Clement O Odigwe

Assessment of cardiac dyssynchrony in Nigerian patients with dilated cardiomyopathy

Background: Interventricular, intraventricular, and atrioventricular dyssynchrony (AVD) have been reported in patients with dilated cardiomyopathy (DCM). However, the causes of DCM vary with the regional distribution in various etiologies, with expected differences in the pattern and frequency of cardiac dyssynchrony. Objective: The aim of this study was to evaluate cardiac dyssynchrony in patients with DCM by conventional echocardiographic assessment. Materials and Methods: Fifteen patients with DCM were studied. All patients underwent conventional Doppler echocardiographic evaluation including septal-to-posterior wall motion delay (SPWMD), interventricular motion delay (IVMD), and diastolic filling period. Results: Cardiac dyssynchrony was present in 13 of the 15 patients (86.7%). The overall frequencies of intra-left ventricular dyssynchrony (intra-LVD), interventricular dyssynchrony (inter-VD), and AVD are 38.5%, 30.8%, and 53.9%, respectively. Conclusion: The prevalence of dyssynchrony in our patients with DCM was significant. This raises the need for the development of local expertise in interventional cardiology including cardiac resynchronization therapy (CRT).

Comparison of spectrum of heart diseases between an Indian and a Nigerian tertiary centre: An echocardiographic study

Background: Changing epidemiographic profile with increase in cardiovascular risk factors in developing nations is well documented. Our study sought to describe how this has affected the cardiovascular disease profile of patients reviewed by echocardiography in two hospitals, one in South-East Nigeria and the other in South-East India. Objective: We compared the range of cardiovascular diagnoses encountered in a Nigerian hospital and an Indian hospital. The underlying objective was to document any difference in cardiovascular disease patterns between the two tertiary hospitals in different regions of the developing world. Materials and Methods: This is a descriptive, retrospective study of echocardiographic records of the two hospitals: November 19, 2012 to September 20, 2013 for Federal Medical Centre (FMC), Umuahia, Nigeria and March 4, 2013 to April 30, 2013 for Madras Medical Mission (MMM), Chennai, India. Results: In FMC, Umuahia, hypertensive heart disease was the only common echocardiographic abnormality. Valvular heart disease and cardiomyopathy were also frequently encountered. In the MMM, ischemic heart disease and valvular heart disease were common echocardiographic abnormalities. Echocardiographic diagnosis correlated significantly with gender in MMM. Conclusions: The findings of this limited study underscore the need for the intensification of therapeutic measures and lifestyle modifications to reverse the trend in India as well as Blood pressure control and other strategies to avert the gathering cardiovascular storm in Nigeria.

Review of 5 year mortality trend at federal medical center, Umuahia Nigeria using the global burden of disease classification

Background: There have been few systematic studies of the causes of death in Nigeria. However, the causes of death as well as the average age at death are important statistics in the public health policy formulation. The global burden of disease (GBD) classification is very useful in describing relative etiologies of mortality, as well as the epidemiologic transition. Objective: The aim of this study was to describe the causes of mortality in the Federal Medical Centre, Umuahia with respect to causes, gender, age at death, and duration of hospital stay using the GBD classification. Methods: We retrospectively reviewed records of mortalities seen between February 2003 and December 2008 at the Federal Medical Centre, Umuahia using the deaths register at our records department. Results: There were 3444 cases of mortality over the period, comprising 58.2% males and 41.4% females. Mean age at death was 40.92 ± 26.12 years communicable, maternal, neonatal, and nutritional disorders comprised 39.91%, noncommunicable diseases made up 48.76%, while Injuries comprised 11.33%. Conclusion: Public health attention should be sustained at reducing morbidity and mortality of noncommunicable diseases.