Cardiovascular Anomalies during Chronic Inflammatory Rheumatic Disease in Yaoundé: A Cross-Sectional Study

Ba Hamadou, Chris Nadège Nganou–Gnindjio, Maggy Mbede, Murielle Guimbang, Dominic Leandry Wouna Angong, Flore Ulrich Nyaga, Félicité Kamdem, Sylvie L Ndongo Amougou, Jerome Boombhi, Liliane Kuate-Mfeukeu, Madeleine Singwe Ngandeu

Abstract


ABSTRACT
Background and rationale. Chronic inflammatory rheumatic disease represent a heterogeneous group of diseases associated to a high inflammatory state. There are associated to a huge morbidity mainly due to cardiovascular complications. Although cardiovascular risk factors associated to CIRD are well described, the major cardiovascular anomalies are largely unknown inour context. Aim. Identify the major cardiovascular anomalies in a Cameroonians population of patient with chronic inflammatory rheumatic disease. Methodology. We carried out a cross sectional study which included CIRD patients followed at the rheumatology unit of the Yaoundé Central Hospital. The cardiovascular complications were diagnosed by determining Ankle to brachial systolic arterial pressure index (ABPI) and performing Electrocardiogram (ECG), transthoracic echocardiography (TTE) and supra aortic trunk ultrasound (SATU). Blood samples were done for evaluating lipid profile and cardiovascular risk were assessed by using the Framingham criteria. Results. In total, 52 patients with CIRD were included. The range of age was 14-82 years the female (71.15%) were more present. In our population, determination of ABPI 1.92% had obliterans arteriopathy of lower limb and 5.76% had mediacalcosis. In ECG, we observed 13 cases of branch block (25%) and 01 case of left ventricular hypertrophy (1.92%). TTE revealed 4.08% of pericarditis and 44.9% of valvulopathies. We found among patients who realized SATU 02 cases atheromatic plaques on 03 cases (7.89%) and 05 patients with calcification (13.15%). We did not found any associated factors to cardiovascular complications through univariate statistical analysis and the assessment of cardiovascular risk showed a globally low risk among the majority of our population. Conclusion. The cardiovascular anomalies in CIRD were numerous in our population instead of the fact that the assessment of the cardiovascular risk using Framingham showed low risk for the majority. We can therefore concluded that this tools underestimated the risk among CIRD.
RÉSUMÉ
Contexte et justification. Les rhumatismes inflammatoires chroniques (RIC) représentent un groupe hétérogène de pathologies associées à un processus inflammatoire important. Elles sont la cause d’une grande morbidité chez ces patients par l’intermédiaire des complications cardiovasculaires (CCV) qu’elles entrainent. Malgré le fait que les facteurs de risque cardiovasculaires (FDRCV) dans les RIC ont été étudiés dans notre contexte, des zones d’ombres subsistent toujours quant aux CCV majeurs retrouvées dans cette population. Objectifs. Identifier les CCV majeures retrouvées chez les patients atteints de RIC. Méthodologie. Nous avons mené une étude transversale descriptive chez des patients suivis pour RIC au sein du service de Rhumatologie de l’Hôpital Central de Yaoundé. Les pathologies cardiovasculaires ont été recherchées à travers la détermination de l’index de pression systolique par la mesure automatique, la réalisation de l’électrocardiogramme (ECG), l’échographie transthoracique (ETT), et de l’échographie des troncs supra aortiques (ETSA). Les prélèvements sanguins étaient destinés à la détermination du profil lipidique et le risque cardiovasculaire a été évalué en utilisant les critères de Framingham. Résultats. Au total, notre population était constituée 52 patients. Le sexe féminin était majoritairement représentée (71,15%) et les extrêmes d’âges étaient 14 et 84 ans. Aussi, 1’artériopathie des membres inférieurs et la médiacalcose étaient retrouvées chez respectivement 1, 92% et 5,76% de nos participants. A l’ECG, nous avons observés 13 cas d’anomalies de la conduction (25%) at 01 cas hypertrophie ventriculaire gauche (1,92%). L’ETT a détecté des cas de péricardites (4,08%) et de valvulopathies (44,9%). Parmi les patients ayant réalisés l’ETSA, nous avons retrouvé 03 cas de plaques athéromateuses (7,89%) et 05 cas de calcification artérielle (13,15%). Nous n’avons pas retrouvé de facteurs associés CCV et notre population avait majoritairement un risque cardiovasculaire faible. Conclusion. Les CCV dans les RIC étaient diverses dans notre population malgré le faible risque cardiovasculaire retrouvé. L’utilisation des critères de Fragmingham aurait donc sous-évalué ce risque dans notre population.


Keywords


Chronic Inflammatory Rheumatic Disease, Cardiovascular anomalies, cardiovascular risk.

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