[Évaluation de la qualité de vie et description des facteurs associés, chez les patients en insuffisance cardiaque chronique vivant dans un pays d'Afrique de l'Ouest à faible revenu]. / Assessment of quality of life and description of associate factors in patients living with chronic heart failure in a low-income country of West Africa.

OBJECTIVE: To assess the quality of life (QOL) and describe associated factors in patients with chronic heart failure (HF) living in a low-income population in West Africa. METHODS: This is was a cross-sectional study conducted from January 2017 to June 2018, in the department of cardiology of the University Teaching Hospital (CHU-Campus) in Lomé (Togo). Enrolled patients had stable chronic HF and have been hospitalized in the past 6 months; QOL was assessed using the Minnesota Living with Heart Failure questionnaire (MLHFQ). RESULTS: 171 patients were included (women = 40.9%, 33% unschooled, 75% without health insurance; 46.8% in NYHA class II). The prevalence of depression was 62%. The mean total score of MLHFQ was 37.2 ± 22.3. In univariate analysis, there was a positive correlation between the total score and the following factors: age (r= 0.33, p ˂0.0001), NYHA classes (r= 0.67, p ˂0.0001), number of rehospitalizations (r= 0.61, p ˂0.0001), number of comorbidities (r= 0.43, p ˂0.0001), and the depression score (r= 0.67, p ˂0.0001). After adjustments, positive correlation persisted with NYHA classes (p ˂0.0001), number of rehospitalizations (p= 0.02), and depression (p ˂0.0001). CONCLUSION: The QOL of HF patients was moderately impaired and was comparable to values reported among high-income populations. Factors associated with poor quality of life were advanced NYHA classes, number of rehospitalizations, and depression.

Hutchinson-Gilford Progeria syndrome: Report of the first Togolese case.

The aim of this article is to describe the first case of Hutchinson-Gilford Progeria Syndrome (HGPS) in Togo and review all Africans cases. Our patient was a 12.8-year-old Togolese boy followed in our unit till he was 15-year-old for HGPS. He was the only child of non-consanguineous parents. The phenotypic findings were craniofacial dysmorphy, dwarfism, lipodystrophy, diffusely scattered hyperpigmented foci, pyriform thorax, nail dystrophy, decreased joint mobility, and camptodactyly. He had characteristic facies with prominent forehead, prominent eyes, absent ear lobule, thin nasal skin, convex nasal profile, micrognathia, and crowded teeth. Radiologicals findings were bilateral coxa valga, pyriform thorax, and acro-osteolysis. We sequenced the entire coding region of LMNA gene, and mutation analysis revealed a heterozygous mutation c.1824C>T (p.Gly608Gly). Our patient is therefore the fifth African and the fourth with classical mutation, first of Western Africa, and second of (sub-Saharan) African black race. The recurrence of HGPS is low like the cause is neomutation or germinal mosaicism.

[Pulmonary embolism at the University Hospital Campus of Lome (Togo): a retrospective study about 51 cases]. / L'embolie pulmonaire au centre hospitalier universitaire Campus de Lomé (Togo): étude rétrospective à propos de 51 cas.

INTRODUCTION: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome. METHODS: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed. RESULTS: The prevalence of PE was 3.1%. Female/male sex ratio was 2.2. The average age was 52.7 ± 14.4 years. Risk factors for venous thromboembolic disease VTD were dominated by: obesity (54.9%), bedrest (25.5%) and long journey (17.6%). The main symptoms were: dyspnoea (98.0%), chest pain (78.4%) and cough (60.8%). Wells' score was high in 29.4% of cases. ECG showed: tachycardia (78.4%), right ventricular hypertrophy (RVH)(49.0%), S1Q3T3 aspect (47.1%) and right block (39.2%). Transthoracic Doppler echocardiogram showed right cavitary dilation and right intraventricular thrombus in 5.6% of cases. Thoracic angioscanner was normal in 9.8% of cases and showed embolus in 82.4% of cases. Treatment was based on Low Molecular Weight Heparin (LMWH) at therapeutic doses with antivitamin K (AVK) relay. Thrombolysis was performed in 8 patients. Evolution was favorable in 86.3% of cases. Case-fatality rate was 13.7%. CONCLUSION: The prevalence of PE is relatively low in our area but it is probably underestimated. PE is a therapeutic problem in Togo because of the high cost of complementary examinations and thrombolysis. Prevention is therefore the only effective weapon.