An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Cardiometabolic Phenotype and Arterial Stiffness in HIV-Positive Black African Patients

Objective: To test the hypothesis that Human Immunodeficiency Virus (HIV) infection in Black patients is associated with increased cardiometabolic risk factors that may increase aortic stiffness assessed by pulse wave velocity (PWV). Methods: We matched 96 Cameroonian Controls to 238 (Un) treated HIV-positive patients [HIV] for age. In each participant, aortic PWV (ComplioR), blood pressures (BP), lipid profile and fasting blood glucose (FPG) were measured. Results: Waist circumference was lower in HIV than in Controls (both p g·dl-1), and of diabetes (FPG > 125 mg·dl-1) were higher in HIV than in the Controls (50% vs 27%, and 23% vs 1%, respectively;both p < 0.0001). HDL-C was lower in HIV as compared to the Control (p = 0.02). Fasting triglycerides (TG) and the atherogenic dyslipidemia ratio [log(TG)/HDL-C] were higher in HIV than in the Controls (both p < 0.05). Hypertension prevalence was high but comparable in the two groups (48% vs 44% respectively, p > 0.05). HIV patients exhibited a twice-higher prevalence of MetS (AHA/NHLBI score 33/5) than that of the Controls (41% vs 21%;p 0.01). Similarly, severity of MetS phenotype was higher in HIV as compared to the Controls (2.14% vs 1.59%;p < 0.0001). PWV adjusted for age, mean BP and gender was faster in HIV in comparison to the controls (7.33 m/s vs 6.86 m/s, respectively;p = 0.036). Conclusions: HIV infection is associated with higher prevalence of MetS and its phenotype in Black African patients that may induce increased aortic stiffness.

Prevalence and Correlates of Glucose Homeostasis Abnormalities in the Far-North Region Cameroon

Background: Evidence indicates a growing burden of glucose homeostasis abnormalities (namely type 2 diabetes mellitus (T2DM) and prediabetes) in Cameroun. The aim of this study was to assess the prevalence and correlates of glucose homeostasis abnormalities (GHA) in the Far-North region of Cameroon, where these variables have not been explored so far. Methods: We included in this population-based cross-sectional survey 461 participants living urban area (Maroua) and 428 dwellers living in rural area (Tokombere) aged at least 18 years, using a multistage-cluster sampling frame. In all participants, we recorded sociodemographic, medical history, clinical data and fasting blood (capillary) glucose (FBG). Diabetes was considered for FBG ≥ 126 mg/dL or being on glucose-lowering medications, and impaired fasting glycemia (IFG) for FBG 100 - 125 mg/dL. Results: The overall age-standardized prevalence of GHA, IFG and diabetes was 33.6%, 21.7% and 11.9%, respectively. Those data were similar between urban and rural areas. Determinants of GHA were age, overweight/obesity, abdominal obesity and hypertension. IFG was only related to abdominal obesity, while diabetes was related to age, family history of diabetes, overweight/obesity, abdominal obesity and hypertension. Conclusion: Glucose homeostasis abnormalities are alarmingly high in Far North Cameroon. Efforts are needed to promote healthier lifestyles and initiate diabetes-screening campaigns in Cameroon.