Non-compaction of left ventricular myocardium in sub-Saharan African adults

Gaye, Ngoné Diaba; Ngaïdé, Aliou Alassane; Bah, Mamadou Bassirou; Babaka, Kana; Mbaye, A.; Abdoul, Kane

doi:10.1136/heartasia-2017-010884

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…This review identified underlying etiologies of SCA/SCD and ventricular arrhythmias in SSA, with hypertensive heart disease, coronary disease, cardiomyopathy, including peripartum cardiomyopathy, and valvular heart disease, especially rheumatic heart disease being the most common causes of SCA/SCD among adults [ 61 64 67 69 71 72 73 90 ]. Others include malignant arrhythmogenic inherited diseases [ 74 75 76 77 78 79 80 81 84 85 86 87 88 102 103 104 ], pericarditis [ 92 ], endemic parasitic infections [ 9 93 ], pulmonary embolism [ 62 91 ], endomyocardial fibrosis [ 95 ], congenital heart disease [ 96 ], pulmonary embolism [ 62 91 ], pulmonary hypertension [ 61 ], and aortic dissection/rupture [ 64 ]. Despite sarcoidosis being prevalent in SSA where approximately one in five cases is often mis-diagnosed as tuberculosis, studies on cardiac manifestations of sarcoidosis are lacking in this region [ 102 103 104 ].…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, studies in African Americans have shown that the relatively high prevalence of ER in this population is not independently predictive of adverse outcomes [82,83]. Ventricular non-compaction, a prominent cause of VT/VF, has been identified in patients of African ancestry with the prevalence of 6.9% in one cardiomyopathy clinic in South Africa [84], and in other SSA studies [85,86]. Apart from one case report in a black infant [87], no other studies have documented congenital long QT syndrome in Black Africans.…”

Section: Reported Underlying Etiologies Of Sca/scd and Ventricular Armentioning

confidence: 99%

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A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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Major structural cardiovascular diseases are associated with cardiac arrhythmias, but their full spectrum remains unknown in sub-Saharan Africa (SSA), which we addressed in this systematic review. Atrial fibrillation/atrial flutter (AF/AFL) prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, but <1% in the general population. Use of oral anticoagulation is heterogenous (9-79%) across SSA. The epidemiology of sudden cardiac arrest/death is less characterized in SSA. Cardiopulmonary resuscitation is challenging, owing to low awareness and lack of equipment for life-support. About 18% of SSA countries have no cardiac implantable electronic devices services, leaving hundreds of millions of people without any access to treatment for advanced bradyarrhythmias, and implant rates are more than 200-fold lower than in the western world. Management of tachyarrhythmias is largely noninvasive (about 80% AF/AFL via rate-controlled strategy only), as electrophysiological study and catheter ablation centers are almost non-existent in most countries. Highlights:-Atrial fibrillation/flutter prevalence is 16-22% in heart failure, 10-28% in rheumatic heart disease, 3-7% in cardiology admissions, and <1% in the general population in sub-Saharan Africa (SSA).-Rates of oral anticoagulation use for CHA2DS2VASC score ≥2 are very diverse (9-79%) across SSA countries.-Data on sudden cardiac arrest are scant in SSA with low cardiopulmonary resuscitation awareness.-Low rates of cardiac implantable electronic devices insertions and rarity of invasive arrhythmia treatment centers are seen in SSA, relative to the high-income countries.

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Section: Discussionmentioning

confidence: 99%

Section: Reported Underlying Etiologies Of Sca/scd and Ventricular Armentioning

confidence: 99%

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Yuyun

Bonny

et al. 2020

Global Heart

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“…NCLV is characterized by prominent left ventricular trabeculae and deep inter-trabecular recesses (94). It is not as rare as once believed, with documented reports from different African countries since 2006 (105).…”

Section: Other Cardiomyopathiesmentioning

confidence: 99%

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja

Nakagaayi

Aliku

et al. 2022

Front. Cardiovasc. Med.

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In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epidemiological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseases- leading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality.

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“…These baseline characteristics were comparable to those of other single‐center, multicenter, or different regional studies. 9 , 10 , 11 , 12 , 13 , 14 A total of 10.5% of the patients were asymptomatic at presentation, and they were usually identified after referral because of the presence of cardiac abnormalities on routine physical examination. Notably, the mean time from the onset of symptom to the correct diagnosis was 2.52 years.…”

Section: Discussionmentioning

confidence: 99%

Prognosis and subtype analysis of left ventricular noncompaction in adults: A retrospective multicenter study

Feng

Ning

Zhang

et al. 2023

Clinical Cardiology

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Background: Left ventricular noncompaction (LVNC) is a heterogeneous myocardial disorder with an uncertain prognosis. There was a lack of studies on LVNC subtypes at present. This study sought to identify the prognosis of the overall population of LVNC and to describe the distribution of different subtypes and compare their prognosis.Hypothesis: Patients with different subtypes of LVNC may have different prognoses.Methods: Patients who fulfilled the Jenni criteria and/or Petersen criteria were included. Major adverse cardiovascular events (MACE) were defined as a combination of heart failure (HF) hospitalization and all-cause mortality.Results: A total of 200 patients from four hospitals were included. The mean age at diagnosis was 48.2 years, and 61.5% of the patients were male. Left ventricular ejection fraction (LVEF) < 50% was present in 54% of the patients. Over a mean retrospective time period of 22.2 months, 47 (23.5%) patients experienced MACE.Age (hazard ratio [HR] 1.03; 95% confidence interval [CI] 1.01-1.06; p = .004), LVEF < 50% (HR 2.32; 95% CI 1.09-4.91; p = .028) and ventricular tachycardia/ ventricular fibrillation (HR 2.17; 95% CI 1.08-4.37; p = .03) were significantly associated with the risk of MACE. The most common subtype was dilated LVNC (51.3%), followed by benign LVNC (21.3%) and LVNC with arrhythmias (10.5%).Patients with dilated LVNC had significantly increased cumulative incidence of MACE, HF hospitalization, and all-cause mortality (p < .05).Conclusions: Age, LVEF < 50%, and ventricular tachycardia/ventricular fibrillation were independent risk factors for prognosis of LVNC. The most common subtype was dilated LVNC, which had a worse prognosis.

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Non-compaction of left ventricular myocardium in sub-Saharan African adults

Abstract: Contrary to previous beliefs, NCLV may not be less common in black Africans than in other ethnic subgroups. Clinicians in Africa should be made aware of NCLV so that it can be diagnosed at earlier stages.

Cited by 7 publications

References 30 publications

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa

Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Prognosis and subtype analysis of left ventricular noncompaction in adults: A retrospective multicenter study

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