Aspirin,other antiplatelet agents,and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases.A concomitant proton pump inhibitor(PPI)treatment is often prescribed in these p...Aspirin,other antiplatelet agents,and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases.A concomitant proton pump inhibitor(PPI)treatment is often prescribed in these patients,as gastrointestinal complications are relatively frequent.On the other hand,a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs;in particular,it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel,due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism.Previously,the concomitant use of clopidogrel and omeprazole or esomeprazole has been discouraged.In contrast,it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel,new P2Y12 receptor antagonists.Current guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding,including advanced age,concurrent use of anticoagulants,steroids,or non-steroidal anti-inflammatory drugs,and Helicobacter pylori(H.pylori)infection.In patients taking oral anticoagulant with risk factors for gastrointestinal bleeding,PPIs could be recommended,even if their usefulness deserves further data.H.pylori infection should always be investigated and treated in patients with a history of peptic ulcer disease(with or without complication)treated with antithrombotic drugs.The present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors,anticoagulants,and PPIs,discussing consequent clinical implications.展开更多
Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitativ...Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.展开更多
Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have b...Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.展开更多
Coronavirus disease 2019(COVID-19) is known to present with respiratory symptoms,which can lead to severe pneumonia and respiratory failure.However,it can have multisystem complications such as cardiovascular manifest...Coronavirus disease 2019(COVID-19) is known to present with respiratory symptoms,which can lead to severe pneumonia and respiratory failure.However,it can have multisystem complications such as cardiovascular manifestations.The cardiovascular manifestations reported comprise myocarditis,cardiogenic shock,arrhythmias,pulmonary embolism,deep vein embolism,acute heart failure,and myocardial infarction.There is also an indirect impact of the pandemic on the management of cardiovascular care that has been shown clearly in multiple publications.In this review,we summarize the deadly relation of COVID-19 with cardiovascular events and the wider impact on several cardiovascular care areas by the pandemic situation。展开更多
Platypnea-onhodeoxia syndrome （POS） describes a clinical entity of arterial hypoxemia in the upright position associated with dyspnoea, which is relieved by recumbency. The syndrome is caused by an intracardiac or i...Platypnea-onhodeoxia syndrome （POS） describes a clinical entity of arterial hypoxemia in the upright position associated with dyspnoea, which is relieved by recumbency. The syndrome is caused by an intracardiac or intrapulmonary shunt, or ventilation-perfusion mismatching. We describe here the first case of resolving/relapsing POS induced by intracardiac right-to-left shunting that was partly dependent on volume overload.展开更多
Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Afri...Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in MAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: 100 blacks sub-Saharan African and 187 white Maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVM within quartiles of physical activity. Results: Among White Maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White Maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.展开更多
The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardi...The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardial infarction (AMI), delaying the diagnostic-therapeutic iter, with an important impact on prognosis. We describe the case of a woman of 59 years with LBBB, came to our observation for a constrictive chest pain associated with dyspnea. The diagnostic workup for suspected acute coronary syndrome (ACS), initially conducted only on the analysis of the electrocardiogram (negative TnI at entry), showed the presence of coronary arteries free of stenosis. However, the diagnostic confirmation of AMI was completed after the rise of cardiac markers and the electrocardiographic changes. This case confirm the difficulty about the diagnosis of AMI in patients with LBBB and stresses, however, as the use of some criteria proposed in the literature [1-3] can guide to its identification, directing patient to an appropriate treatment.展开更多
Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 20...Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 2007 to 2010, with a complete evaluation including family history and personal cardiac history, clinical examination and electrocardiography. Diagnosis was based on three published definitions. Results: The diagnosis of LVNC was placed in 1.4% of cases. Clinical and echo-cardiographic data for the 250 cases of LVNC are presented. Trabecular meshwork was observed predominantly at the apex (91.6%), in the lateral and inferior wall (40.4% and 38.0% respectively), and less frequently in the posterior and anterior wall (21.6% and 9.2% respectively). Conclusions: This study suggests that LVNC is a form of cardiomyopathy with higher prevalence and relatively better prognosis than previously reported.展开更多
<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Stroke is the second leading cause of death in the world and ...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Stroke is the second leading cause of death in the world and the third due to disability. However, there are few data available that identify the risk factors associated with it and their weight in different populations (population risk). </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Contribute to the knowledge of burden risk factors in stroke </span></span><span style="font-family:Verdana;">in a large cohort of Southern Italy</span><span style="font-family:;" "=""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: The data refer to a randomized Campania cohort of 1200 subjects (35</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">74 years) enrolled in 2008-09. Ten years later (2018-19) they were re-evaluated. We analyzed data from 32 patients who reported a cerebrovascular event (stroke or TIA) with the event-free group of subjects (804 subjects: 378 men and 426 women). We evaluated: absolute risk, Odds Ratio (OR), Additional Risk (AR), Risk Attributable to the Population (PAR) and, finally, the Population Attributable risk Fraction (FAP). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the comparison between the two groups (patients with events and patients without events) the risk factors with statistically significant differences were: age, Systolic Blood Pressure (SBP), BMI, cholesterol, triglycerides, glycemia and hyperinsulinemia. The ORs with the greatest impact were: blood glucose (5.1), BMI (3.3) and BPS (2.9). Linear regression analysis identified Glycemia and BMI as the only independent variables. The FAPs with the greatest impact were SBP (47.4%) and BMI (42.6%). </span><b><span style="font-family:Verdana;">Discussion and Conclusions</span></b><span style="font-family:Verdana;">: Our data confirm that the high incidence of stroke in Campania is particularly related to the high prevalence of obesity and hypertension. In the single patient, however, the risk factors with the greatest impact are: glycaemia BMI an SBP.</span></span>展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortalit...<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Res</span></b></span><b><span style="font-family:Verdana;">ults:</span></b><span style="font-family:Verdana;"> During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dilated cardiomyopathy.</span>展开更多
<div style="text-align:justify;"> <strong>Background</strong>: <span "="">Insulin resistance (IR) is the backbone of cardiovascular diseases (CVDs). The latter are the ...<div style="text-align:justify;"> <strong>Background</strong>: <span "="">Insulin resistance (IR) is the backbone of cardiovascular diseases (CVDs). The latter are the most common non-communicable diseases globally. Diet is an important determinant of CVDs. The link between diet and cardiovascular health could be explained by an association between diet pattern and IR. <b>Aims</b>: To investigate the association between salt and specific food consumption as well as different diet patterns (Mediterranean, westernized, and intermediate dietary patterns) with HOMAIR as a surrogate marker of IR, and fasting insulin in Black, sub-Saharan essential hypertensive</span> patient<span "="">s. <b>Methods</b>: The multicentric, cross-sectional analysis involved 77 Congolese Black hypertensive participants with no history of cardiovascular disease. Daily sodium chloride intake (NaCl g/24h) was estimated from 24-hour urine collection. Dietary behaviours were evaluated through a semi-quantitative food frequency questionnaire (FFQ). Homeostatic model assessment of insulin resistance (HOMAIR) ≥ 2.5 was used as surrogate marker of IR. <b>Results</b>: A decrease in weekly consumption of fruits, vegetables and fish would significantly explain an increase of 29% (r = 0.292;p = 0.010), 24% (r = 0.242;p = 0.034) and 23% (r = 0.226;p = 0.048) of the value of HOMAIR respectively. In contrast, an increase in daily sodium chloride intake was associated with 28% (r = 0.283, p = 0.027) of the increase in HOMAIR. Also, a decrease in the average weekly consumption of fruit, vegetables and fish would significantly explain an increase of 25% (r = 0.247;p = 0.030), 30% (r = 0.302;p = 0.008) and 31% (r = 0.313;p = 0.006) of fasting insulin. In contrast, an increase in red meat consumption was associated with a 26% increase (r = 0.257, p = 0.024) in fasting insulin. In multivariable adjusted analysis 45% of variation in fasting insulin (R<sup>2</sup> = 0.452;overall p = 0.005) were explained by fruits, vegetables and fish consumption. 38% of variation in HOMAIR (R<sup>2</sup> = 0.379;overall p = 0.047) were explained by fruits and vegetable consumption and daily sodium chloride intake (NaCl g/24h). <b>Conclusions: </b>In hypertensive Black sub-Saharan Africans, Salt intake and westernized diet seem to promote insulin resistance whereas Mediterranean diet, fruits, vegetables and fish consumption enhance insulin sensitivity.</span> </div>展开更多
The quick evaluation of venous thromboembolism is a key point of modern medicine since the delayed diagnosis is associated with a worse prognosis.Venous ultrasound(VU)is a sensitive and rapidly performed test in cases...The quick evaluation of venous thromboembolism is a key point of modern medicine since the delayed diagnosis is associated with a worse prognosis.Venous ultrasound(VU)is a sensitive and rapidly performed test in cases of suspected deep venous thrombosis.Various protocols have been proposed for its execution,such as the study of the whole deep venous circulation of the lower limb or the analysis of the femoral-popliteal area.The aim is to detect a vessel thrombus and the most sensitive element is the non-compressibility with the probe.Initially,the thrombus is hypoechogenic and adherent to the vessel;later,it tends to organize and recanalize.Usually,in the early stages,the risk of embolism is higher.The role of studying the iliac axis and calf veins is still uncertain.VU is not useful for assessing response to anticoagulation therapy and it is unclear whether the persistence of thrombotic abnormalities can guide on a possible prolongation of therapy.展开更多
Classical risk factors only partially account for variations in cardiovascular disease incidence;therefore,also other so far unknown features,among which meteorological factors,may influence heart diseases(mainly coro...Classical risk factors only partially account for variations in cardiovascular disease incidence;therefore,also other so far unknown features,among which meteorological factors,may influence heart diseases(mainly coronary heart diseases,but also heart failure,arrhythmias,aortic dissection and stroke)rates.The most studied phenomenon is ambient temperature.The relation between mortality,as well as cardiovascular diseases incidence,and temperature appears graphically as a"U"shape.Exposure to cold,heat and heat waves is associated with an increased risk of acute coronary syndromes.Other climatic variables,such as humidity,atmospheric pressure,sunlight hours,wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and nonfatal cardiovascular diseases incidence.Main limitation of these studies is the unavailability of data on individual exposure to weather parameters.Effects of weather may vary depending on other factors,such as population disease profile and age structure.Climatic stress may increase direct and indirect risks to human health via different,complex pathophysiological pathways and exogenous and endogenous mechanisms.These data have attracted growing interest because of the recent earth’s climate change,with consequent increasing ambient temperatures and climatic fluctuations.This review evaluates the evidence base for cardiac health consequences of climate conditions,and it also explores potential further implications.展开更多
BACKGROUND It has been suggested that chronic pancreatitis(CP)may be an independent risk factor for development of cardiovascular disease(CVD).At the same time,it seems that congestive heart failure(CHF)and CP share t...BACKGROUND It has been suggested that chronic pancreatitis(CP)may be an independent risk factor for development of cardiovascular disease(CVD).At the same time,it seems that congestive heart failure(CHF)and CP share the responsibility for the development of important clinical conditions such as sarcopenia,cachexia and malnutrition due to development of cardiac cachexia and pancreatic exocrine insufficiency(PEI),respectively.AIM To explore the evidence regarding the association of CP and heart disease,more specifically CVD and CHF.METHODS A systematic search of MEDLINE,Web of Science and Google Scholar was performed by two independent investigators to identify eligible studies where the connection between CP and CVD was investigated.The search was limited to articles in the English language.The last search was run on the 1st of May 2019.The primary outcomes were:(1)Incidence of cardiovascular event[acute coronary syndrome(ACS),chronic coronary disease,peripheral arterial lesions]in patients with established CP;and(2)Incidence of PEI in patients with CHF.RESULTS Out of 1166 studies,only 8 were eligible for this review.Studies regarding PEI and CHF showed an important incidence of PEI as well as associated malabsorption of nutritional markers(vitamin D,selenium,phosphorus,zinc,folic acid,and prealbumin)in patients with CHF.However,after substitution of pancreatic enzymes,it seems that,at least,loss of appetite was attenuated.On the other side,studies investigating cardiovascular events in patients with CP showed that,in CP cohort,there was a 2.5-fold higher incidence of ACS.In another study,patients with alcohol–induced CP with concomitant type 3c diabetes had statistically significant higher incidence of carotid atherosclerotic plaques in comparison to patients with diabetes mellitus of other etiologies.Earlier studies demonstrated a marked correlation between the clinical symptoms in CP and chronic coronary insufficiency.Also,statistically significant higher incidence of arterial lesions was found in patients with CP compared to the control group with the same risk factors for atherosclerosis(hypertension,smoking,dyslipidemia).Moreover,one recent study showed that PEI is significantly associated with the risk of cardiovascular events in patients with CP.CONCLUSION Current evidence implicates a possible association between PEI and malnutrition in patients with CHF.Chronic pancreatic tissue hypoxic injury driven by prolonged splanchnic hypoperfusion is likely to contribute to malnutrition and cachexia in patients with CHF.On the other hand,CP and PEI seem to be an independent risk factor associated with an increased risk of cardiovascular events.展开更多
BACKGROUND Since 2010,the European Society of Cardiology has extended prescription criteria for oral antithrombotic therapy(OAT)in atrial fibrillation(AF).Direct oral anticoagulants(DOACs)were upgraded from an IIAa re...BACKGROUND Since 2010,the European Society of Cardiology has extended prescription criteria for oral antithrombotic therapy(OAT)in atrial fibrillation(AF).Direct oral anticoagulants(DOACs)were upgraded from an IIAa recommendation in 2012 to an IA in 2016.In real-world scenarios,however,OAC prescription is still suboptimal,mainly for DOACs.AIM To evaluate OAT temporal prescription patterns in a cohort of patients hospitalized with AF in a Cardiology Department.METHODS A retrospective observational study was conducted on a cohort of hospitalized patients in a secondary setting(Trapani,Italy)from 2010 to 2021 with AF as the main or secondary diagnosis.For 4089 consecutive patients,the variables extracted from the Cardiology department database were:Sex,age,time of hospitalization,antithrombotic therapy(warfarin,acenocoumarol,apixaban,dabigatran,edoxaban,rivaroxaban,aspirin,clopidogrel,other antiplatelet agents,low molecular weight heparin,and fondaparinux),diagnosis at discharge and used resources.Basal features are presented as percentage values for categorized variables and as mean+/-SD for categorized once.RESULTS From January 1st,2010 to October 6th,2021,25132 patients were hospitalized in our department;4089(16.27%,mean age 75.59+/-10.82)were discharged with AF diagnosis;of them,2245 were males(54.81%,mean age 73.56+/-11.45)and 1851 females(45.19%,mean age 78.06+/-9.47).Average length of stay was 5.76+/-4.88 days;154 patients died and 88 were moved to other Departments/Structures.AF was the main diagnosis in 899 patients(21.94%).The most frequent main diagnosis in patients with AF was acute myocardial infarction(1973 discharges,48.19%).The most frequent secondary cardiac diagnosis was chronic coronary syndrome(1864 discharges,45.51%),and the most frequent secondary associated condition was arterial hypertension(1010 discharges,24.66%).For the analysis of antithrombotic treatments,the final sample included 3067 patients,after excluding in-hospital deaths,transferred out or self-discharged patients,as well as discharges lacking indications for prescribed treatments.OAC treatment increased significantly(35.63%in 2010-2012 vs 61.18%in 2019-2021,+25.55%,P<0.0001),in spite of any antiplatelet agent use.This rise was due to increasing use of DOACs,with or without antiplatelet agents,from 3.04%in 2013-2015 to 50.06%in 2019-2021(+47.02%,P<0.0001)and was greater for factor Xa inhibitors,especially apixaban.In addition,treatment with a vitamin K antagonist,in spite of any antiplatelet agent use,decreased from 35.63%in 2010-2012 to 11.12%in 2019-2021(-24.48%,P<0.0001),as well as any antiplatelet therapy,alone or in double combination,(49.18%in 2010-2012 vs 34.18%in 2019-2021,-15.00%,P<0.0001);and patients not receiving antithrombotic therapy declined with time(14.58%in 2010-2012 vs 1.97%in 2021,P<0.0001).CONCLUSION Real-world patients with AF are elderly and affected by cardiovascular and non-cardiovascular diseases.The percentage of patients on OAT and DOACs increased.These data suggest a slow,gradual guidelines implementation process.展开更多
There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertroph...There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The MA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: The MAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin Maghreb within the age of 18 to 55 years underwent a resting echocardiography. Multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: Men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.展开更多
文摘Aspirin,other antiplatelet agents,and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases.A concomitant proton pump inhibitor(PPI)treatment is often prescribed in these patients,as gastrointestinal complications are relatively frequent.On the other hand,a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs;in particular,it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel,due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism.Previously,the concomitant use of clopidogrel and omeprazole or esomeprazole has been discouraged.In contrast,it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel,new P2Y12 receptor antagonists.Current guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding,including advanced age,concurrent use of anticoagulants,steroids,or non-steroidal anti-inflammatory drugs,and Helicobacter pylori(H.pylori)infection.In patients taking oral anticoagulant with risk factors for gastrointestinal bleeding,PPIs could be recommended,even if their usefulness deserves further data.H.pylori infection should always be investigated and treated in patients with a history of peptic ulcer disease(with or without complication)treated with antithrombotic drugs.The present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors,anticoagulants,and PPIs,discussing consequent clinical implications.
文摘Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.
文摘Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.
文摘Coronavirus disease 2019(COVID-19) is known to present with respiratory symptoms,which can lead to severe pneumonia and respiratory failure.However,it can have multisystem complications such as cardiovascular manifestations.The cardiovascular manifestations reported comprise myocarditis,cardiogenic shock,arrhythmias,pulmonary embolism,deep vein embolism,acute heart failure,and myocardial infarction.There is also an indirect impact of the pandemic on the management of cardiovascular care that has been shown clearly in multiple publications.In this review,we summarize the deadly relation of COVID-19 with cardiovascular events and the wider impact on several cardiovascular care areas by the pandemic situation。
文摘Platypnea-onhodeoxia syndrome （POS） describes a clinical entity of arterial hypoxemia in the upright position associated with dyspnoea, which is relieved by recumbency. The syndrome is caused by an intracardiac or intrapulmonary shunt, or ventilation-perfusion mismatching. We describe here the first case of resolving/relapsing POS induced by intracardiac right-to-left shunting that was partly dependent on volume overload.
文摘Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in MAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: 100 blacks sub-Saharan African and 187 white Maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVM within quartiles of physical activity. Results: Among White Maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White Maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.
文摘The occurrence of left bundle branch block (LBBB) is quite common in clinical practice. The changes in cardiac repolarization, caused by this disorder of electric conduction, may mask the presence of an acute myocardial infarction (AMI), delaying the diagnostic-therapeutic iter, with an important impact on prognosis. We describe the case of a woman of 59 years with LBBB, came to our observation for a constrictive chest pain associated with dyspnea. The diagnostic workup for suspected acute coronary syndrome (ACS), initially conducted only on the analysis of the electrocardiogram (negative TnI at entry), showed the presence of coronary arteries free of stenosis. However, the diagnostic confirmation of AMI was completed after the rise of cardiac markers and the electrocardiographic changes. This case confirm the difficulty about the diagnosis of AMI in patients with LBBB and stresses, however, as the use of some criteria proposed in the literature [1-3] can guide to its identification, directing patient to an appropriate treatment.
文摘Objectives: To analyse the clinical profile of consecutive cases of Left Ventricular Non Compaction (LVNC) with particular interest in non-compacted segments valuation. Methods: There were 18,000 patients seen from 2007 to 2010, with a complete evaluation including family history and personal cardiac history, clinical examination and electrocardiography. Diagnosis was based on three published definitions. Results: The diagnosis of LVNC was placed in 1.4% of cases. Clinical and echo-cardiographic data for the 250 cases of LVNC are presented. Trabecular meshwork was observed predominantly at the apex (91.6%), in the lateral and inferior wall (40.4% and 38.0% respectively), and less frequently in the posterior and anterior wall (21.6% and 9.2% respectively). Conclusions: This study suggests that LVNC is a form of cardiomyopathy with higher prevalence and relatively better prognosis than previously reported.
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Stroke is the second leading cause of death in the world and the third due to disability. However, there are few data available that identify the risk factors associated with it and their weight in different populations (population risk). </span><b><span style="font-family:Verdana;">Aim: </span></b><span style="font-family:Verdana;">Contribute to the knowledge of burden risk factors in stroke </span></span><span style="font-family:Verdana;">in a large cohort of Southern Italy</span><span style="font-family:;" "=""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: The data refer to a randomized Campania cohort of 1200 subjects (35</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">74 years) enrolled in 2008-09. Ten years later (2018-19) they were re-evaluated. We analyzed data from 32 patients who reported a cerebrovascular event (stroke or TIA) with the event-free group of subjects (804 subjects: 378 men and 426 women). We evaluated: absolute risk, Odds Ratio (OR), Additional Risk (AR), Risk Attributable to the Population (PAR) and, finally, the Population Attributable risk Fraction (FAP). </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> In the comparison between the two groups (patients with events and patients without events) the risk factors with statistically significant differences were: age, Systolic Blood Pressure (SBP), BMI, cholesterol, triglycerides, glycemia and hyperinsulinemia. The ORs with the greatest impact were: blood glucose (5.1), BMI (3.3) and BPS (2.9). Linear regression analysis identified Glycemia and BMI as the only independent variables. The FAPs with the greatest impact were SBP (47.4%) and BMI (42.6%). </span><b><span style="font-family:Verdana;">Discussion and Conclusions</span></b><span style="font-family:Verdana;">: Our data confirm that the high incidence of stroke in Campania is particularly related to the high prevalence of obesity and hypertension. In the single patient, however, the risk factors with the greatest impact are: glycaemia BMI an SBP.</span></span>
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Cardiovascular disease has become a major concern for the nephrologist as it is the leading cause of morbidity and mortality in patients with chronic kidney disease, and affects all stages of the disease, including the earliest stages of the disease. The goal of this work was to determine the frequency of cardiovascular complications during chronic kidney failure.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This was a six-month, descriptive cross-sectional study from March 01 to August 31, 2018. It covered all patients with chronic kidney disease hospitalized in the ward during the study period. Included were all chronic kidney failure patients with at least one cardiac and/or vascular complication diagnosed either on clinical examination, and/or paraclinical examination (Electrocardiogram or cardiac ultrasound, vessel echodoppler, scan)</span><span style="font-family:Verdana;">.</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Res</span></b></span><b><span style="font-family:Verdana;">ults:</span></b><span style="font-family:Verdana;"> During the study period, 84 out of 378 patients or 22.22% had at least one cardiovascular complication. Cardiovascular complications were hypertrophy of the left ventricle with 49/84 (44 at Electrocardiogram and 5 at cardiac echodoppler), valvulopathy with 33.33%, stroke with 50% of cases, obliterating arterial disease of the lower limbs 25%, hypokinetic dilated cardiomyopathy with 9/36 cases and pericarditis with 2/36.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Cardiovascular complications affect both sexes and all ages. They were dominated by enlarged left ventricle, valvulopathy and dilated cardiomyopathy.</span>
文摘<div style="text-align:justify;"> <strong>Background</strong>: <span "="">Insulin resistance (IR) is the backbone of cardiovascular diseases (CVDs). The latter are the most common non-communicable diseases globally. Diet is an important determinant of CVDs. The link between diet and cardiovascular health could be explained by an association between diet pattern and IR. <b>Aims</b>: To investigate the association between salt and specific food consumption as well as different diet patterns (Mediterranean, westernized, and intermediate dietary patterns) with HOMAIR as a surrogate marker of IR, and fasting insulin in Black, sub-Saharan essential hypertensive</span> patient<span "="">s. <b>Methods</b>: The multicentric, cross-sectional analysis involved 77 Congolese Black hypertensive participants with no history of cardiovascular disease. Daily sodium chloride intake (NaCl g/24h) was estimated from 24-hour urine collection. Dietary behaviours were evaluated through a semi-quantitative food frequency questionnaire (FFQ). Homeostatic model assessment of insulin resistance (HOMAIR) ≥ 2.5 was used as surrogate marker of IR. <b>Results</b>: A decrease in weekly consumption of fruits, vegetables and fish would significantly explain an increase of 29% (r = 0.292;p = 0.010), 24% (r = 0.242;p = 0.034) and 23% (r = 0.226;p = 0.048) of the value of HOMAIR respectively. In contrast, an increase in daily sodium chloride intake was associated with 28% (r = 0.283, p = 0.027) of the increase in HOMAIR. Also, a decrease in the average weekly consumption of fruit, vegetables and fish would significantly explain an increase of 25% (r = 0.247;p = 0.030), 30% (r = 0.302;p = 0.008) and 31% (r = 0.313;p = 0.006) of fasting insulin. In contrast, an increase in red meat consumption was associated with a 26% increase (r = 0.257, p = 0.024) in fasting insulin. In multivariable adjusted analysis 45% of variation in fasting insulin (R<sup>2</sup> = 0.452;overall p = 0.005) were explained by fruits, vegetables and fish consumption. 38% of variation in HOMAIR (R<sup>2</sup> = 0.379;overall p = 0.047) were explained by fruits and vegetable consumption and daily sodium chloride intake (NaCl g/24h). <b>Conclusions: </b>In hypertensive Black sub-Saharan Africans, Salt intake and westernized diet seem to promote insulin resistance whereas Mediterranean diet, fruits, vegetables and fish consumption enhance insulin sensitivity.</span> </div>
文摘The quick evaluation of venous thromboembolism is a key point of modern medicine since the delayed diagnosis is associated with a worse prognosis.Venous ultrasound(VU)is a sensitive and rapidly performed test in cases of suspected deep venous thrombosis.Various protocols have been proposed for its execution,such as the study of the whole deep venous circulation of the lower limb or the analysis of the femoral-popliteal area.The aim is to detect a vessel thrombus and the most sensitive element is the non-compressibility with the probe.Initially,the thrombus is hypoechogenic and adherent to the vessel;later,it tends to organize and recanalize.Usually,in the early stages,the risk of embolism is higher.The role of studying the iliac axis and calf veins is still uncertain.VU is not useful for assessing response to anticoagulation therapy and it is unclear whether the persistence of thrombotic abnormalities can guide on a possible prolongation of therapy.
文摘Classical risk factors only partially account for variations in cardiovascular disease incidence;therefore,also other so far unknown features,among which meteorological factors,may influence heart diseases(mainly coronary heart diseases,but also heart failure,arrhythmias,aortic dissection and stroke)rates.The most studied phenomenon is ambient temperature.The relation between mortality,as well as cardiovascular diseases incidence,and temperature appears graphically as a"U"shape.Exposure to cold,heat and heat waves is associated with an increased risk of acute coronary syndromes.Other climatic variables,such as humidity,atmospheric pressure,sunlight hours,wind strength and direction and rain/snow precipitations have been hypothesized as related to fatal and nonfatal cardiovascular diseases incidence.Main limitation of these studies is the unavailability of data on individual exposure to weather parameters.Effects of weather may vary depending on other factors,such as population disease profile and age structure.Climatic stress may increase direct and indirect risks to human health via different,complex pathophysiological pathways and exogenous and endogenous mechanisms.These data have attracted growing interest because of the recent earth’s climate change,with consequent increasing ambient temperatures and climatic fluctuations.This review evaluates the evidence base for cardiac health consequences of climate conditions,and it also explores potential further implications.
文摘BACKGROUND It has been suggested that chronic pancreatitis(CP)may be an independent risk factor for development of cardiovascular disease(CVD).At the same time,it seems that congestive heart failure(CHF)and CP share the responsibility for the development of important clinical conditions such as sarcopenia,cachexia and malnutrition due to development of cardiac cachexia and pancreatic exocrine insufficiency(PEI),respectively.AIM To explore the evidence regarding the association of CP and heart disease,more specifically CVD and CHF.METHODS A systematic search of MEDLINE,Web of Science and Google Scholar was performed by two independent investigators to identify eligible studies where the connection between CP and CVD was investigated.The search was limited to articles in the English language.The last search was run on the 1st of May 2019.The primary outcomes were:(1)Incidence of cardiovascular event[acute coronary syndrome(ACS),chronic coronary disease,peripheral arterial lesions]in patients with established CP;and(2)Incidence of PEI in patients with CHF.RESULTS Out of 1166 studies,only 8 were eligible for this review.Studies regarding PEI and CHF showed an important incidence of PEI as well as associated malabsorption of nutritional markers(vitamin D,selenium,phosphorus,zinc,folic acid,and prealbumin)in patients with CHF.However,after substitution of pancreatic enzymes,it seems that,at least,loss of appetite was attenuated.On the other side,studies investigating cardiovascular events in patients with CP showed that,in CP cohort,there was a 2.5-fold higher incidence of ACS.In another study,patients with alcohol–induced CP with concomitant type 3c diabetes had statistically significant higher incidence of carotid atherosclerotic plaques in comparison to patients with diabetes mellitus of other etiologies.Earlier studies demonstrated a marked correlation between the clinical symptoms in CP and chronic coronary insufficiency.Also,statistically significant higher incidence of arterial lesions was found in patients with CP compared to the control group with the same risk factors for atherosclerosis(hypertension,smoking,dyslipidemia).Moreover,one recent study showed that PEI is significantly associated with the risk of cardiovascular events in patients with CP.CONCLUSION Current evidence implicates a possible association between PEI and malnutrition in patients with CHF.Chronic pancreatic tissue hypoxic injury driven by prolonged splanchnic hypoperfusion is likely to contribute to malnutrition and cachexia in patients with CHF.On the other hand,CP and PEI seem to be an independent risk factor associated with an increased risk of cardiovascular events.
文摘BACKGROUND Since 2010,the European Society of Cardiology has extended prescription criteria for oral antithrombotic therapy(OAT)in atrial fibrillation(AF).Direct oral anticoagulants(DOACs)were upgraded from an IIAa recommendation in 2012 to an IA in 2016.In real-world scenarios,however,OAC prescription is still suboptimal,mainly for DOACs.AIM To evaluate OAT temporal prescription patterns in a cohort of patients hospitalized with AF in a Cardiology Department.METHODS A retrospective observational study was conducted on a cohort of hospitalized patients in a secondary setting(Trapani,Italy)from 2010 to 2021 with AF as the main or secondary diagnosis.For 4089 consecutive patients,the variables extracted from the Cardiology department database were:Sex,age,time of hospitalization,antithrombotic therapy(warfarin,acenocoumarol,apixaban,dabigatran,edoxaban,rivaroxaban,aspirin,clopidogrel,other antiplatelet agents,low molecular weight heparin,and fondaparinux),diagnosis at discharge and used resources.Basal features are presented as percentage values for categorized variables and as mean+/-SD for categorized once.RESULTS From January 1st,2010 to October 6th,2021,25132 patients were hospitalized in our department;4089(16.27%,mean age 75.59+/-10.82)were discharged with AF diagnosis;of them,2245 were males(54.81%,mean age 73.56+/-11.45)and 1851 females(45.19%,mean age 78.06+/-9.47).Average length of stay was 5.76+/-4.88 days;154 patients died and 88 were moved to other Departments/Structures.AF was the main diagnosis in 899 patients(21.94%).The most frequent main diagnosis in patients with AF was acute myocardial infarction(1973 discharges,48.19%).The most frequent secondary cardiac diagnosis was chronic coronary syndrome(1864 discharges,45.51%),and the most frequent secondary associated condition was arterial hypertension(1010 discharges,24.66%).For the analysis of antithrombotic treatments,the final sample included 3067 patients,after excluding in-hospital deaths,transferred out or self-discharged patients,as well as discharges lacking indications for prescribed treatments.OAC treatment increased significantly(35.63%in 2010-2012 vs 61.18%in 2019-2021,+25.55%,P<0.0001),in spite of any antiplatelet agent use.This rise was due to increasing use of DOACs,with or without antiplatelet agents,from 3.04%in 2013-2015 to 50.06%in 2019-2021(+47.02%,P<0.0001)and was greater for factor Xa inhibitors,especially apixaban.In addition,treatment with a vitamin K antagonist,in spite of any antiplatelet agent use,decreased from 35.63%in 2010-2012 to 11.12%in 2019-2021(-24.48%,P<0.0001),as well as any antiplatelet therapy,alone or in double combination,(49.18%in 2010-2012 vs 34.18%in 2019-2021,-15.00%,P<0.0001);and patients not receiving antithrombotic therapy declined with time(14.58%in 2010-2012 vs 1.97%in 2021,P<0.0001).CONCLUSION Real-world patients with AF are elderly and affected by cardiovascular and non-cardiovascular diseases.The percentage of patients on OAT and DOACs increased.These data suggest a slow,gradual guidelines implementation process.
文摘There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The MA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: The MAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin Maghreb within the age of 18 to 55 years underwent a resting echocardiography. Multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: Men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.
