[Knowledge of an urban population about arterial hypertension: prospective study carried out in Ouagadougou, Burkina Faso]. / Connaissances d'une population urbaine sur l'hypertension artérielle: enquête prospective menée à Ouagadougou, Burkina Faso.

The objective of this prospective survey was to estimate the prevalence of hypertension in the city of Ouagadougou and to evaluate the information level as well as the knowledge of the population regarding hypertension. We carried out a urban community based cross sectional study. Subjects were black African, and aged of 18 years at least. They were considered hypertensive when they were under a treatment for hypertension, or when they had high blood pressure (> or = 140/90 mm Hg) according to the WHO classification in 1999. The study selected 3441 subjects, among them 60.4% of women and 39.6% of men. The average age in the sample was 33.1 +/- 13.3 years; 64.4% of the subjects were 20 to 40 years old. The average systolic blood pressure in the population was of 124 +/- 21 mm Hg, and of 78 +/- 12 mm Hg for the diastolic one. The prevalence of hypertension in our sample was 23%, with 20.4% of unknown hypertensive subjects. Hypertension is highly frequent in urban area in Burkina Faso. As it could be expected, the knowledge of the population regarding hypertension proved inversely proportional to the educational level. Information programs and consciousness-raising campaign as well as detection program should be implemented urgently.

[Routine electrocardiographic criteria for the diagnosis of left ventricular hypertrophy: performance in Black Africans]. / Indices électrocardiographiques de routine pour le diagnostic de l'hypertrophie ventriculaire gauche: performances chez le sujet noir africain.

OBJECTIVE: To determine, in Black Africans, the performance of routine electrocardiographic criteria in the diagnosis of left ventricular hypertrophy (LVH). METHODS: Thirty voluntary healthy subjects and 154 patients were explored at echocardiography (according to Pen convention) and 12-lead electrocardiography (ECG). The performance of Lewis, Sokolow and Cornell (Cornell S1 for a threshold of 28 mm in men, and Cornell S2, for a threshold of 24 mm) criteria were defined by their sensitivity, specificity, positive and negative predictive values. RESULTS: The prevalence of LVH in the 154 patients ranged from 15.6% to 35.7%, according to the ECG criteria. Sensitivities were of 0.19, 0.43, 0.30 and 0.76 for the Lewis, Sokolow, Cornell S1 respectively, and the specificities were of 0.89, 0.73, 0.91 and 0.54. Positive predictive value ranged from 0.16 (Cornell S2) to 0.91 (Cornell S2), and the negative predictive value, from 0.48 (Lewis) to 0.86 (Cornell S2). CONCLUSION: Routine ECG criteria for the diagnosis LVH have low performance in Black African. There is a need of new ECG criteria with better performance.

[Cardiovascular diseases and HIV infection: study of 79 cases at the National Hospital of Ouagadougou (Burkina Faso)]. / Atteintes cardio-vasculaires et infection par le VIH: étude de 79 cas au CHN de Ouagadougou (Burkina Faso).

Cardiovascular diseases during HIV infection are frequent and serious. The aim of this first study in Burkina Faso was to analyse cardiovascular affections in HIV-positive African patients, admitted to the adult cardiology unit of the Yalgado Ouedraogo National Hospital of Ouagadougou. We conducted a retrospective study of consecutive cases admitted to the cardiology unit between 1 January 1993 and 31 March 1999. The inclusion criteria were: progressive heart affection, positive HIV serology, and the absence of cardiovascular antecedents or pathology. We studied age, sex, clinical and complementary parameters (electrocardiogram, thoracic radiography, electrocardiography), treatment and evolution. 79 black Africans were included, 44 men and 35 women. The mean age was 36.3 +/- 9.8 years. The clinical presentation was principally heart failure (79% of cases). Myocarditis or cardiomyopathy was found in 45 cases (57%); isolated pericarditis--in 25 cases (32%); pulmonary hypertension--in 4 cases (5%); pulmonary embolism--in 3 cases; and myocardial infarction--in 2 cases. According to the Atlanta CDC classification for HIV infection, 70% of the patients where in stage C. The overall hospital mortality rate was 15%. Cardiac lesions were present principally with myocardium and pericardium, with high specific mortality.

[Left ventricular hypertrophy in hypertensive African blacks: echocardiographic study of 452 patients]. / L'hypertrophie ventriculaire gauche du Noir Africain hypertendu: étude échocardiographique chez 452 sujets.

OBJECTIVE: The aim of this study was to define in a population of hypertensive Black African, the frequency of left ventricular hypertrophy (LVH), the different kind of LVH, and the factors of LVH occurring. METHODS: Clinical and echographic (according to Penn convention) data was collected in 452 consecutive hypertensive patients (193 women and 259 men). LVH was defined as an indexed left ventricular mass (ILVM) > 134 g/m2 in man and 110 g/m2 in woman. RESULTS: The mean systolic blood pressure was 187 mmHg, and the mean diastolic, 111 mmHg. The mean ILVM was 135.25 g/m2. LVH was present in 53.3% of the patients. Concentric LVH represented 48.5%, eccentric LVH 41.1%, and asymmetric hypertrophy of the septum, 10.4%. LVH increased with patient's age (p = 0.008), hypertension severity (p = 0.0001), and the ancientness of the hypertension (p = 0.0001). CONCLUSION: LVH is frequent in hypertensive black African, and concentric LVH is the most frequent kind of LVH. Factors of LVH occurring are patient's age, severity and the ancientness of the hypertension.

[Cardiothyreosis: retrospective study of 32 cases in the cardiology and internal medicine department at Ouagadougou, Burkina Faso (1993-1998)]. / La cardiothyréose: étude rétrospective de 32 cas dans les services de cardiologie et de médecine interne à Ouagadougou, Burkina Faso (1993-1998).

Cardiothyreosis is a relatively frequent condition in Sub-Saharan Africa and represents 1.7% of cardiac admissions in Ouagadougou. In this retrospective study, our aim has been to describe clinical characteristics of the disease and its cross-disciplinary management. Over a period of six years (1993-1998), we observed 32 cases of cardiothyreosis at the Centre Hospitalier Yalgado Ouedraogo. Average age was 43.3 +/- 14.7, with a clear majority of women (78.1%). Systolic blood pressure was on average 136 +/- 5 mmHg and mean diastolic blood pressure was 78 +/- 16 mmHg. Mean heart frequency was measured at 125 +/- 27 beats/minute and we detected 13 cases (41%) of atrial fibrillation. Heart failure occurred in 22 cases (69%). Underlying mitral valvulopathy was found in 5 cases. Arrhythmia was reduced in 53% of the cases, after treating with betablocker or cibenzoline (4 cases). Eighteen out of 25 patients presented anaemia (72%), 64% had hypocalcemia, and 50%--hypokaliemia. The average cardio-thoracic index was 0.63 +/- 0.09 with extremes of 0.75 and 0.40. An echocardiogramme was conducted for 10 patients and showed atrial dilation in 4 cases and ventricular dilation in one case. This turned out to be Basedow illness in 62.5% of the cases and multinodular goitre in 37.5%. Mean hospitalisation was 18.3 +/- 12.7 days. Antithyroidian treatment led to a positive evolution in 97% of the cases (only one death occurred through refractory heart failure).

[Efficacy of cibenzoline in a case of atrial fibrillation due to cardiac thyrotoxicosis]. / Efficacité de la cibenzoline dans un cas de fibrillation auriculaire sur cardiothyréose.

The authors report a case of reduction of thyrotoxicosis-related atrial fibrillation by cibenzoline. The initial clinical features of heart failure rapidly resolved and the echocardiographic left ventricular shortening fraction returned to normal. Cibenzoline could be used as antiarrhythmic treatment in atrial fibrillation related to thyrotoxicosis.