ABSTRACT
AIM: Studies of the influence of aortic root remodelling on the left ventricle are scarce in sub Saharan Africa even though this region has got high prevalence of arterial hypertension which is positively related to sinuses of Valsalva diameter. The present work aims to determine the frequency of the proximal aortic root enlargement and to evaluate its association with the left ventricle structure and function respectively among Congolese patients. METHOD: Four hundreds and three (403) patients who realised transthoracic cardiac echography were recruited. The association between the proximal aortic root diameter and the left ventricular echocardiographic parameters was modelised in a multiple linear regression using the Stepwise method. RESULTS: Among the 403 patients, 69.4% were hypertensive. A multivariate linear regression analysis showed correlations between the proximal aortic root diameter and the left ventricular mass (ß=1.12; P=0.01), the left ventricular diastolic diameter (ß=0.26, P=0.001) and the E/A ratio (ß=-0.02; P<0.0001) respectively. The independent predictor of the proximal aortic root diameter were age (ß=0.06, P=0.0006), duration of arterial hypertension (ß=0.11, P=0.002) and diastolic blood pressure (ß=0.03; P=0.02). The frequency of the proximal aortic root dilatation was 3.5%. CONCLUSION: These results infancies the importance of including the proximal aortic root dilatation as specific infra clinic risk factor among Congolese.
Subject(s)
Aorta/physiopathology , Dilatation, Pathologic/physiopathology , Heart Ventricles/physiopathology , Ventricular Remodeling/physiology , Age Factors , Aorta/diagnostic imaging , Cross-Sectional Studies , Democratic Republic of the Congo , Diastole/physiology , Dilatation, Pathologic/diagnostic imaging , Echocardiography , Female , Heart Ventricles/diagnostic imaging , Humans , Hypertension/physiopathology , Linear Models , Male , Middle AgedABSTRACT
BACKGROUND: Providing factual data about non-communicable diseases (NCDs) is of utmost importance in the sub-Saharan African countries where NCDs and arterial hypertension data remain scattered, scarce, and less representative given the region's heterogeneous population. Within this context, the interuniversity cooperation VLIR-UOS/Catholic University of Bukavu (Democratic Republic of Congo) has established an integrated project for monitoring hypertension and cardiovascular risk factors in the population of South Kivu. The aim of the study was to present the basic results of the determinants of blood pressure in the cohort studied. METHODS: In 2013 and 2014, trained interviewers collected the anthropometric parameters, blood pressure, and medical history of 7405 adults (3060 in urban areas and 4345 in rural areas) including 3162 males and 4243 females; the cohort is expected to be followed for 9 years. RESULTS: The average age of the entire group was 33.0±16.7 years. Compared to men, women had significantly higher obesity indices (P<0.0001), lower blood pressure between 20 and 39 years of age (P<0.0001) but higher blood pressure at 60 years of age and older (P<0.0001). Blood pressure was positively correlated with body mass index, waist circumference, and paradoxically with consumption of vegetables, but negatively correlated with the consumption of fruit, intense physical activity, and relaxation at home. CONCLUSIONS: These results show that a cohort study is feasible in the Democratic Republic of Congo. The factual data analysis can contribute to health policy orientation and setting up of preventive measures. Since most correlated risk factors are preventable, recommendations can already be made in the fight against high blood pressure in this population.
