Abstract:
AIM:To determine whether a single elevated myocardial performance index (MPI) value in the third trimester of pregnancy is a marker for later adverse obstetric outcomes in stable placental-mediated disease, defined as well-controlled pre-eclampsia (PE) on a single agent and/or uncompensated intra-uterine growth restriction (IUGR). METHODS:Fifty-five foetuses whose mothers had stable placental-mediated disease, either mild pre-eclampsia controlled on a single agent, and/or uncompensated IUGR in the third trimester, attending the Foetal Unit at Inkosi Albert Luthuli Hospital, Durban, South Africa were prospectively recruited with 55 matched controls. Recorded data for the subjects included demographic data of maternal age and parity, sonographic data of estimated foetal weight (EFW) and amniotic fluid index (AFI), myocardial performance index (MPI), and foetal Doppler data of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV). RESULTS:The mean gestational age in the controls, the IUGR and any PE cases was 31.4, 31.8 and 31.0 weeks, respectively. The distribution of MPI values was significantly lower in the controls compared to all other groups. The highest standardised MPI values were observed in the PE-IUGR group, where a median of 5.62 was observed. The only significant differences observed between the PE and IUGR groups was the UA resistance index (p = 0.01), where the IUGR cases tended to have higher UA values compared to the combined PE group. Borderline statistical significance was observed for the MCA resistance index values ( p = 0.05) between these groups. The overall adverse event rate in the cases was 49%. The highest rate was observed in the PE + IUGR group, where eight out of 12 (67%) experienced adverse events. MPI z-scores served as a good marker of adverse events, as evidenced by the total area under the curve (AUC) of 0.90 on the ROC curve. A cut-off value of 4.5 on the MPI z-score conferred a sensitivity of 89% and specificity of 68% for an adverse event later in pregnancy. In univariate logistic regression, MPI z-score, AFI, EFW, UA Doppler, CPR category, DV Doppler and MCA Doppler were assessed separately as potential predictors of adverse outcome. The only significant predictor of adverse outcome was MPI z-score. CONCLUSIONS:A single elevated value of the MPI ( z-score > 4.5) in the third trimester in stable placental-mediated disease was a strong indicator of adverse obstetric outcomes later in pregnancy. This has the potential to be incorporated in conjunction with standard monitoring models in stable placental-mediated disease to predict an adverse event later in pregnancy and thus to reduce perinatal morbidity and mortality.
journal_name
Cardiovasc J Afrjournal_title
Cardiovascular journal of Africaauthors
Bhorat I,Pillay M,Reddy Tdoi
10.5830/CVJA-2018-036subject
Has Abstractpub_date
2018-09-01 00:00:00pages
310-316issue
5eissn
1995-1892issn
1680-0745journal_volume
29pub_type
杂志文章abstract:INTRODUCTION:Growing evidence has demonstrated that diastolic heart failure occurs in about half of heart failure (HF) patients. We investigated the effects of perindopril on echocardiographic parameters, New York Heart Association (NYHA) functional class and serum N-terminal pro B-type natriuretic peptide (NT-proBNP) ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,随机对照试验
doi:10.5830/CVJA-2019-022
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:Few studies have evaluated young adults in their third and fourth decades with coronary artery disease (CAD). This study evaluated the clinical and angiographic profile of young adults ( < 35 years) with CAD. METHODS:A 10-year (2003-2012) retrospective chart review was performed on patients less than 35 yea...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-035
更新日期:2018-01-01 00:00:00
abstract::Acute myocardial infarction is a rare complication of dobutamine stress echocardiography. We describe the case of a diabetic patient who presented with an anterior myocardial infarction complicated by an acute pulmonary oedema and cardiogenic collapse during dobutamine stress echocardiography, requiring five days' hos...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2013-021
更新日期:2013-06-23 00:00:00
abstract::Resistant hypertension is a common clinical problem in South Africa and is frequently associated with low renin and aldosterone levels, especially in black Africans. In South Africa, novel variants in the epithelial sodium channel (ENaC) have been described to be associated with varying degrees of hypokalaemia and hyp...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-012
更新日期:2017-09-23 00:00:00
abstract:INTRODUCTION:Associations between ambient temperature and blood pressure have been demonstrated in countries where the temperature varies between the seasons. This phenomenon has been overlooked in blood pressure surveys in sub-Saharan Africa. We assessed the effect of ambient temperature on blood pressure in an adult ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Few data are available on heart failure (HF) in sub-Saharan Africa. We aimed to provide a current picture of HF aetiologies in urban Uganda, access to heart surgery, and outcomes. METHODS:We prospectively collected clinical and echocardiographic data from 272 consecutive patients referred for suspected heart...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2014-034
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Dyslipidaemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. At the time the study was conducted, guidelines recommended a low-density lipoprotein cholesterol (LDL-C) target of less than 1.8 mmol/l and a reduction of at least 50% if the baseline LDL-C was between 1.8 and 3.5 mm...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,多中心研究
doi:10.5830/CVJA-2020-010
更新日期:2020-09-01 00:00:00
abstract::In developing countries, rheumatoid arthritis (RA) remains a seriously under-prioritised disease, particularly among the underprivileged, often resulting in presentation of patients late in the course of their disease, further complicated by limited therapeutic options and inconsistent follow up. The consequences are ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2018-018
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Cardiac complications of human immunodeficiency virus (HIV) infection are important causes of morbidity and mortality. We set out to determine the electrocardiographic (ECG) abnormalities in treatment-naïve HIV-positive patients in Enugu, south-east Nigeria. METHODS:This was a cross-sectional study involvin...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-013
更新日期:2017-09-01 00:00:00
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journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2008-03-01 00:00:00
abstract:AIM:To investigate the osteogenic differentiation of vascular smooth muscle cells (VSMCs) in mice with chronic kidney disease (CKD) and to evaluate the effects of p53 on the osteogenic differentiation of the VSMCs. METHODS:Experimental models of CKD-associated vascular calcification generated by five-sixth (5/6) nephr...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2011-069
更新日期:2012-07-12 00:00:00
abstract:OBJECTIVE:Pulmonary embolism (PE) is a potentially fatal disease. In Angola, few data are available on its occurrence. The aim of the study was to characterise the clinical profile, management and outcomes of patients with PE. METHODS:A retrospective observational study was conducted at the Girassol Clinic in Luanda, ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2017-017
更新日期:2017-11-01 00:00:00
abstract::Pulmonary hypertension (PH) has progressively moved from an orphan disease to a significant global health problem with a major disease burden in limited7hyphen;resource countries, where over 97% of patients live. The aetiologies of PH differ between high- and low-income nations, but PH due to left heart disease is cre...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2018-042
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study, we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further, we tried to demonstrate the effects of infliximab, an anti-TNF-alpha agent, on echoc...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2014-036
更新日期:2014-07-01 00:00:00
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journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2015-006
更新日期:2015-05-01 00:00:00
abstract::The year 2011 marks the 30th anniversary of the founding of the Pan-African Society of Cardiology (PASCAR). Throughout its brief history, PASCAR has been integral to improving the cardiovascular health of the people of Africa. During the past three decades, many African countries have been vulnerable to political and ...
journal_title:Cardiovascular journal of Africa
pub_type: 社论,历史文章
doi:
更新日期:2011-05-01 00:00:00
abstract::Peripheral arterial disease (PAD) represents a major public health problem due to its high and increasing prevalence, worldwide distribution, and significant morbidity and mortality rate. Female gender is a risk factor for PAD globally and especially in low-income countries. In this review, we summarise the present kn...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2018-023
更新日期:2018-09-01 00:00:00
abstract::Risk models are widely used to predict outcomes after cardiac surgery. Not only is risk modelling applied in the assessment of the relative impact of specific risk factors on surgical outcomes, but also in patient counselling, the selection of treatment options, comparison of postoperative results, and quality-improve...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2011-047
更新日期:2012-04-01 00:00:00
abstract::A review of heart diseases in Africa shows that the cardiomyopathies continue to be important causes of morbidity and mortality in the population. Hypertension remains the commonest cause of myocardial disease, followed by the cardiomyopathies. Ischaemic heart disease continues to be rare. Of the cardiomyopathies, dil...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2012-046
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Previous studies have shown controversial results on the role of androgens in coronary artery disease (CAD). We performed this study to assess the relationship between androgen levels and selective coronary angiography (SCA) findings. METHODS:This study was conducted on 502 consecutive men who underwent SCA...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2007-11-01 00:00:00
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journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2020-017
更新日期:2020-11-01 00:00:00
abstract::Hypertension is more prevalent and severe in urban black populations compared to whites, and is associated with a greater degree of target-organ damage for any given blood pressure level. In general, compared to whites, blacks respond well to diuretics and calcium channel blockers and less well to beta-blockers and AC...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:To assess the influence of diabetes mellitus on early morbidity and mortality following a femoro-popliteal bypass. METHODS:Clinical data on patients subjected to a prosthetic above-the-knee femoro-popliteal bypass for atherothrombotic disease over a four-year period in the Durban Metropolitan Vascular Servi...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract:INTRODUCTION:Coronary artery bypass grafting (CABG) results in higher morbidity and mortality rates in end-stage renal disease (ESRD) patient populations than in patients with normal renal function. This study aimed to identify the early results of CABG performed on ESRD patients, and the factors that affected the mort...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2016-066
更新日期:2017-03-01 00:00:00
abstract::Levosimendan was developed as a treatment for acute decompensation of severe heart failure (HF). Its use has evolved during recent years, and new HF treatment strategies in different settings have been developed. This case series aimed to show indications for the use of levosimendan and to discuss the treatment respon...
journal_title:Cardiovascular journal of Africa
pub_type:
doi:10.5830/CVJA-2020-058
更新日期:2021-01-15 00:00:00
abstract::We report on the case of a 65-year-old man with unstable angina due to a left anterior descending (LAD) coronary artery single aneurysm. On a beating heart, the aneurysm was partially resected and the left internal thoracic artery was grafted in situ as a patch to the LAD opening. The patient remains well and free of ...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2009-03-01 00:00:00
abstract::Optimal maternal body composition during pregnancy is a public health priority due to its implications on maternal health and infant development. We therefore aimed to conduct a systematic review of randomised, controlled trials, and case-control and cohort studies using lifestyle interventions to improve body composi...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章,评审
doi:10.5830/CVJA-2017-003
更新日期:2017-11-01 00:00:00
abstract::Left ventricular hypertrophy is a common complication of primary hyperparathyroidism. Numerous disturbances of myocardial physiology have been described as a result of excess parathyroid hormone action. In this brief communication, another phenotype of the hyperparathyroid heart is proposed, the 'pseudo-myocardial inf...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) has been the leading cause of death in developed countries for most of the last century. Most CVD deaths, however, occur in low- and middle-income, developing countries (LMICs) and there is great concern that CVD mortality and burden are rapidly increasing in LMICs as a result of...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2015-036
更新日期:2015-03-01 00:00:00
abstract::A 104-year-old male patient was admitted to the emergency department with chest pain. An electrocardiogram showed ST-segment elevation in the anterior leads. He was immediately taken to the catheterisation laboratory for emergency angiography, which showed thrombotic stenosis at the proximal portion of the left anteri...
journal_title:Cardiovascular journal of Africa
pub_type: 杂志文章
doi:10.5830/CVJA-2014-001
更新日期:2014-02-23 00:00:00