Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in t...Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in the first and only one cardiac catheterization center opened in Kinshasa. Methods: An analytical cross-sectional study was carried out over a period from October 2019 (date of establishment of the first coronary angiography unit in DR Congo) to March 2021. We proceeded to a serial sampling of the consecutive cases of all the patients who have an angiographic exploration of coronary arteries. Clinical, ECG and cardiac ultrasound data were collected in all patients. The indications for the coronary angiography examination were set by differents cardiologists on the basis of repolarization troubles in the electrocardiogram, cinetic troubles in echocardiography, positive stress test and chest pain in patients with cardiovascular risq factors. Results: The serie (47 patients) was predominantly male with a sex ratio M/W of 2.6. The average age was 59.8 ± 10.5 years. Arterial hypertension (HBP) was the main risk factor (89.4%);followed by diabetes mellitus (14.9%). Chest pain was the main functional sign with an atypical character in 44.7%. The ECG showed ST segment depression (17%) and T wave inversion (17%), the anterior region being the most affected. Hypokinesia was the most common echocardiographic abnormality (34%), followed by akinesia (10.6%). The anteroseptal and apical territories were affected in 12.8%. Dilated myocardiopathy (DMC) was significantly predominant in the male sex (29.4% vs 7.7%;p = 0.011). With radial puncture as the main approach, coronary angiography was pathological in 44% revealing mono-truncal lesions. The left coronary network was the most affected: the middle inter ventricular artery (12.8%), the proximal interventricular artery (10.6%) and the proximal circonflex artery (10.6%). In multivariate logistic regression analysis, age (for age > 50 years for men and >60 years for women), arterial hypertension and dilated cardiomyopathy emerged as independent determinants of pathological coronary angiography. Transluminal angioplasty was performed in 27.7% of patients. The bypass indication was retained in 4.3% of cases and medical treatment in 68%. Conclusion: Coronary angiography was used to diagnose lesions responsible for ischemic heart disease and to treat 27.7% of patients locally. The young age of patients and limited financial resources encourage the strengthening of preventive measures against cardio vascular risq factors.展开更多
Background and Objective: 24-h ambulatory blood pressure monitoring (ABPM) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates...Background and Objective: 24-h ambulatory blood pressure monitoring (ABPM) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates of tRH among patients with clinically suspected RH. Methods: Medical records of treated hypertensive patients referred in four healthcare centers for BP control evaluation by 24-h ABPM were reviewed to assess the prevalence of tRH. Inclusion criteria were age ≥ 18 years, clinical diagnosis of RH. Data on demographic, clinical, laboratory, 2D-echocardiography and 24-h ABPM parameters were retrieved from patient’s medical records. True RH (tRH) was defined as office blood pressure (BP) ≥ 140/90 mmHg and 24-h ambulatory BP ≥ 130/80 mmHg. Simple and multiple linear regression analyses were used to assess factors associated with systolic BP (SBP) as a proxy of RH among patients with tRH. P 0.05 defined the level of statistical significance. Results: Of 636 patients referred for BP control evaluation by 24-h ABPM, 75 (11.7%) had suspected RH by office BP measurements. After 24-h ABPM, pseudo or apparent RH (aRH) and tRH were observed in 15 (2.3%) and 60 (9.4%) patients, respectively. BMI (p = 0.007) and blood glucose (p = 0.024) were positively associated with SBP whereas a negative association was observed with eGFR (p = 0.022) among tRH hypertensive patients in multiple regression analysis. Conclusion: True RH was a common finding among patients with clinical RH and associated with obesity and silent target organ, especially kidney dysfunction. The present study highlights the diagnostic and prognostic importance of 24-h ABPM among patients with clinical RH.展开更多
文摘Background: The objective of this pilot study was to describe clinical profile, electric, echocardiographic and angiographic caracteristics with procedural outcome of congolease patients undergoing coronarography in the first and only one cardiac catheterization center opened in Kinshasa. Methods: An analytical cross-sectional study was carried out over a period from October 2019 (date of establishment of the first coronary angiography unit in DR Congo) to March 2021. We proceeded to a serial sampling of the consecutive cases of all the patients who have an angiographic exploration of coronary arteries. Clinical, ECG and cardiac ultrasound data were collected in all patients. The indications for the coronary angiography examination were set by differents cardiologists on the basis of repolarization troubles in the electrocardiogram, cinetic troubles in echocardiography, positive stress test and chest pain in patients with cardiovascular risq factors. Results: The serie (47 patients) was predominantly male with a sex ratio M/W of 2.6. The average age was 59.8 ± 10.5 years. Arterial hypertension (HBP) was the main risk factor (89.4%);followed by diabetes mellitus (14.9%). Chest pain was the main functional sign with an atypical character in 44.7%. The ECG showed ST segment depression (17%) and T wave inversion (17%), the anterior region being the most affected. Hypokinesia was the most common echocardiographic abnormality (34%), followed by akinesia (10.6%). The anteroseptal and apical territories were affected in 12.8%. Dilated myocardiopathy (DMC) was significantly predominant in the male sex (29.4% vs 7.7%;p = 0.011). With radial puncture as the main approach, coronary angiography was pathological in 44% revealing mono-truncal lesions. The left coronary network was the most affected: the middle inter ventricular artery (12.8%), the proximal interventricular artery (10.6%) and the proximal circonflex artery (10.6%). In multivariate logistic regression analysis, age (for age > 50 years for men and >60 years for women), arterial hypertension and dilated cardiomyopathy emerged as independent determinants of pathological coronary angiography. Transluminal angioplasty was performed in 27.7% of patients. The bypass indication was retained in 4.3% of cases and medical treatment in 68%. Conclusion: Coronary angiography was used to diagnose lesions responsible for ischemic heart disease and to treat 27.7% of patients locally. The young age of patients and limited financial resources encourage the strengthening of preventive measures against cardio vascular risq factors.
文摘Background and Objective: 24-h ambulatory blood pressure monitoring (ABPM) aids to precisely identify patients with true resistant hypertension (tRH). The present study was aimed to assess the frequency and correlates of tRH among patients with clinically suspected RH. Methods: Medical records of treated hypertensive patients referred in four healthcare centers for BP control evaluation by 24-h ABPM were reviewed to assess the prevalence of tRH. Inclusion criteria were age ≥ 18 years, clinical diagnosis of RH. Data on demographic, clinical, laboratory, 2D-echocardiography and 24-h ABPM parameters were retrieved from patient’s medical records. True RH (tRH) was defined as office blood pressure (BP) ≥ 140/90 mmHg and 24-h ambulatory BP ≥ 130/80 mmHg. Simple and multiple linear regression analyses were used to assess factors associated with systolic BP (SBP) as a proxy of RH among patients with tRH. P 0.05 defined the level of statistical significance. Results: Of 636 patients referred for BP control evaluation by 24-h ABPM, 75 (11.7%) had suspected RH by office BP measurements. After 24-h ABPM, pseudo or apparent RH (aRH) and tRH were observed in 15 (2.3%) and 60 (9.4%) patients, respectively. BMI (p = 0.007) and blood glucose (p = 0.024) were positively associated with SBP whereas a negative association was observed with eGFR (p = 0.022) among tRH hypertensive patients in multiple regression analysis. Conclusion: True RH was a common finding among patients with clinical RH and associated with obesity and silent target organ, especially kidney dysfunction. The present study highlights the diagnostic and prognostic importance of 24-h ABPM among patients with clinical RH.
