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Cardiac Hypertrophy in Neonates Born to Diabetic Mothers at Farhat Hached of Sousse University Hospital
Dari Mossi Mahamadou,
Dodo Boubacar,
Ben Abdessalem Mohamed Aymen,
Mghirbi Oussama,
Saley Hammadou,
Maliki Abdoulaye Moctar,
Souley Kimba,
Bonkano Ali,
Mahdhaoui Abdallah,
Mahdhaoui Nabiha,
Ernez Hajri Samia,
Toure Ali Ibrahim
Issue:
Volume 7, Issue 2, June 2023
Pages:
22-27
Received:
21 March 2023
Accepted:
17 April 2023
Published:
10 May 2023
Abstract: Introduction: The association between cardiac hypertrophy and hyperinsulinism is mainly observed in the newborn, although the onset in older infants has also been described. The aim of our study is to research a cardiac hypertrophy in newborns of diabetic mothers. Methodology: This was a cross-sectional study, involving one hundred and twenty (120) newborns of diabetic mothers from August 1st to November 30, 2020. These newborns of diabetic mothers had received an echocardiographic examination at the laboratory of the FARHAT HACHED University Hospital in Sousse (Tunisia) regardless of the associated cardiac or extracardiac pathology, during the study period, to detect cardiac hypertrophy. Results: The sex ratio was in favor of the female gender at 0.90. The average weight was 3554.04 g, with extremes ranging from 1,600 g to 5,200 g. Twelve (12) newborns had a weight greater than or equal to 4,000 g (10.00% of macrosomes). Among mothers, there were 03 types of diabetes: type 1 diabetes (2.65%), type 2 diabetes (0.88%) and gestational diabetes (96.46%). Echocardiography was normal in 91 neonates (75.83%) and abnormal in 29 neonates (24.17%). The prevalence of cardiac hypertrophy was 09.17% and that of other associated cardiac abnormalities was 21.66%. There were 11 cases of patent foramen ovale, 11 cases of patent ductus arteriosus, 02 cases of ostium secundum atrial septal defect, 01 case of interrupted aortic arch, 01 case of pulmonary stenosis. These abnormalities were associated on the one hand with the septal hypertrophy and on the other hand, associated with each other in the same newborn. Left ventricular ejection function was normal in all neonates with an average of 66% and extremes between 59% and 76%. Conclusion: Cardiac hypertrophy described in the newborn of diabetic mother is characterized by hypertrophy of the ventricular walls more often predominating over the septum. Transthoracic echocardiography is the reference (non-invasive) technique for diagnosing and monitoring these hypertrophies.
Abstract: Introduction: The association between cardiac hypertrophy and hyperinsulinism is mainly observed in the newborn, although the onset in older infants has also been described. The aim of our study is to research a cardiac hypertrophy in newborns of diabetic mothers. Methodology: This was a cross-sectional study, involving one hundred and twenty (120)...
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A Patient with Right-to-Left Shunt Atrial Septal Defect Without Pulmonary Hypertension
Issue:
Volume 7, Issue 2, June 2023
Pages:
28-31
Received:
12 April 2023
Accepted:
27 April 2023
Published:
10 May 2023
Abstract: We present a case of atrial septal defect (ASD) in a 27-year-old young woman who presented with a right-to-left shunt despite normal pulmonary artery pressure without anomalous pulmonary venous drainage and only mild tricuspid regurgitation (TR), but it was associated with right ventricular dysfunction. Considering the dysfunction of the right heart and significant dilatation of the tricuspid annulus, the surgeon still decided to repair ASD and perform tricuspid valvuloplasty. The surgery lasted approximately three hours, and the whole procedure was smooth and uneventful. Her postoperative recovery was uneventful and discharged in good condition. The occurrence of right-to-left (R-L) shunting in patients with ASD is uncommon and is usually an ominous sign, heralding irreversible pulmonary hypertension (PH). There is little information about similar shunts for patients without PH and tricuspid regurgitation (TR), and the majority of these patients have an anatomic anomaly that favors this type of shunt. ASD with R-L shunt without Eisenmenger physiology is rarely reported and may be underestimated due to difficulty in its diagnosis. Intraoperative transesophageal echocardiography (TEE) examination should not only focus on cardiac structure but also the evaluation of ventricular function. Right-to-left shunt is possible in ASD patients even with normal pulmonary arterial pressure.
Abstract: We present a case of atrial septal defect (ASD) in a 27-year-old young woman who presented with a right-to-left shunt despite normal pulmonary artery pressure without anomalous pulmonary venous drainage and only mild tricuspid regurgitation (TR), but it was associated with right ventricular dysfunction. Considering the dysfunction of the right hear...
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Etiological Aspects of Lower Extremity Peripheral Arterial Disease: Multicentric Prospective Study of 126 Cases
Affangla Désiré Alain,
Sow Coumba,
Akanni Stéphanie Claudia,
Faye Julien,
Dione Jean-Michel Amath,
Elame-Ngwa Hugues Eli,
Ba Djibril Marie,
Aw Fatou,
Ngaide Aliou Alassane,
Leye Mohamed Mamadou Cordior Ben Omar,
Dieng Papa Adama
Issue:
Volume 7, Issue 2, June 2023
Pages:
32-37
Received:
21 April 2023
Accepted:
16 May 2023
Published:
29 May 2023
Abstract: Introduction: Atherosclerosis is the main cause of lower extremity peripheral arterial disease (PAD). However, there are other etiologies little reported. The objective of this work was to study the socio-demographic, clinical and etiological aspects of PAD. Patients and study method: This was a multicentre, descriptive, cross-sectional study conducted from January 1st to October 30th, 2021, in Thies and Dakar, Senegal. Any clinically suspected PAD was confirmed by arterial Doppler ultrasound and/or CT angiography. Clinical, biological and ultrasound data were used to establish the etiology and diagnosis criteria of OLIN for the diagnosis of thromboangiitis obliterans (TAO). Results: A total of 126 patients were collected, 31 (24.6%) in Thies and 95 (75.4%) in Dakar. There were 72 men (57.1%) and 54 women (42.9%), a male-to-female sex ratio of 1.3. The average age was 62.5 years 10.8 years. The majority of patients had a low socio-economic profile (52%). Etiologies were dominated by atheromatous disease (n= 120; 95.2%) and the cardiovascular risk factors were in order of frequency: physical inactivity (n=98; 77.8%), type 2 diabetes (n=78; 62%), hypertension (n= 69; 54.8%), smoking (n= 46; 36.5%) and dyslipidemia (n=29; 23%). Thromboangiitis obliterans (Buerger’s disease) was the second etiology found in 5 patients (3.96% of cases) and concerned only men who regularly used tobacco and cannabis. One case of ANCA-associated vasculitis was also found. In addition, there was a considerable delay in diagnosis with 117 patients (92.8%) at the critical ischemia stage at the time of diagnosis and amputation of varying magnitude in 110 patients (87.3%). This delay in diagnosis was at least due to insufficient screening, limited access to arterial Doppler echo and the lack of specialized services in vascular medicine, outside the capital Dakar. Conclusion: The most common etiology of lower extremity PAD was atherosclerosis. Obliterating thromboangiitis was not uncommon. Early detection of PAD and control of risk factors for atherosclerosis must be the rule.
Abstract: Introduction: Atherosclerosis is the main cause of lower extremity peripheral arterial disease (PAD). However, there are other etiologies little reported. The objective of this work was to study the socio-demographic, clinical and etiological aspects of PAD. Patients and study method: This was a multicentre, descriptive, cross-sectional study condu...
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Left Ventricular Assessment in Patients with Significant Mitral Incompetence; a Multi-Modality Imaging Study
Reham Mostafa Elgammal,
Mona Adel Elsaiedy,
Mahmoud Zki Alamrosy,
Mohamed Elsaied Elsetiha,
Magdy Mohamed Almasry
Issue:
Volume 7, Issue 2, June 2023
Pages:
38-49
Received:
18 February 2023
Accepted:
4 March 2023
Published:
31 May 2023
Abstract: Background: Mitral valve regurgitation (MR) is a major cause of morbidity and death across the world. It obliges volume overload over left ventricle (LV) leading to LV dysfunction and subsequently heart failure. Detection of deleterious effect on left ventricle is crucial in guiding surgical decision in such cases. Aim of the study: Comprehensive assessment of left ventricle in case of significant primary mitral incompetence using multimodality imaging tools, namely 2D echo, 3D echo and cardiac magnetic resonance (CMR). Methods: 40 consecutive patients have been recruited from May 2019 to May 2021 in a prospective observational study which has been conducted in Aswan and Tanta heart centers. All patients suffered from significant primary MR. Patients underwent 2D echo where LV volumes, function and global longitudinal strain (GLS) were calculated. The same parameters were calculated by 3D echo. CMR study for all patient was done and post processing was done on appropriate software. LV volumes, function and GLS (feature tracking) were calculated in addition to detection of myocardial fibrosis. Results: End diastolic volume (EDV) and end systolic volume (ESV) were significantly larger when measured by CMR (mean EDV = 220.63, mean ESV = 87.6) as compared to 3D echo (mean EDV =180.43, mean ESV =68.13) and 2D echo (mean EDV =166.25, mean ESV=61.58) (all P <0.001). EDV measures were strongly correlated with CMR and 3D echocardiography (r=0.88, p < 0.001).2D echo ESV measures were strongly correlated with CMR and 3D echo (r=0.7 and 0.63 respectively, P<0.001).3D echo ESV measures were moderately correlated with CMR (r=0.5, P<0.001). GLS values measured by 2D and CMR were moderately correlated (r=0.5, p<0.001). Conclusion: Left ventricle is playing an important role in the prognosis and intervention decision in mitral regurgitation. It’s important to identify early deleterious LV changes so that intervention is recommended prior to the development of irreversible LV damage.
Abstract: Background: Mitral valve regurgitation (MR) is a major cause of morbidity and death across the world. It obliges volume overload over left ventricle (LV) leading to LV dysfunction and subsequently heart failure. Detection of deleterious effect on left ventricle is crucial in guiding surgical decision in such cases. Aim of the study: Comprehensive a...
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