[Contribution of the 6-minutes walking test and the plasma NT-proBNP at admission and discharge to the prognostic evaluation of patients with NYHA class II-III Heart Failure.] / Contribution du test de marche de six minutes et des taux de NT-proBNP à l'admission et la sortie dans l'évaluation pronostique de l'insuffisance cardiaque classe II-III de la NYHA.

OBJECTIVE: To study the 6MWT and NT-proBNP contribution to the prognosis evaluation of patients with NYHA class II-III heart failure in the Yalgado Ouédraogo Teaching Hospital. METHODS: We carried out a nine months prospective observational cohort from the 1st February to the 31st October 2020. Patients with NYHA class II-III HF who consented to participate were included in the study. We identified two variables of interest: death and readmission. RESULTS: We included 50 patients with congestive heart failure representing 37.3% of heart failure. The average follow up time of patients was 154.58 ± 74.8 days. Twelve patients (24%) were readmited and 11 passed away with five during hospitalisation. On admission, The average distance on the 6MWT (194.6 ± 85.5 m) on admission and average NT-proBNP (5812.1±4729.4 ng/L) measured on admission and before discharge wasn't significantly correlated to the risk of death and re-hospitalisation. The average distance on the 6MWT before discharge (306.2±84.6) was significantly correlated to an increase risk of death and re-hospitalisation. Patients with an increase in NT-proBNP superior to 30% from measurement on admission to the one before discharge had a high risk of re-hospitalisation and death compare to those with a decrease of more than 30% with a moderate to good correlation coefficient of 0.6 between the two. CONCLUSION: 6MWT and NT-proBNP variations from admission to discharge have been necessary to evaluate the prognosis of patients with CHF.

[Evaluation of the quality-of-life of patients with pacemakers : experience of Burkina Faso about 120 patients paired with the collaboration of doctors from AUVERGNE (France)]. / Évaluation de la qualité de vie des patients porteurs d'un stimulateur cardiaque (pacemaker) : expérience du Burkina Faso à propos de 120 patients appareillés avec la collaboration des médecins d'Auvergne (France).

INTRODUCTION: In Burkina Faso, cardiac stimulation was introduced in October 2000 has grown over time.In orderto evaluate the effectiveness of stimulation on life, we proposed to evaluate the quality of life of patients with a pacemaker. GENERAL OBJECTIVE: to study the effect of the pacemaker on the quality of life of patients PATIENTS AND METHODS: This was a cross-sectional study aimed at describingthe wearers of a pacemaker for at least six months at the Yalgado OUEDRAOGO University Hospital and the Schiphramedical center.The AQUAREL questionnaire has been adapted to our context to establish a quality-of-life score. RESULTS: The mean age of the study population was 68 years with a female predominance (53.3%). Complete atrioventricular block was the main indication of stimulation in 55%. The average duration of implantation was 41.6 months with extremes of 8 and 128 months. The primo implantation was found in 79.1 % of patients against 18.3 % for a first change of case and2.5 % for a second change of housing. Double chamber stimulation was performed in 65% of cases. DDD mode was the most used followed by VVIR. The average quality of life score was 90.12. Negative predictors of quality of life were age and female.A correlation between quality-of-life score and age, hypertension and dyslipidemia was found (p< 0.05). On the other hand, no correlation between the number of implantation, the duration of implantation and the mode of stimulation was found (p> 0.05). CONCLUSION: patients with a pacemaker have a good quality of life. However, quality-of-life is not correlated with the number of pacemakers, nor the duration and mode of stimulation.

[High performance athlete's heart: Results of a cross-sectional survey conducted in Bobo-Dioulasso, Burkina Faso]. / Le cœur d'athlète de haut niveau d'entraînement : résultats d'une enquête transversale menée à Bobo-Dioulasso, Burkina Faso.

PURPOSE OF THE STUDY: To describe the clinical, electrocardiographic and echocardiographic features of the athlete's heart. PATIENTS AND METHODS: This was a cross-sectional study conducted from August 2015 to February 2016 in the city of Bobo-Dioulasso in Burkina Faso. Athletes of high level of training (at least 8hours of weekly training, for more than six months regardless of the type of sport) have benefited from: a clinical examination, an electrocardiography and a cardiac ultrasound rest to look for electrical, morphological and functional cardiac changes. RESULTS: The 192 athletes with an athlete heart included had a median age of 24 years (IQI: 21-27). The median seniority in high performance sport was 6 years (IQI: 4-8) and 10hours weekly training sessions (IQI: 10-10). The consumption of tobacco, alcohol, tea/coffee, medicines and/or energy drinks was reported respectively in 4.2%, 7.3%, 99.0%, 53.4%. A history of exertional discomfort was reported by 4.7 athletes. Electrical modifications were present in 92.1%. Sinus bradycardia was the most common abnormality (75.0% of cases). The prevalence of left atrium dilatation and left ventricular dilation was 72.4 and 22.4%, respectively. That of left ventricular hypertrophy was 9.0%. CONCLUSION: In the high-performance athlete, the prevalence of electrical, morphological and functional changes was high. These need to be known by practitioners to differentiate them from cardiac pathology.

[Evolution profiles of acute coronary syndromes and GRACE, TIMI and SRI risk scores in Burkina Faso. A monocentric study of 111 patients]. / Profils évolutifs des syndromes coronaires aigus et scores de risque GRACE, TIMI et SRI au Burkina Faso. À propos d'une série monocentrique de 111 patients.

OBJECTIVES: The aims of this study was to assess evolution profile of acute coronary syndrome (ACS) based on risk level by GRACE, TIMI and SRI scores in the cardiology department, Yalgado Ouedraogo university hospital. PATIENTS AND METHODS: This was a prospective study of 111 consecutive patients admitted for ACS (mean age 57.61 years, 77.5% male) between January 1st and 2010 to May 31st 2015 in the department of cardiology. For each patient, risk scores were calculated and they were divided into risk group. Global survival at one month was described by Kaplan Meier method and prognostic factors were analyzed by multivariable Cox regression. RESULTS: The prevalence of ACS was 4.2%. Patients were admitted for ST-elevation ACS and non-ST-elevation ACS in 88.3% and 11.7%, respectively. Nineteen patients (17.1%) were admitted before the 12th hour. Hospital mortality was 8.1% and increased to 16.2% in one month. After risk stratification, one-month survival of patients with high risk, was shorter than patients at low-risk regardless of the score GRACE (log-rank=9.93, P=0.007), TIMI (log-rank=14.91, P=0.001) and SRI (log-rank=10.01, P=0.006). GRACE score (HR=1.01; P=0.002), TIMI (HR=1.33; P=0.01) and SRI (HR=1.02; P=0.01) were major prognostic factors for overall survival. CONCLUSION: ACS remains a serious disease with high morbidity and mortality in the days following the initial accident. These risk scores are applicable tools in Burkina Faso as evidenced statistic C (GRACE=0.75, TIMI=0.78 and SRI=0.74).

[Management and prognosis of pulmonary embolism associated with right heart thrombi: A prospective study at the University Hospital Yalgado Ouédraogo]. / Prise en charge et pronostic des embolies pulmonaires associées à des thrombi intracavitaires droits : à propos d'une série prospective au centre Hospitalier Universitaire Yalgado Ouédraogo.

OBJECTIVE: To describe the management and evolution of high risk of death pulmonary embolism associated with right heart thrombi. MATERIAL AND METHODS: We conducted a prospective cohort survey over a 54 month-period, from March 1st, 2012 to September 30th 2015. Were included all patients with pulmonary embolism and having high or intermediate-high risk of death. Patients were divided into two groups according to whether cardiac Doppler-echography found a thrombus in the right chambers or not (ICT+ vs. ICT-). The survival curves for the patients were obtained using the software STATA. RESULTS: The prevalence of pulmonary embolism associated with right heart thrombi was 4% in our study. Thrombi were mobile, straight localization in all cases. The ICT+group was characterized by a significantly higher proportion of congestive heart and chronic lung disease. The proportion of patients' thrombolysis was significantly higher in the ICT-group. In the ICT+group, thrombolysis significantly reduced mortality giving a 30-day survival of 80% against 20% among patients receiving only heparin. CONCLUSION: Pulmonary embolism associated with right heart thrombi including the atrium are not exceptional. These patients are at high risk of early death. Thrombolysis is significantly improving the mortality of pulmonary embolism associated with right-sided heart thrombi.

[Five years assessment of cardiac stimulation in two public hospitals in Burkina Faso: An experiment of collaboration with two hospitals in Auvergne]. / Bilan de cinq ans de stimulation cardiaque dans deux structures hospitalières publiques du Burkina Faso : expérience d'une collaboration avec deux centres hospitaliers d'Auvergne.

OBJECTIVES: Cardiac stimulation becomes a reality in Burkina Faso. The aim of our study was to evaluate this activity over five years and to appreciate the impact of collaboration with French hospitals of Auvergne area in its development. MATERIALS AND METHODS: Prospective study including consecutively patients who underwent pacemaker implantation since June 2011. Data collected included indications, time to care, type of stimulation, complications, cost of treatment, and education and quality of life of the patient. RESULTS: Sixty-nine patients received definitive pacemaker from June 2011 to June 2016, of whom 45.5% were women. The mean age was 69 years (extremes 35 to 89s). Almost all patients (94%) were symptomatic (54% syncope and 30% dizziness and lipothymias). The main indication for definitive cardiac pacing was complete atrioventricular block of degenerative origin (83%). The mean time between indication and surgery was 8.2 days, and only 4% of patients received temporary stimulation. The lack of financial support was the main reason for the delay in taking charge. During the study period, the two health centers received support in the form of stimulation equipment, a technical platform, and regular training and practical training. This collaboration made it possible to overcome the lack of material, human and financial resources. We recorded as complications a case of case exteriorization, two cases of benign local hematoma and two cases of probe displacement. The quality of life of the patients improved markedly, none of patients undergoing surgery remained symptomatic. CONCLUSION: The organization of cardiac stimulation in Burkina Faso is a reality. Efforts must be made to sustain the activity and strengthen collaboration with hospitals in the north.

Complications aiguës de l'infarctus du myocarde (IDM) en milieu hospitalier universitaire au Burkina Faso : Profil et implications en santé publique

l'infarctus du myocarde (idM) constitue une urgence cardiologique absolue. Peu d'études ont été réalisées sur les complications précoces de cette affection au Burkina Faso. le but de ce travail était de décrire les aspects épidémiologiques, et évolutifs des complications aiguës de l'infarctus du myocarde dans le service de cardiologie du Chu Yo et d'entrevoir les implications en santé publique. il s'est agi d'une étude rétrospective sur une période de cinq (05) ans allant du 1er Janvier 2010 au 31 décembre 2014, portant sur les dossiers médicaux des patients hospitalisés dans le service pour syndrome coronarien aigu confirmé par l'eCg de surface et le dosage de la troponine sérique (SCa ST+ Troponine+). durant cette période, 2 469 patients ont été hospitalisés dans le service dont 102 pour infarctus du myocarde ST+, soit une prévalence hospitalière de 4,1 %. Quatre et vingt (80) patients étaient de sexe masculin contre 22 de sexe féminin, soit un sexe ratio homme/Femme de 3,6. l'âge moyen de nos patients était de 57 ans avec des extrêmes de 21 et 90 ans. l'hTa et l'obésité étaient les facteurs de risque modifiables les plus rencontrés avec respectivement 57,7 % (n= 58) et 29,7 % (n = 21). la grande majorité de nos patients (74,8 % (n = 76)) résidait en zone urbaine, et 84,3 % (n = 90) de nos patients avaient été hospitalisés dans le service après la 12e heure du début de la douleur. a l'électrocardiogramme de surface (eCg), les atteintes du territoire antérieur étaient le plus retrouvées, suivi de celles des territoires inférieur et antéro-septal avec respectivement 25,2 % ; 23,4 %. Soixante de nos patients (58,8 % des cas) avaient présenté des complications précoces, dominées par les complications hémodynamiques (37,2 %), rythmiques (25,5 %) et thromboemboliques (14,7 %). la thrombolyse à la streptokinase n'a pu être réalisée que chez 08 patients (7,8 %). nous avons enregistré 11,7 % (12) cas de décès. l'infarctus du myocarde est une urgence cardiovasculaire absolue avec la possibilité de survenue de complications surtout à la phase aiguë de la maladie. il s'agit complications en lien avec le retard de consultation des patients. Pour éviter les conséquences socio-économiques suite à l'idM, il importe de réduire les facteurs de risque cardiovasculaire modifiables et à réorganiser les services de santé pour y faire face avec une offre de soins et services de santé conséquente à tous les niveaux du système de santé

Affections cardio-vasculaires et l'infection à VIH en milieu hospitalier universitaire au Burkina Faso : profil épidémiologique, clinique et évolutif, et implications en santé publique

Le Syndrome immunodéficitaire acquis (Sida) constitue l'une des épidémies les plus meurtrières de l'histoire de l'humanité. l'avènement des médicaments antirétroviraux(aRV) en modifiant l'histoire naturelle de la maladie, par l'amélioration de la survie des patients, les exposeraient à l'émergence des pathologies cardiovasculaires. Ce travail avait pour objectif de décrire les aspects épidémiologique, clinique, paraclinique et évolutif des affections cardio-vasculaires au cours de l'infection à Vih, et entrevoir les implications en santé publique. il s'est agi d'une étude rétrospective réalisée du 01 Janvier 2011 au 31 mars 2015, elle a inclus 91 patients Vih recrutés au Centre hospitalier universitaire Yalgado ouédraogo de ouagadougou, présentant des anomalies cliniques et/ou des facteurs de risque cardiovasculaires (FdRCV) évoquant une maladie cardiovasculaire. un bilan cardiologique était réalisé en vue d'une confirmation. l'âge moyen des patients ayant présenté une pathologie cardiovasculaire associant l'infection au Vih était de 45 ± 10 ans avec les extrêmes de 20 et de 83 ans. il y avait 53 femmes (58,24 %) pour un sexe ratio homme / femme de 0,7. les sujets du niveau socio- économique faible étaient les plus représentés avec une fréquence de 56 % des cas. le tableau clinique cardiovasculaire était dominé par l'insuffisance cardiaque globale (28,57 %). les signes majeurs étaient la dyspnée, la douleur précordiale, la toux, la tachycardie et la grosse jambe douloureuse. les manifestations cardiovasculaires étaient diverses, les maladies thromboemboliques (48,35 %) étaient les plus représentées. les atteintes myocardiques (17,59 %), les atteintes péricardiques (15,39 %) et les atteintes de l'endocarde (12,09 %) étaient notées en leurs proportions respectives. il est ressorti que 3,30 % des patients ont présenté un infarctus du myocarde chez des patients vivant avec le Vih (PVVih) sous traitement antirétroviral (aRV). la mortalité hospitalière était de 14,29 %. au vu de leur fréquence, de leur taux de décès et pour leur prise en charge précoce, les atteintes cardiovasculaires au cours de l'infection par le Vih seraient multiformes. une bonne connaissance de la question par le personnel médical et paramédical et une prise en charge précoce contribuerait à la réduction de létalité y afférente

[Evaluation of the knowledge of patients about the management of treatment with anti-vitamin K drugs in the Service of Cardiology of Ouagadougou]. / Évaluation du niveau de connaissance des patients sur la gestion du traitement par les antivitamines K dans le service de cardiologie de Ouagadougou.

INTRODUCTION: Vitamin K antagonists (VKA), the most widely prescribed oral anticoagulant therapy, represent a major public health problem by the adverse events related to their use. The aim of this study was to clarify the level of knowledge that patients have about the management of their oral anticoagulant treatment. PATIENTS AND METHODS: This was a descriptive cross-sectional study performed at Yalgado Ouedraogo university Hospital, over a period of three months starting from March 1st to May 31st 2012. A questionnaire was given to patients receiving VKA treatment for at least a month. RESULTS: Seventy patients were enrolled in the study of which 30 men. The median age was 49±16 years. Heart disease and venous thromboembolic disease justifying the introduction of VKA treatment were found respectively in 58.6 and 41.4% of the cases. The name of the VKA and the exact reason for the treatment were known respectively in 91.4 and 61.7% of the case. More than half of patients (68.6%) knew that the VKA makes blood more fluid. Forty-six patients (65.7%) cited INR as biological monitoring of treatment but only 28 patients (40%) were aware of INR target values. The majority of patients did not know the risks in case of overdose (72.8%) and underdosing (71.4%). Self-medication by non-steroidal anti-inflammatory drugs was reported by 18 patients (25.7%). Cabbage (74.3%) and lettuce (62.9%) were the main foods reported to be consumed moderately. CONCLUSION: The knowledge of patients on the management of VKA is fragmentary and remains insufficient to ensure the effectiveness of the treatment. The creation of a therapeutic education program is then necessary.