Open Access Case Study

Endomyocardial Fibrosis: An Unusual Presentation

C. M. Chundusu, S. C. Rapheal, Y. C. Kumtap, V. S. Gomerep, S. S. Danbauchi

Cardiology and Angiology: An International Journal, Page 1-6
DOI: 10.9734/CA/2017/34890

Endomyocardial fibrosis is a tropical disease, characterised by fibrosis in the endocardium and subjacent myocardium affecting particularly the inflow tract and the apex of one or both ventricles. This case highlights the occurrence of EMF in an elderly woman without the typical/characteristic physical findings of EMF.


Open Access Original Research Article

Sex-related Association of Serum Uric Acid and Carotid Atherosclerosis in a Hypertensive Nigerian Population

Norbert N. Unamba, Maclean R. Akpa

Cardiology and Angiology: An International Journal, Page 1-11
DOI: 10.9734/CA/2017/34813

Background: Atherosclerosis is a primary cause of cardiovascular morbidity and mortality. Dyslipidemia is a key risk factor for the development of atherosclerosis. Carotid intima-media thickness (CIMT) is an established tool for the detection and assessment of progression of atherosclerosis. Serum uric acid (SUA) a product of purine metabolism has been recognized as a marker of endothelial dysfunction. The aim of this study was to determine the effect of gender difference in serum uric acid on subclinical carotid atherosclerosis as determined by CIMT in hypertensive patients attending the cardiology clinic of the UPTH.

Methods: 144 Hypertensive subjects and 72 age- and sex- matched controls were recruited. Their waist circumference, body mass indices and fasting lipid profile and SUA were determined. Diabetics and patients receiving uric acid-lowering drugs were excluded. CIMT was measured in all study subjects using standard protocol. Results were subjected to linear, multiple, and logistic regression analyses.

Results: Eighty-seven (61.7%) of the cases had hyperuricemia while it was present in 29(39.7%) of the controls (p=0.002). The mean uric acid was significantly higher among the cases when compared to the control group (382.8 ±109.2 µmol/l versus 347.8 ±97.4 µmol/l, p=0.021). The male subjects had a higher SUA levels than the female subjects (415.1± 98.53 µmol/l versus 334.7± 98.50 µmol/l, p<0.001). The mean CIMT of the hypertensive subjects was significantly higher than that of the control cohorts (0.79± 0.19 mm versus 0.62± 0.78 mm, p<0.001). Binary logistic regression analysis of the whole population after adjusting for age, sex, waist circumference, SBP, TG, revealed that the association between SUA and carotid atherosclerosis was significant in men but not in women.

Conclusion: A significantly positive association between SUA level and CIMT was observed in the present sample of hypertensive Nigerian adult population. This association was evident in men with essential hypertension, but not in the women.


Open Access Original Research Article

Awareness and Attitudes of University of Ibadan Freshmen towards Learning and Performing Cardiopulmonary Resuscitation

Adewale Ismahil Badru, Kehinde Kazeem Kanmodi

Cardiology and Angiology: An International Journal, Page 1-7
DOI: 10.9734/CA/2017/29506

Objectives: To assess the level of awareness of cardiopulmonary resuscitation (CPR), and the attitude of the University of Ibadan (UI) freshmen towards learning CPR, and performing CPR on cardiac arrest victims.

Methods: This research was a cross-sectional study. Between October and November 2014, questionnaires were administered to 370 first-year undergraduate students of UI to obtain information about their bio-data, awareness of CPR, and attitudes toward learning CPR, and performing CPR on cardiac arrest victims. Their participation was voluntary and anonymous. A total of 333 questionnaires were returned filled, out of which 4 were discarded because they were not properly filled. So only the data of 329 respondents were used. Analysis was done using the SPSS version 16 software.

Results: A total of 305 (92.7%) respondents had not received any training on how to perform CPR, 59 (17.9%) had witnessed situations where an individual collapsed and died, 282 (85.0%) showed positive attitude towards learning CPR, and 311 (94.5%) respondents were willing to rescue a cardiac arrest victims if they have the know-how of what  to do.

Conclusion: The majority of the UI freshmen had never received any CPR training before, however the majority of them showed positive attitude towards learning CPR, and performing CPR. There is a need to introduce CPR training into the UI curriculum for the freshmen, as recommended by the Liaison Committee on Resuscitation.


Open Access Original Research Article

Hypertension and Uterine Artery Waveform

Ramkumar Jayavelan, Nidhi Sharma

Cardiology and Angiology: An International Journal, Page 1-7
DOI: 10.9734/CA/2017/35474

Background: Pregnancy Induced Hypertension is a multisystem heterogeneous disorder occurring in 4-7% of all pregnancies. Fetal villi in the intervillous space at fetomaternal interphase show ischemic, oxidative and immune mediated damage. This study was conducted to outline the relation between abnormal uterine artery flow and perinatal outcome in a tertiary care center.

Objectives: To assess the relationship between uterine artery Doppler pulsatility index and adverse perinatal outcome.

Materials and Methods: This prospective study involved Doppler ultrasound examination of the uterine arteries at 20-23 weeks gestation in 697 women with singleton pregnancies attending a routine target scan. Pregnancy Induced Hypertension (PIH) was recorded in 57(8.18%) of all pregnancies.

Results: High pulsatility index (>95th percentile) as compared to low pulsatility Index is a good tool for the prediction of PIH (sensitivity 91.23% and specificity 99.06%, p<0.05).

Conclusion: Uterine artery Doppler has better detection rates for early onset PIH and Intrauterine Growth Restriction (IUGR). It also has high specificity in the prediction of preterm labor and abruption of placenta.

Open Access Original Research Article

Effect of an Increase in Global Left Ventricular Afterload on Myocardial Deformation in Patients with Aortic Stenosis, Comparison with Hypertensive Patients

Yoshikazu Ohara, Yuki Yoshimura, Yohko Fukuoka, Atsuko Furukawa, Shingo Hosogi, Katsuhito Yamamoto

Cardiology and Angiology: An International Journal, Page 1-11
DOI: 10.9734/CA/2017/35862

Aims: Left ventricular hypertrophy (LVH) secondary to hypertension and aortic stenosis (AS) are often considered together to be pressure overload hypertrophy. We hypothesized that important differences could exist in the myocardial function with these 2 origins of pressure-overload LVH.

Methods: Global LV longitudinal peak strain (GLS), circumferential strain (GCS) and peak left  atrial (LA) longitudinal strain (PALS) were measured using speckle-tracking echocardiography in 38 hypertensive LVH (H-LVH) patients and 36 patients with severe AS and preserved LV ejection fraction. The ratio of E/Ea to PALS was used as an index of LA stiffness. To estimate the global LV afterload, we calculated the valvuloarterial impedance (Zva) as the sum of the systolic arterial pressure and the mean transvalvular pressure gradient divided by the stroke volume index.

Results: The patients in the high Zva (n=49, Zva≥3mmHg ml/m2) were divided into two groups: AS group (n=28) and H-LVH group (n=21). GLS and PALS were significantly worsened in the AS group (p<0.0001 and p<0.0001, respectively). However, GCS was not significantly difference between two groups. LA stiffness was greater in the AS group than in the H-LVH group (p<0.0001).

Conclusions: Despite of similar global LV afterload and LV hypertrophy, myocardial LV longitudinal systolic function and LA function are impaired in patients with severe AS compared with H-LVH patients.