Open Access Original Research Article

Kindergarten Children with Congenital Heart Disease Show Good Physical Activity but Reduced Motor Skills in Comparison with Healthy Children

Andrea Engelhardt, Pinar Bambul Heck, Renate Oberhoffer, Peter Ewert, Alfred Hager

Cardiology and Angiology: An International Journal, Page 90-97
DOI: 10.9734/CA/2015/17997

Objective: For the interaction of individuals with their environment, motor competence is of major importance. It is known that school children with congenital heart disease (CHD) have motoric limitations even without hemodynamic residuals. Data from kindergarten children is lacking. This study was to compare the motor competence of kindergarten children with congenital heart disease (4-6 years) with healthy children of the same age group.

Patients and Methods: A motor test “MOT 4-6” with 18 tasks in different groups of motor skills was performed in 62 children (19 female, 43 male) with various forms of CHD and compared to 39 healthy children (22 female, 17 male). In addition to the motor test all subjects answered the Kiddy-KINDL® quality of life questionnaire, and wore an accelerometer to capture daily physical activity for seven consecutive days.

Results: The median (quartile 1; quartile 3) motor quotient in the CHD group (104 [96;113]) was significantly lower than in the control group (111 [104;116]; Mann-Whitney-U test p=0.005). Quality of life did not differ significantly (p=0.774, parents’ questionnaire p=0.066), nor the minutes in moderate and vigorous physical activity (p=0.093). No correlation between the motor quotient and the other variables could be shown.

Conclusion: Kindergarten children with CHD should be screened for a normal motor development. This delay seems to be independent from daily physical activity.


Open Access Original Research Article

Antioxidant and Radical Scavenging Properties of β-Carotene on Cisplatin Induced Cardiotoxicity

B. Uday Kiran, M. Sushma, K. V. S. R. G. Prasad, V. Uma Maheshwara Rao, D. Jhansi Laxmi Bai, V. Nisheetha

Cardiology and Angiology: An International Journal, Page 98-106
DOI: 10.9734/CA/2015/19092

Objective: To investigate the protective role of β-Carotene against cisplatin induced cardiotoxicity in male albino rats.

Methods: Various biochemical parameters such as Creatine kinase-MB, Lactate dehydrogenase (LDH), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Triglycerides (TG) and Total cholesterol (TC) are being assessed. Also the levels of the in vivo antioxidants such as Reduced glutathione (GSH), Catalase (CAT), and Malondialdehyde (MDA) in the post mitochondrial supernatant of heart were measured. In addition, the histopathological studies were performed to study the protective activity of β-carotene.

Results: Cisplatin administration has shown the elevated levels of the cardiac markers and diminished the endogenous antioxidant levels when compared with the normal rats. β-carotene treatment showed the inhibitory effect on the free radicals showing decreased levels of the cardiac markers like CK-MB, LDH, AST, ALT and ALP. The β-carotene treated rats showed significant (p<0.001) decrease in lipid peroxidation in both prophylactic and curative groups when compared to the cisplatin group. Also showed a significant (p<0.05, p<0.001) increase in the levels of GSH in prophylactic and curative group respectively when compared with the cisplatin group. Both prophylactic and curative groups have shown a significant (p<0.001) increase in the levels of CAT. Further, the histopathological studies confirm the protective effect of β-carotene.

Conclusion: These findings justify the biological and traditional uses of β-carotene as confirmed by its promising radical scavenging activity against cisplatin induced cardiotoxicity.


Open Access Original Research Article

Carotid-radial Pulse Wave form and Velocity in Normotensive and Hypertensive Pregnant Women at University Teaching Hospital (UTH), Lusaka, Zambia

Longa Kaluba, Bellington Vwalika, Methuselah Jere, Fastone M. Goma

Cardiology and Angiology: An International Journal, Page 107-114
DOI: 10.9734/CA/2015/19997

Background: Hypertensive disease in pregnancy continues to be one of the leading causes of maternal death. Pregnancy induced hypertension (PIH) is said to be accompanied by several cardiovascular pathophysiological changes including increases in arterial stiffness. Pulse wave velocity (PWV) is a method for measuring arterial stiffness. Both the pulse wave form and the velocity are said to change in PIH. However, studies documenting these characteristics of the pulse wave have mainly been in the Caucasian population.

Aims and Objectives: To establish the characteristics of the carotid-radial (cr) pulse wave in normotensive (NTN) and hypertensive (HTN) pregnant black African women at the UTH in Lusaka, Zambia.

Methodology: This cross-sectional study comprised of 26 systemically selected pregnant women between the ages 18-45 years old who met the criteria. A structured interview was used to collect socio demographic data. Anthropometric measurements were taken. After a 15 minute rest, peripheral systolic and diastolic blood pressures (BP) were measured. The PWV measurement involved applying non-invasive piezoelectric sensors on the skin over the carotid artery in the neck and the radial artery on the wrist (carotid-radial segment crPWV). Using IBM® SPSS® version 20.0 analyses were made using mann - whitney and spearman correlation tests. A 95% confidence interval (CI) and P-value of <0.05 were set. Quality recordings were obtained from the crPWV recording processes showing the wave forms and specific measurements were made.

Results: The anthropometric measurements were comparable between the 2 groups. There were significant changes in the pulse wave forms. While the normotensive participants had the type C wave form, the type A wave form was recorded from hypertensive participants. The augmentation pressure (AP) in NTN was 4±5 mmHg while it was 9±8 mmHg in HTN, indicating an increase in pressure difference from the systolic shoulder to the peak of the pulse wave (p <0.05). There was also a significant increase in the augmentation index (Aix) (1±22% vs 16±23%) (p<0.05).             The hypertensive pregnant women also had a significantly higher PWV (9±4 m/s vs 13±7 m/s) (p<0.05).

Conclusion: Distinct differences were seen in the cr pulse wave forms and velocity between normotensive and hypertensive individuals with PIH indicating an increase in arterial stiffness. These findings suggest the presence of significant peripheral vascular changes that may underly the pathophysiology of PIH.


Open Access Original Research Article

Clinical Factors Associated with Atrial Fibrillation in Congestive Heart Failure Patients Admitted to the University Teaching Hospital, Lusaka, Zambia

Methuselah Jere, Fastone M. Goma, Ben Andrews, Longa Kaluba, Charity Kapenda

Cardiology and Angiology: An International Journal, Page 115-126
DOI: 10.9734/CA/2015/19731

Introduction: Atrial fibrillation (AF) and Congestive Heart failure (CHF) have emerged as major global epidemics. Each of these conditions predisposes to the other, and their concomitant presence has additive adverse effects. This study examined the clinical factors associated with AF in CHF patients admitted to the University Teaching Hospital (UTH), Lusaka, Zambia.

Methods: This was a hospital-based cross-sectional study done in the admission wards of the UTH involving adult patients with the primary diagnosis of congestive heart failure. The data was collected from July 2014 to September 2014. A structured interview schedule was used to capture the socio-demographic and related historical data. Then all patients had a standard 12-lead ECG done on them to check for AF. Those participants with no AF on a standard 12-lead ECG had 24-hours ECG DR180+ Digital Recorder applied to try to pick-up paroxysmal AF. Finally all participants with AF were assessed for clinical factors (i.e. sex, age, BMI, smoking, excessive alcohol intake, hypertension, coronary artery disease, dilated cardiomyopathy, diabetes mellitus, and chronic lung disease). Pearson chi-square of independence of the data was used to analyze the data in SPSS® 20.0 to determine clinical factors of AF in CHF patients.

Results: A total of 49 patients were included in the study and 13 (26.5%) of them had AF, 7 diagnosed by standard ECG and 6 diagnosed by holter ambulatory ECG monitoring. The prevalence of AF in CHF was found to be strongly associated with age 65 years and above, obesity, smoking, excessive alcohol intake, hypertension, dilated cardiomyopathy, diabetes mellitus and chronic lung disease. These findings suggest the need for clinicians to consider full scale use of ambulatory ECG monitors in all CHF patients with the above conditions. 


Open Access Original Research Article

Comparison of Doppler Echocardiographic Findings in Patients with Chronic Liver Disease with and without Intrapulmonary Shunt

Vítor G. Mota, Brivaldo Markman-Filho, Liana G. Macêdo, Mônica M. de C. Becker, Edmundo P. de A. Lopes, Ana Lúcia C. Domingues

Cardiology and Angiology: An International Journal, Page 127-134
DOI: 10.9734/CA/2015/20427

Aims: Doppler echocardiography is the gold standard for the diagnosis of intrapulmonary shunt (IPS) and screening for portopulmonary hypertension in chronic liver disease (CLD). Echocardiography has become fundamental to the diagnosis of cirrhotic cardiomyopathy in the last decade. The purpose of this article was to compare echocardiographic changes in patients with CLD, with and without IPS.

Methodology: A total of 168 patients with CLD and portal hypertension underwent transthoracic contrast echocardiography and were allocated to two groups: Group 1 – 72 (42.9%) patients with IPS; and Group 2 – 96 (57.1 %) patients without IPS (control group). Echocardiographic variables and the presence/absence of IPS were evaluated in bilateral tests, with the level of statistical significance established at 5% (p < 0.05).

Results: A higher prevalence of moderate diastolic dysfunction was found in patients with IPS (24 vs. 16 patients; p = 0.034). Patients with grade II IPS had a greater frequency of moderate diastolic dysfunction than those with grade I (16 vs. 8 patients; p = 0.028). No statistically significant differences between groups were found in left atrial volume (58 vs. 55 ml; p = 0.181) or the occurrence of pulmonary arterial hypertension (25 vs. 33 patients; p = 0.963).

Conclusion: In the present study, IPS and grade II IPS were associated with moderate diastolic dysfunction determined by contrast-enhanced transthoracic Doppler echocardiography. Moderate diastolic dysfunction appeared to be a predictive factor for the onset of intrapulmonary shunt.