Burden, Severity and Characteristic Pattern of Coronary Artery Disease using 160-Slice Computed Tomographic Angiography: Earliest Report from Northern Nigeria.

BACKGROUND: Coronary computed tomography angiography (CCTA) allows for non-invasive visualization of the coronary arteries which is promising in diagnosing coronary artery disease. OBJECTIVES: To determine the prevalence, morphology, anatomic distribution pattern and correlates of CAD in our environment. METHODS: This cross-sectional study was conducted on the first cohort of patients referred for CCTA in our hospital. The patients were examined with 160-slice Toshiba® CT scanner. Their demographic data, relevant clinical information as well as the findings on CCTA were extracted and documented. The data were analysed using the R programming software version 4.0.4. RESULTS: Out of a total of 153 patients who presented for CCTA within the study period, 133 (84.7%) were eligible for analysis. Their age ranged from 22-78 years with a mean ± SD of 55.8 ± 11.7 years. A total of 33 (24.8%) had normal CCTA, while 100 (75.2%) had either stenosis or total occlusion. There was a significantly higher (p-value of 0.00001) calcium score among those with stenosis compared to those with normal CCTA. The severity of the stenotic lesion was associated with the calcium score. The logistic regression analyses showed a statistically significant (P = 0.0415, OR = 1.0569, 97.5% CI =1.078152-1.123240) association between age and the presence of coronary stenosis. In addition, most of the stenotic lesions were in the left anterior descending artery (LAD). CONCLUSION: Majority of the patients had coronary artery disease of variable severity and the LAD was the most involved artery. There was no significant association between sex and severity of the disease; however, old age and higher number of lesions were associated with severe disease.

CONTEXTE: L'angiographie coronaire par tomodensitométrie (ATCC) permet une visualisation non invasive des artères coronaires, ce qui est prometteur pour le diagnostic de la maladie coronarienne. OBJECTIFS: Déterminer la prévalence, la morphologie, le modèle de distribution anatomique et les corrélats de la maladie coronarienne dans notre environnement. MÉTHODES: Cette étude transversale a été menée sur la première cohorte de patients envoyés pour un CCTA dans notre hôpital. Les patients ont été examinés à l'aide d'un tomodensitomètre Toshiba® à 160 coupes. Leurs données démographiques, les informations cliniques pertinentes ainsi que les résultats de l'ACTC ont été extraits et documentés. Les données ont été analysées à l'aide du logiciel de programmation R version 4.0.4. RÉSULTATS: Sur un total de 153 patients qui se sont présentés pour une ACTC pendant la période de l'étude, 133 (84,7 %) étaientéligibles pour l'analyse. Leur âge était compris entre 22 et 78 ans,avec une moyenne + écart-type de 55,8 + 11,7 ans. Au total, 33 (24,8%) avaient une CCTA normale, tandis que 100 (75,2 %) présentaient une sténose ou une occlusion totale. Le score calcique était significativement plus élevé (valeur p de 0,00001) chez les patients présentant une sténose que chez ceux dont l'ACTC était normale. La gravité de la lésion sténosée était associée au score calcique. Les analyses de régression logistique ont montré une association significative (P=0,0415, OR= 1,0569, 97,5% CI=1,078152-1,123240) entre l'âge et la présence d'une sténose coronaire. En outre, la plupart des lésions sténosées se trouvaient dans l'artère descendante antérieure gauche (LAD). CONCLUSION: La majorité des patients présentaient une maladie coronarienne de gravité variable et l'artère LAD était l'artère la plus touchée. Il n'y avait pas d'association significative entre le sexe et la sévérité de la maladie ; cependant, l'âge avancé et le nombre plus élevé de lésions étaient associés à la sévérité de la maladie. Mots-clés: Angiographie, Tomodensitométrie, Artères Coronaires, Stenose.

The role of K+ATP channels in the control of pre- and post-ischemic left ventricular developed pressure in septic rat hearts.

Myocardial function is impaired 24 h after the induction of sepsis, however, recovery of left ventricular (LV) function after 35 min of global ischemia is complete. The mechanisms by which this protection occurs are unknown. Ischemic preconditioning, another form of myocardial protection from ischemia/reperfusion (I/R) injury, has been shown to be modulated by ATP-sensitive potassium (K+ATP) channels. To investigate the role of K+ATP channels in the regulation of coronary flow (CF) and protection from I/R injury in septic rat hearts, we assessed the effects of the K+ATP channel antagonist glibenclamide (GLIB) and the agonist cromakalim (CROM) on pre- and post-ischemic CF and left ventricular developed pressure (LVDP). Although GLIB decreased pre-ischemic CF in both control and septic rat hearts, LVDP was unaffected. After I/R, CF was decreased in GLIB-treated control and septic rat hearts and LVDP was more severely depressed in control rat hearts than in septic rat hearts. CROM increased pre-ischemic CF in the septic group although LVDP was unaltered in both groups. After I/R, control rat heart CF was depressed but LVDP completely recovered. Post-ischemic CF in septic rat hearts was elevated compared with vehicle-treated septic rat hearts, but the recovery of LVDP was not improved. These results suggest that K+ATP channels modulate CF in septic rat hearts, but do not mediate cardioprotection as observed in control rat hearts.

The role of coronary flow and adenosine in postischemic recovery of septic rat hearts.

Sepsis depresses myocardial function but prevents subsequent ischemia-reperfusion injury. Elevated coronary flow (CF) and endogenous adenosine may be important factors in the complete recovery of postischemic myocardial function observed in septic rat hearts. The purpose of this study was to determine the effects of manipulating CF and of antagonizing adenosine receptors on the postischemic recovery of left ventricular developed pressure (LVDP) in septic and control rat hearts. The relationship between CF and LVDP in septic rat hearts before ischemia was depressed compared with control. However, this relationship was unaltered by ischemia in septic hearts, whereas in control hearts it was severely depressed. Preventing the elevation of CF during reperfusion did not significantly affect the recovery of LVDP in septic rat hearts. Adenosine antagonism by 8-phenyltheophylline (0.1 and 1 nM) prevented the elevated CF during reperfusion, and the higher dose significantly depressed postischemic function. We conclude that elevated CF did not contribute to the recovery of postischemic LVDP in septic rat hearts but that endogenous adenosine may provide protection from ischemia.