WJCS  Vol.4 No.7 , July 2014
Epidemiology and Pathophysiology of Acquired Heart Failures Amenable to Surgical Interventions in the Sub-Saharan Africa
Abstract: Heart failure (HF) is an important cause of morbidity and mortality in sub-Saharan Africa and indeed worldwide. The management of this condition has largely been thought to be within the domain of the Physician with the Surgeon having little or no role to play. The commonest cause of HF that may require surgical intervention is rheumatic valvular heart disease especially in the young age group while ischaemic heart disease still remains at the low rung of the ladder and interestingly, hypertrophic cardiomyopathy is becoming common. Most of the literatures reviewed failed to identify pericardial diseases, though it ranked topmost in the face of tuberculosis and HIV infections in the sub-region, and the other non-cardiac structures as important causes of HF which is amenable to surgical intervention. Equally, what have not been clearly identified are the surgical aspects; indeed its sub-classifications into heart and non-heart causes have hitherto not been documented. Even though these lists from this review are not exhaustive of the numerous unidentified causes of surgical HF, this would act as stimulus for further and extensive documentation of guideline for the recognition of these sub-classifications of HF amenable to surgery.
Cite this paper: Okonta, K. (2014) Epidemiology and Pathophysiology of Acquired Heart Failures Amenable to Surgical Interventions in the Sub-Saharan Africa. World Journal of Cardiovascular Surgery, 4, 116-122. doi: 10.4236/wjcs.2014.47018.

[1]   Akinkugbe, O.O. and Falase, A.O. (1987) Clinical Medicine in the Tropics Series: Cardiovascular Disease. Blackwell Scientific Publications, Hoboken, 65.

[2]   Mayosi, B.M. (2007) Contemporary Trends in the Epidemiology and Management of Cardiomyopathy and Pericarditis in Sub-Saharan Africa. Heart, 93, 1176-1183.

[3]   Tettey, M., Sereboe, L., Aniteye, E., Edwin, F., Kotei, E., Tamatey, M., et al. (2007) Surgical Management of Constrictive Pericarditis. Ghana Medical Journal, 41, 190-193.

[4]   Massoure, P.L., Boddaert, G., Caumes, J.L., Gaillard, P.E., Lions, C. andGrassin, F. (2010) Porridge-Like Tuberculous Cardiac Tamponade: Treatment Difficulties in the Horn of Africa. General Thoracic and Cardiovascular Surgery, 58, 276-278.

[5]   Strang, J.I., Nunn, A.J., Johnson, D.A., Casbard, A., Gibson, D.G. and Girling, D.J. (2004) Management of Tuberculous Constrictive Pericarditis and Tuberculous Pericardial Effusion in Transkei: Results at 10 Years Follow-Up. QJM, 97, 525-535.

[6]   Mabogunje, O.A., Adesanya, C.O., Khwaja, M.S., Lawrie, J.H. and Edington, G.M. (1981) Surgical Management of Pericarditis in Zaria, Nigeria. Thorax, 36, 590-595.

[7]   Salami, M.A., Adeoye, P.O., Adegboye, V.O. and Adebo, O.A. (2012) Presentation Pattern and Management of Effusive-Constrictive Pericarditis in Ibadan. Cardiovascular Journal of Africa, 23, 206-211.

[8]   Abubakar, U., Adeoye, P.O., Adebo, A.O., Adegboye, V.A., Kesieme, E.B. and Okonta, K.E. (2011) Pattern of Pericardial Diseases in HIV-Positive Patients at University College Hospital, Ibadan, Nigeria. Southern African Journal of HIV Medicine, 12, 25-26.

[9]   Nzuobontane, D., Blackett, K.N. and Kuaban, C. (2002) Cardiac Involvement in HIV Infected People in Yaounde, Cameroon. Postgraduate Medical Journal, 78, 678-681.

[10]   Magula, N.P. and Mayosi, B.M. (2003) Cardiac Involvement in HIV-Infected People Living in Africa: A Review. Cardiovascular Journal of South Africa, 14, 231-237.

[11]   Nkoua, J.L., Tsombou, B. and Bouramoue, C. (1999) Non Rheumatic Pericarditis with Effusion: Causes, Outcome and Relation to HIV-Infection. Annals of Oncology, 25, 3-6.

[12]   Ekra, A. and Bertrand, E. (1992) Rheumatic Heart Disease in Africa. World Health Forum, 13, 331-333.

[13]   Essop, M.R. and Nkomo, V.T. (2005) Rheumatic and Nonrheumatic Valvular Heart Disease: Epidemiology, Management, and Prevention in Africa. Circulation, 112, 3584-3591.

[14]   Onwuchekwa, A.C. and Asekomeh, G.E. (2009) Pattern of Heart Failure in a Nigerian Teaching Hospital. Vascular Health and Risk Management, 5, 745-750.

[15]   Akinwusi, P.O., Peter, J.O., Oyedeji, A.T. and Odeyemi, A.O. (2013) The New Face of Rheumatic Heart Disease in South West Nigeria. International Journal of General Medicine, 6, 375-381.

[16]   Tantchou Tchoumi, J.C., Ambassa, J.C., Kingue, S., Giamberti, A., Cirri, S., Frigiola, A., et al. (2011) Occurrence, Aetiology and Challenges in the Management of Congestive Heart Failure in Sub-Saharan Africa: Experience of the Cardiac Centre in Shisong, Cameroon. The Pan African Medical Journal, 8, 11.

[17]   Mendez, G.F. and Cowie, M.R. (2001) The Epidemiological Features of Heart Failure in Developing Countries: A Review of the Literature. International Journal of Cardiology, 80, 213-219.

[18]   Ntusi, N.B. and Mayosi, B.M. (2009) Epidemiology of Heart Failure in Sub-Saharan Africa. Expert Review of Cardiovascular Therapy, 7, 169-180.

[19]   Kotto, R.M. and Bouelet, B.A. (2000) Cardiovascular Diseases in Adults in Douala, Cameroon. Cardiologie Tropicale, 26, 61-64.

[20]   Anabwani, G.M. and Bonhoeffer, P. (1996) Prevalence of Heart Disease in School Children in Rural Kenya Using Colour-Flow Echocardiography. East African Medical Journal, 73, 215-217.

[21]   Oyoo, G.O. and Ogola, E.N. (1999) Clinical and Socio Demographic Aspects of Congestive Heart Failure Patients at Kenyatta National Hospital, Nairobi. East African Medical Journal, 76, 23-27.

[22]   Mendez, G.F. and Cowie, M.R. (2001) The Epidemiological Features of Heart Failure in Developing Countries: A Review of the Literature. International Journal of Cardiology, 80, 213-219.

[23]   Falase, A.O. and Ogah, O.S. (2012) Cardiomyopthies and Myocardial Disorders in Africa: Present Status and the Way Forward. Cardiovascular Journal of Africa, 23, 553-562.

[24]   Antony, K.K. (1980) Pattern of Cardiac Failures in Northern Savanna Nigeria. Tropical and Geographical Medicine, 32, 118-125.

[25]   Amoah, A.G. and Kallen, C. (2000) Aetiology of Heart Failure as Seen from a National Cardiac Referral Centre in Africa. Cardiology, 93, 11-18.

[26]   Mensah, G.A. (2008) Ischaemic Heart Disease in Africa. Heart, 94, 836-843.

[27]   Ntusi, N.B.A. and Mayosi, B.M. (2009) Epidemiology of Heart Failure in Sub-Saharan Africa. Expert Review of Cardiovascular Therapy, 7, 169-180.

[28]   Onen, C.L. (2013) Epidemiology of Ischaemic Heart Disease in Sub-Saharan Africa. Cardiovascular Journal of Africa, 24, 34-42.

[29]   Sani, M.U., Adamu, B., Mijinyawa, M.S., Abdu, A., Karaye, K.M., Maiyaki, M.B., et al. (2006) Ischaemic Heart Disease in Aminu Kano Teaching Hospital, Kano, Nigeria: A 5-Year Review. Nigerian Journal of Medicine, 15, 128-131.

[30]   Mbanya, J.C., Minkoulou, E., Salah, J. and Balkau, B. (1998) The Prevalence of Hypertension in Rural and Urban Cameroon. International Journal of Epidemiology, 27, 181-185.

[31]   Nethononda, M.R., Essop, M.R., Mbewu, A.D. and Galpin, J.S. (2004) Coronary Artery Disease and Risk Factors in Black South Africans—A Comparative Study. Ethnicity & Disease, 14, 515-519.

[32]   Ekpe, E.E., Aghaji, M.A., Edaigbini, S.A., Onwuta, C.N. and Anisiuba, B. (2008) Cardiac Pacemaker Treatment of Heart Block in Enugu: A 5-Year Review. Nigerian Journal of Medicine, 17, 7-12.

[33]   Adeoye, P.O., Okonta, K.E., Salami, M.A. and Adegboye, V.O. (2013) Experience with Permanent Pacemaker Insertion at the University College Hospital, Ibadan, Nigeria. Nigerian Journal of Cardiology, 10, 3-5.

[34]   Omotoso, A. and Kane, A. (2000) Intraventricular Conduction Block in Adult Nigerians with Hypertensive Heart Disease; Epidemiological Study of Cardiovascular Disease and Risk Factors in Senegal: Cardiology—Out of Africa. Cardiovascular Journal of South Africa, 11, 173-174.

[35]   Olurin, E.O., Itayemi, S.O., Oluwasanmi, J.O. and Ajayi, O.O. (1973) The Pattern of Thyroid Gland Diseases in Ibadan, Nigeria. Nigerian Medical Journal, 3, 58-65.

[36]   Evangelopoulou, M.E., Alevizaki, M., Toumanidis, S., Piperingos, G., Mavrikakis, M., Sotou, D., Evangelopoulou, K. and Koutras, D.A. (1999) Mitral Valve Prolapse in Autoimmune Thyroid Disease: An Index of Systemic Autoimmunity? Thyroid, 9, 973-977.

[37]   Ogbera, A.O., Fasanmade, O. and Adediran, O. (2007) Pattern of Thyroid Disorders in the Southwestern Region of Nigeria. Ethnicity & Disease, 17, 327-330.

[38]   Fokou, M., Ashuntantang, G., Teyang, A., Kaze, F., Chichom Mefire, A., Halle, M.P., et al. (2012) Patients Characteristics and Outcome of 518 Arteriovenous Fistulas for Hemodialysis in a Sub-Saharan African Setting. Annals of Vascular Surgery, 26, 674-679.

[39]   Alhassan, S.U., Adamu, B., Abdu, A. and Aji, S.A. (2013) Outcome and Complications of Permanent Hemodialysis Vascular Access in Nigerians: A Single Centre Experience. Annals of African Medicine, 12, 127-130.

[40]   Liam, C.K., Lim, K.H. and Wong, C.M. (2000) Causes of Pleural Exudates in a Region with a High Incidence of Tuberculosis. Respirology, 5, 33-38.

[41]   Okonta, K.E., Anbarasu, M. and Kanagaraj, G. (2011) Intra-Aortic Balloon Pump in Coronary Artery Bypass Graft-Factors Affecting Outcome. Journal of West African College of Surgeons, 1, 15-25.

[42]   Spodick, D.H. (1997) The Pericardium. Marcel Dekker, Inc., New York.

[43]   Syed, F.F., Ntsekhe, M., Mayosi, M.B. and Jae, K. (2013) Effusive-Constrictive Pericarditis. Heart Failure Reviews, 18, 277-287.

[44]   Fullerton, D.A. and Harken, H.A. (2007) Acquired Heart Disease: Valvular. In: Townsend, C.M., Beauchamp, R.D., Evers, B.M. and Mattox, K.L., Eds., Sabiston Textbook of Surgery, 18th Edition, Saunders, Philadelphia.

[45]   Chen, M.Y., Chen, Y.S., Chen, S.J. and Lu, C.W. (2011) A Girl with Right Heart Failure Related to Effusive-Constrictive Pericarditis. Pediatric Cardiology, 32, 681-684.

[46]   Sagrista-Sauleda, J., Angel, J., Sanchez, A., Permanyer-Miralda, G. and Soler-Soler, J. (2004) Effusive-Constrictive Pericarditis. New England Journal of Medicine, 350, 469-475.

[47]   Enriquez-Sarano, M., Schaff, H.V. and Frye, R.L. (1997) Early Surgery for Mitral Regurgitation: The Advantages of Youth. Circulation, 96, 4121-4123.

[48]   Swan, H.J., Forrester, J.S., Diamond, G., Chatterjee, K. and Parmley, W.W. (1972) Hemodynamic Spectrum of Myocardial Infarction and Cardiogenic Shock: A Conceptual Model. Circulation, 42, 1097-1110.

[49]   Cleland, J.G. and McGowan, J. (1999) Heart Failure Due to Ischaemic Heart Disease: Epidemiology, Pathophysiology and Progression. Journal of Cardiovascular Pharmacology, 33, S17-S29.

[50]   Borer, J.S., Rosing, D.R., Miller, R.H., Stark, R.M., Kent, K.M., Bacharach, S.L., et al. (1980) Natural History of Left ventricular Function during One Year after Acute Myocardial Infarction: Comparism with Clinical, Electrocardiographic and Biochemical Determinations. American Journal of Cardiology, 46, 1-12.

[51]   Jiang, L., Levine, R.A., King, M.E. and Weyman, A.E. (1987) An Integrated Mechanism for Systolic Anterior Motion of the Mitral Valve in Hypertrophic Cardiomyopathy Based on Echocardiographic Observations. American Heart Journal, 113, 633-644.

[52]   Stern, A.B. and Klemmer, P.J. (2011) High-Output Heart Failure Secondary to Arteriovenous Fistula. Hemodialysis International, 15, 104-107.

[53]   Wasse, H. and Singapuri, M.S. (2012) High-Output Heart Failure: How to Define It, When to Treat It, and How to Treat It. Seminars in Nephrology, 32, 551-557.

[54]   Neff, T.A. and Buchanan, B.D. (1975) Tension Pleural Effusion. A Delayed Complication of Pneumothorax Therapy in Tuberculosis. American Review of Respiratory Disease, 111, 543-548.

[55]   Samet, P. (1973) Hemodynamic Sequelae of Cardiac Arrhythmias. Circulation, 47, 399-407.

[56]   Degroot, W.J. and Leonard, J.J. (1970) Hyperthyroidism as a High Cardiac Output State. American Heart Journal, 79, 265-275.

[57]   Durhan, D. and Worthley, L.I. (2002) Cardiac Arrhythnias: Diagnosis and Management. The Bradycardias. Critical Care and Resuscitation, 4, 54-60.

[58]   Czarkowski, M., Hilgertner, L., Powalowski, T., Radomski, D. and Mikulska, M. (2005) Is the Resistance of Large Conduit Arteries also Decreased in Thyrotoxic Patients with Grave’s Disease? Thyroid, 15, 377-381.

[59]   Klein, I. and Danzi, S. (2007) Cardiovascular Involvement in General Medical Conditions. Thyroid Disease and the Heart. Circulation, 116, 1725-1735.