Glutathione S-transferase M1 and T1 genes deletion polymorphisms and blood pressure control among treated essential hypertensive patients in Burkina Faso.

OBJECTIVE: Glutathione S-transferases have been associated with experimental resistance to some drugs. The present study investigated the factors associated with blood pressure control in patients with essential hypertension, especially the role of GSTT1 and GSTM1 genes polymorphisms. This cross-sectional study in Burkina Faso consisted of 200 patients with essential hypertension and under treatment. RESULTS: In the present study, 57.5% (115/200) of patients had their hypertension under control. No statistically significant difference was found between controlled and uncontrolled groups for anthropometric and biochemical parameters as well as for GSTT1 or GSTM1 gene polymorphisms (all p > 0.05). Current alcohol consumption (OR = 3.04; CI 1.88-6.13; p < 0.001), Physical inactivity (OR = 3.07; CI 1.71-5.49; p < 0.001), severe hypertension before any treatment (Grade III [OR = 3.79; CI 2.00-7.17; p < 0.001]) and heart damage (OR = 3, 14; CI 1.59-6.02; p < 0.001) were statistically more frequent in uncontrolled essential hypertensive patients than controlled hypertensive patients.

[Elite athletes' electrocardiogram in Bobo-Dioulasso, Burkina Faso]. / Electrocardiographie du sportif de haut niveau d'entrainement à Bobo-Dioulasso, Burkina Faso.

High-performance sport results in electrocardiographic changes. Some are benign, other can cause sudden death. The purpose of this study is to describe the features of electrocardiogram at rest in elite athletes living in Bobo-Dioulasso. We conducted a cross-sectional descriptive study in the Department of Cardiology at the Souro Sanou University Hospital in Bobo-Dioulasso from August 2015 to February 2016. Elite athletes aged 17 to 35 years who had been training at least eight hours per week for more than six months, regardless of the type of sport, were enrolled. Two hundred elite athletes from four different sporting disciplines were included. The average age of athletes was 24 years (IIQ: 21-27). The median seniority in sport practice was 6 years (IIQ: 4-8) and the median duration of weekly training was 10 hours (IIQ: 10-10). Only 4% of the athletes had already undergone electrocardiogram. ECG showed abnormalities in 90.5% of cases and sinus bradycardia was the most common abnormality in 72.5% of cases. Left ventricular hypertrophy and left-atrial dilatation were reported in 44% and 34.5% respectively. Early repolarization syndrome was found in 47% of cases. In athletes, high-performance sport can result in electrical modifications. Practitioners need to know them in order to differentiate them from heart disease.

No correlation between the variants of exostosin 2 gene and type 2 diabetes in Burkina Faso population.

Recent genome-wide association studies and replication analyses have reported the association of variants of the exostosin- 2 gene (EXT2) and risk of type 2 diabetes (T2D) in some populations, but not in others. This study aimed to characterize the variants rs1113132, rs3740878 and rs11037909 of EXT2 and to determine the existence of a possible correlation with T2D in Burkina Faso. It is a case-control study undertaken in Burkina Faso in the city of Ouagadougou at the Hospital of Saint Camille of Ouagadougou from December 2014 to June 2015. It relates to 121 type 2 diabetes cases and 134 controls. The genotyping of these polymorphisms was done by real-time PCR using the allelic exclusion method with TaqMan probes. The minor allele frequencies (MAFs) was almost identical in diabetic and control subjects for the all three Single Nucleotide Polymorphisms (SNPs) with no statistical significance, p>0.05: rs1113132 (OR=0.89; p=0.82); rs11037909 (OR=0.89; p=0.74) and rs3740878 (OR=1.52; p=0.42). None of the three polymorphisms studied was associated with the risk of DT2. However, an association between the BMI, age and type 2 diabetes was noted. The variants of EXT2 would not be associated to the risk of T2D in the African black population of Burkina Faso.

Glutathione S-transferase M1 and T1 genes deletion polymorphisms and risk of developing essential hypertension: a case-control study in Burkina Faso population (West Africa).

BACKGROUND: Glutathione S-transferases play a key role in the detoxification of persistent oxidative stress products which are one of several risks factors that may be associated with many types of disease processes such as cancer, diabetes, and hypertension. In the present study, we characterize the null genotypes of GSTM1 and GSTT1 in order to investigate the association between them and the risk of developing essential hypertension. METHODS: We conducted a case-control study in Burkina Faso, including 245 subjects with essential hypertension as case and 269 control subjects with normal blood pressure. Presence of the GSTT1 and GSTM1 was determined using conventional multiplex polymerase chain reaction followed by gel electrophoresis analysis. Biochemical parameters were measured using chemistry analyzer CYANExpert 130. RESULTS: Chi-squared test shows that GSTT1-null (OR = 1.82; p = 0.001) and GSTM1-active/GSTT1-null genotypes (OR = 2.33; p <  0.001) were significantly higher in cases than controls; the differences were not significant for GSTM1-null, GSTM1-null/GSTT1-active and GSTM1-null/GSTT1-null (p > 0.05). Multinomial logistic regression revealed that age ≥ 50 years, central obesity, family history of hypertension, obesity, alcohol intake and GSTT1 deletion were in decreasing order independent risk factors for essential hypertension. Analysis by gender, BMI and alcohol showed that association of GSTT1-null with risk of essential hypertension seems to be significant when BMI < 30 Kg/m2, in non-smokers and in alcohol users (all OR ≥ 1.77; p ≤ 0.008). Concerning GSTT1, GSTM1 and cardiovascular risk markers levels in hypertensive group, we found that subjects with GSTT1-null genotype had higher waist circumference and higher HDL cholesterol level than those with GSTT1-active (all p <  0.005), subjects with GSTM1-null genotype had lower triglyceride than those with GSTM1-active (p = 0.02) and subjects with the double deletion GSTM1-null/GSTT1-null had higher body mass index, higher waist circumference and higher HDL cholesterol than those with GSTM1-active/GSTT1-active genotype (all p = 0.01). CONCLUSION: Our results confirm that GSTT1-null genotype is significantly associated with risk of developing essential hypertension in Burkinabe, especially when BMI < 30 Kg/m2, in non-smokers and in alcohol users, and it showed that the double deletion GSTM1-null/GSTT1-null genotypes may influence body lipids repartition.

Positive association between ATP2B1 rs17249754 and essential hypertension: a case-control study in Burkina Faso, West Africa.

BACKGROUND: Genetic and environment play a significant role in the etiology of essential hypertension (EH). Recently STK39 rs3754777, ATP2B1 rs2681472 and rs17249754 have been associated with BP variation and hypertension. In this study we aimed to determine firstly whether index variants were associated with the risk of developing EH in Burkina Faso and secondly to characterize cardiovascular risk markers. METHODS: We conducted a case-control study with 380 participants including 180 case subjects with EH and 200 control subjects with normal BP. We used TaqMan genotyping assays with probes from Applied Biosystems to genotype polymorphisms using the 7500 Real-Time PCR System. Biochemical parameters were measured using chemistry analyzer COBAS C311. RESULTS: T-test showed that cardiovascular risk markers such as body mass index, waist circumference, blood sugar, total cholesterol and triglycerides were significantly higher in hypertensive compared to normotensive (all p <  0.05). Binary logistic regression analysis revealed in decreasing order that overweight, family history of hypertension, central obesity and alcohol intake increased the risk of developing EH (all OR > 3.8; all p <  0.001). In genetic level we observed that individuals carrying the AA+AG genotype of ATP2B1 rs17249754 had a low risk of developing EH than those carrying the GG genotype (OR = 0.48 [95% CI: 0.31-0.75] p = 0.001) and the A allele frequency in the cases was significantly lower than that of the controls (OR = 0.56 [95% CI: 0.38-0.82] p = 0.003). We also observed that ATP2B1 rs17249754 was significantly associated with higher SBP and DPB in case and control groups (GG versus AG + AA; p <  0.05), ATP2B1 rs2681472 was significantly associated with higher SBP only in case and control group (AA versus AG + GG; p <  0.05), STK39 rs3754777 was not significantly associated with any of the BP traits (CC versus CT + TT; p > 0.05). CONCLUSION: Our results confirmed the significant association of ATP2B1 rs17249754 with the risk of developing EH in Burkinabe and showed an increase of cardiovascular risk markers levels in subjects with EH.

[Accidents in patients under anticoagulant therapy in the Department of Cardiology at the Yalgado Ouedraogo Teaching Hospital, Ouagadougou (Burkina Faso)]. / Les accidents du traitement anticoagulant dans le Service de Cardiologie du Centre Hospitalier Universitaire Yalgado Ouedraogo de Ouagadougou (Burkina Faso).

This study aimed to evaluate the profile of patients hospitalized for anticoagulant-induced hemorrhage. We conducted a retrospective, descriptive study within the Department of Cardiology at the Yalgado Ouedraogo Teaching Hospital, in Ouagadougou, over a period of 2 years from 1 January 2007 to 31 December 2008. All hospitalized patients with anticoagulant-induced hemorrhage were included in the study. The average age of patients was 49,31 ± 17,68 years, the sex-ratio was 2,17. Myocardial infarction was the first indication for anticoagulant treatment, with a rate of 21.05%. Anti vitamin K (AVK) was associated with hemorrhage in 63,16% (n=12) of patients versus 36,84% (n=7) of patients treated with low molecular weight heparins (LMWH); 10 patients had major hemorrhage while nine patients had minor hemorrhage. The average duration of Anti vitamin K (AVK) treatment was 16 ± 58 weeks. Hemorrhage in the digestive tract was the most frequent symptom (31,58%) and, in 89,47% of patients, treatment was associated with platelet aggregation. Treatment of hemorrhagic accident was based on definitive cessation of anticoagulant therapy in 73,68% of patients. Four patients (21.05%) died. The inaccessibility to antidotes such as protamine sulphate and PPSD (Prothrombin, Proconvertine, Stuart factor, and anti-haemophilia B factor) constitutes a real obstacle to adequate treatment for complications; a better education of patients receiving these drugs would be the most important preventive measure, because more than 50% of these accidents are preventable.

[Contribution of stress test to the treatment of ischemic heart disease]. / Apport de l'épreuve d'effort dans la prise en charge des cardiopathies ischémiques.

Stress test is a useful diagnostic tool in patients with suspected angina pectoris with low sensitivity but high specificity. It is also very useful in the evaluation of the risk, of the effectiveness of treatment and it is a useful guidance on medical prescriptions after controlling the symptoms of ischemia. This study aims to analyze the contribution of stress test to the treatment of ischemic heart disease in the Department of Cardiology at the University Hospital CHU YO. We conducted a retrospective study of 60 patients who had undergone stress test from January 2012 to December 2013. Stress test was performed using a treadmill according to the modified Bruce protocol. Sixty patients underwent stress test during the study period. The average age of patients was 49± 10.8 years. Sex-ratio was 1.2. All patients underwent treadmill stress test. Twenty-two patients had a history of coronary artery disease. Estimating presence of coronary artery disease was the indication for stress test in 83% of cases. It was detected in 78% of cases. Stress test was stopped when maximal workload was reached in 46 cases (or 77%). Mean exercise duration was 11,7 mn ± 3,2. Ten percent of patients had a positive stress test and 10% a dubious test. Our study will also contribute to transfer knowledge on this diagnostic test which is still little prescribed in our environment and even among cardiologists. However, efforts should be made in order to improve the quality of stress test practice in the management of coronary artery disease in a context of countries with limited resources.

[Contribution of the myocardial scintigraphy to the management of stable angina in Burkina Faso]. / Apport de la scintigraphie myocardique d'effort dans le diagnostic de l'angor stable au Burkina Faso.

OBJECTIVE: The objective of our work was to analyze the contribution of stress myocardial scintigraphy in the diagnosis of stable angina in the Cardiology Department of CHU YO. METHOD: This was a retrospective study of 47 patients who received a stress myocardial scintigraphy from January 2012 to December 2013 for the diagnosis of stable angina. The scintigraphic sections were made after injection of the radiotracer (MibiTc99m) during the treadmill stress test. RESULTS: Myocardial scintigraphy accounted for 16% of all scintigraphy and stress myocardial scintigraphy for diagnosis of stable angina accounted for 64% of all myocardial scintigraphy. The average age of the patients was 47 ± 10 years. The sex ratio was 1.1. All patients had completed the treadmill stress test. The treadmill stress test was stopped for maximum effort in 42 cases (89%). The average duration of the effort was 12 minutes ± 2.4. Treadmill stress test was positive in three patients. Nineteen percent of patients had a pathologic myocardial scintigraphy. Scintigraphy was pathologic in all patients with a positive treadmill stress test. CONCLUSION: Myocardial scintigraphy remains a sensitive examination for the diagnosis of stable angina. It helps to better stratify risk and adjust patient treatment.

OBJECTIF: L'objectif de notre travail était d'analyser l'apport de la scintigraphie myocardique d'effort dans le diagnostic de l'angor stabledans le service de Cardiologie du CHU YO. MÉTHODE: Il s'est agi d'une étude rétrospective sur 47 patients ayant bénéficié d'une scintigraphie myocardique d'effort de Janvier 2012 à Décembre 2013 pour le diagnostic d'un angor stable.Les coupes scintigraphiques ont été réalisées après injection du radio-traceur (MibiTc99m) au cours de l'épreuve d'effort. RÉSULTATS: La scintigraphie myocardique représentait 16% des scintigraphies et celle d'effort pour diagnostic d'un angor stable 64% des scintigraphies myocardiques. L'âge moyen des patients était de 47 ± 10 ans.Le sex-ratio était de 1,1. Tous les patients avaient effectué l'épreuve d'effort sur tapis roulant. L'épreuve d'effort était arrêtée pour effort maximal dans 42 cas (soit 89%). La durée moyenne de l'effort était de 12 mn ± 2,4.L'épreuve d'effort était positive chez trois patients. Dix-neuf pour cent des patients avaient eu une scintigraphie myocardique pathologique.La scintigraphie était pathologique chez tous les patients ayant une épreuve d'effort positive. CONCLUSION: la scintigraphie myocardique reste un examen sensible pour le diagnostic l'angor stable. Elle permetde mieux stratifier le risque et ajuster le traitement des patients.

[Evaluation of patients' satisfaction in the department of cardiology at the University Hospital Yalgado Ouedraogo]. / Évaluation de la satisfaction des patients dans le service de cardiologie du CHU Yalgado Ouedraogo.

INTRODUCTION: Patients' satisfaction is an important component of health care quality evaluation. Patients and physicians are now care partners. This new relationship deserves to be evaluated. Our study aimed to evaluate the satisfaction of patients hospitalized in the Department of Cardiology at the University Hospital Yalgado Ouedraogo. METHODS: We conducted a cross-sectional descriptive study with a single data collection phase of all the patients hospitalized from 1 January to 30 June 2014. We administered SAPHORA questionnaire adapted to suit our context. The scores and the satisfaction rates were calculated according to the studied parameters. RESULTS: During the study period we collected data from 230 patients. The mean hospitalization time was approximately 10 days. 125 (53.2%) men were enrolled in the study, sex ratio was 1.1. 32% (n = 75) of patients were unschooled. Public servants accounted for 24.3% (n = 57) of our study population. The average age of our sample was 50.7 years. Patients over the age of 65 years accounted for 25.6% of the study population. 113 (48.1%) patients had been admitted as medical emergencies. 21 patients (8.9%) had a history of hospitalization in the Depatment of Cardiology. Dilated cardiomyopathy was the diagnosis made during hospitalization in 75 (32%) cases. The overall score of satisfaction of the patients treated in the Department of Cardiology was 78.3%. Satisfaction score on hospital admission was 68.1% and on patients' comfort was 65.8%. Satisfaction score on health care quality and on hospital discharge planning was 84.7% and 84.5% respectively. Patients' suggestions for improvement were based on comfort during hospital stay in 99 (42.1%) cases and on staff identification in 176 (74.9%) cases. CONCLUSION: The evaluation of the satisfaction is infrequent in our country. It is becoming increasingly frequent in western countries using common and validated tools. It is an important aspect that our hospitals should include in order to increase quality approach to accreditation.

Use of Vitamins K antagonists in non-valvular atrial fibrillation thromboembolic risk prevention in Burkina Faso.

INTRODUCTION: Atrial fibrillation is the commonest cardiac rythm disorder. Thromboembolic accidents are common complications that should be prevented by anticoagulant treatment. The aim of our study is to assess the use of vitamins K antagonists in the prevention of thromboembolic risk in atrial fibrillation. METHODS: It was a descriptive retrospective study of patients folders, performed in the cardiology department from January 1st 2010 to December 31st 2011. The study included all patients with non valvular atrial fibrillation. Thromboembolic risk was assessed through the CHA2DS2VASc score, and hemorrhagic risk through the HAS-BLED score. RESULTS: Atrial fibrillation accounted for 10.6% of all hospitalizations (103/970). Five patients had contra indication to anticoagulants. Non valvular AF was noticed in 68 cases (66%). The non valvular AF was chronic in 40 cases (59%) and paroxystic in eight cases (12%). The median age of the population was 64.5+13.8 years old. Median CHA2DS2VASc score was 3.9 + 1.6. Two patients had a score < 1. Sex, place of residence, age > 65, and cardiac failure did not interfere with prescription of vitamins K antagonists. Ischemic stroke and intra cavity thrombus were the indications for vitamins K antagonists' prescriptions. The median HAS-BLED score was 3.5 + 1.5. The rate of vitamins K antagonists use was 35.3%. One case of death due to hemorrhagic stroke was noticed. CONCLUSION: Guidelines on thromboembolic risk prevention are poorly used in the cardiology department. But the use of scoring systems allows the assessment of vitamins K antagonists treatment benefit/risk in atrial fibrillation, and minimizes the hemorrhagic risk.