Search

Background/Purpose: Owing to genetic predilection of type 2 diabetes mellitus (T2DM), the risk of developing impaired glucose metabolism is thought to be higher in first-degree relatives (FDRs) of those with T2DM. The aim of this study was to estimate the prevalence of impaired glucose tolerance (IGT) and impaired fasting glycemia (IFG) and its associated risk factors in FDRs of patients with T2DM. Materials and Methods: This is a cross-sectional descriptive study of 320 cases (FDRs of T2DM outpatients) aged ≥25 years (145 males and 175 females) and 160 controls (76 males, 84 females) who were age and sex matched. All subjects underwent anthropometric, physical activity, and laboratory assessments after an overnight fast. Oral glucose tolerance test with 75g anhydrous glucose was administered. Fasting plasma glucose of 6.1–6.9 mmol/L and 2-h post-fasting glucose value of 7.8–11.0 mmol/L were used to define IFG and IGT, respectively. Statistical analysis was carried out using the Statistical Package for the Social Sciences software, version 20 (SPSS, Chicago, Illinois), and P value of

The field of pacing in Africa has evolved in an uncoordinated way across the continent with significant variation in local expertise, cost, and utilization. There are many countries where pacemaker services do not meet one-hundredth of the national demand. Regional, national, and institutional standards for pacemaker qualification and credentials are lacking. This paper reviews the current needs for bradycardia pacing and evaluates what standards should be set to develop pacemaker services in a resource-constrained continent, including the challenges and opportunities of capacity building and training as well as standards for training programs (training prerequisites, case volumes, program content, and evaluation)., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Patients commencing on haemodialysis (HD) have an increased risk of cardiovascular events in the first year after starting HD compared to those patients established on HD longer. Left ventricular (LV) hypertrophy and abnormal myocardial strain predict mortality. There may be changes in the myocardium of incident HD patients over a 6-month period of HD which may explain changes in cardiovascular risk. We used CMR to consider changes in LV mass, myocardial strain and T1 mapping. We examined changes in pre-dialysis highly sensitive troponin T. 33 patients undergoing HD for <12 months were recruited. Participants underwent CMR at baseline and after 6-months of standard care. 6-months of HD was associated with reduction in LV mass index (Baseline: 78.8 g/m 2 follow up: 69.9 g/m 2 , p = <0.001). LV global longitudinal strain also improved (Baseline: -17.9%, follow up: -21.6%, p = <0.001). Change in T1 time was not significant (Baseline septal T1 1277.4 ms, follow up 1271.5 p = 0.504). Highly sensitive troponin T was lower at follow up (Baseline 38.8 pg/L, follow up 30.8 pg/L p = 0.02). In incident HD patients, 6-months of HD was associated with improvements in LV mass, strain and troponin. These findings may reflect improvement in known cardiac tissue abnormalities found in patients over the first year of HD.

Background: The estimated rate of sudden cardiac death (SCD) in Western countries ranges from 300,000 to 400,000 annually, which represents 0.36 to 1.28 per 1 000 inhabitants in Europe and the United States. The burden of SCD in Africa is unknown. Our aim is to assess the epidemiology of SCD in Africa., Methods: The Pan-Africa SCD study is a prospective, multicentre, community-based registry monitoring all cases of cardiac arrest occurring in victims over 15 years old. We will use the definition of SCD as 'witnessed natural death occurring within one hour of the onset of symptoms' or 'unwitnessed natural death within 24 hours of the onset of symptoms'. After approval from institutional boards, we will record demographic, clinical, electrocardiographic and biological variables of SCD victims (including survivors of cardiac arrest) in several African cities. All deaths occurring in residents of districts of interest will be checked for past medical history, circumstances of death, and autopsy report (if possible). We will also analyse the employment of resuscitation attempts during the time frame of sudden cardiac arrest (SCA) in various patient populations throughout African countries., Conclusion: This study will provide comprehensive, contemporary data on the epidemiology of SCD in Africa and will help in the development of strategies to prevent and manage cardiac arrest in this region of the world.