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IntroductionL'insuffisance cardiaque (IC) est une cause fréquente de décès en Afrique. La présente étude a pour but de déterminer le taux de létalité de l'IC et de rechercher les facteurs associés.MéthodesIl s'agissait d'une étude rétrospective transversale réalisée dans le service de cardiologie du CHUL. Elle portait sur l'analyse de dossiers de patients hospitalisés pour IC gauche ou globale colligés de Janvier 2014 à Décembre 2016.Résultatsla létalité était de 10,3%. L'âge moyen des patients décédés (n=64) était de 57,4 ± 17 ans. Le délai moyen de prise en charge était de 15± 18 jours et la décompensation faisait suite à un écart de traitement chez 51,4% des patients décédés. L'association hypertension artérielle et diabète augmentait significativement le risque de décès (OR= 2,2 (1,2-6,6)). Les facteurs associés à la létalité étaient essentiellement: l'hypotension artérielle (OR=6,8(3,2-14,1)), l'insuffisance rénale sévère (OR=3,5(1,7-7,2)), un index cardio-thoracique supérieur à 0,7 (OR= 54,4 (15,3-193,1)), une altération sévère de la fraction d'éjection ventriculaire gauche (OR= 3,0(1,5-5,9)) et un taux élevé de NT-proBNP (OR=3,5(1,2-10,5)). La mortalité augmentait significativement avec le nombre de comorbidités. Les décès étaient dus dans 28,4% des cas à une complication extracardiaque.ConclusionLa létalité de l'IC est liée à la sévérité et à la précocité des lésions. Le retard de prise en charge et les comorbidités aggravent cette létalité. Le dépistage des facteurs de risque et l'éducation thérapeutique pourraient diminuer cette mortalité qui concerne des sujets relativement jeunes.

Background: Early detection of hypertension is necessary to reduce the risk of cardiovascular events. The aim of our study was to determine the prevalence of hypertension in high school students from Libreville, the capital city of Gabon and to identify their associated factors. Methods: This was a cross-sectional and analytical study carried out on a population of students enrolled in two professional technical high schools in Libreville during the 2018-2019 school years. The collection of students was done randomly in the two establishments after parental consent and administrative authorizations. The sample size was calculated using the Daniel Sharwtz's formula. The parameters collected were anamnestic, socio-demographic and clinical. The National High Blood Pressure and European Cardiology Society 2017 classifications were used for the analysis of blood pressure in children and young adults respectively. Results: A total of 613 students with mean an age of 20.3±2.5 years were included. Sex ratio was 2.3. Prevalence of hypertension was 19.4% and the following factors were found to be independently associated with hypertension:

The objective of this study was to analyze the effect of hydroxychloroquine or chloroquine associated with azithromycin on the QTc interval in Gabonese patients treated for COVID-19. Methods: This was an observational study conducted from April to June 2020, at the Libreville University Hospital Center in Gabon. Patients admitted for COVID-19 and treated with hydroxychloroquine or chloroquine, each combined with azithromycin were included. The QTc interval was measured upon admission and 48 h after starting treatment. The primary endpoint was QTc prolongation exceeding 60 ms and/or a QTc value exceeding 500 ms at 48 h. Results: Data from 224 patients, 102 (45.5%) who received hydroxychloroquine and 122 treated with chloroquine, were analyzed. The median baseline QTc was 396 (369–419) ms. After 48 h of treatment, 50 (22.3%) patients had a significant prolongation of QTc. This tended to be more frequent in patients treated with chloroquine (n = 33; 27.0%) than in those treated with hydroxychloroquine (n = 17; 16.7%) (p = 0.06). QTc prolongation exceeding 60 ms was found in 48 (21.3%) patients, while 11 patients had a (4.9%) QTc exceeding 60 ms at admission and exceeding 500 ms after 48 h. Conclusion: Early QTc prolongation is frequent in COVID-19 patients treated with hydroxychloroquine or chloroquine in association with azithromycin.

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Introduction Cardiovascular affections are frequent in COVID-19. Purpose The aim of this study was to describe the profile of cardiovascular manifestations in a population of patients with SARS-CoV-2 infection. Methods This was a descriptive retrospective study carried out at the center hospitalier universitaire de Libreville on April 1st, 2020 to March 30th, 2021. All the files of patients hospitalized for COVID-19 that were confirmed by PCR and presenting a cardiovascular affection were included. These patients had undergone a complete clinical examination and an electrocardiogram. Doppler echocardiography and/or thoracic CT angiography were performed according to clinical suspicion. The data were processed with SPSS 16.0 software. Quantitative variables are described as median or mean and qualitative variables as a percentage. Results Out of the 452 patients admitted for COVID-19 during this period, 51 (11.3%) presented a cardiovascular affection. The mean age was 59.1 ± 13.3 years with a predominance of men (sex ratio 1.4). Cardiovascular risk factors were dominated by high blood pressure (60.7%), obesity (43.1%) and diabetes (19.6%). The most common cardiovascular manifestations were pulmonary embolism (31.3%), arrhythmias (33.3%) and heart failure (21.6%). Acute coronary syndromes were rarer (5.9%). The medians of D dimers and CRP were 3270 microg/L and 60.5 mg/L, respectively. COVID-19-specific pulmonary CT lesions were severe in 19.6% of cases. Non-invasive ventilation was performed in 17.6% of patients. Hospital mortality was 7.8%. Conclusion Cardiovascular manifestations are frequent in Libreville for COVID-19 and affect young people. The early diagnostic and management of these affections are essential despite this particular infectious context.

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