 2 diabetes patients. On average; type 1 patients had 0.8 and type 2 had 2.2 additional CV risk factors. Conclusion: ECG-LVH was present in 16of diabetic patients in Tanzania. Systolic BP was the most important predictor of ECG-LVH. Clustering of CV risks was significantly higher in type 2 than in type 1 diabetics; demonstrating the need for systematic multiple risk-factor assessment in these patients