I am Prof M. O. Balogun Bsc; MBChB; FMCP; FWACP; FSM; FNCS; FRCP (Glasg); FESC. Professor of Medicine and Consultant Cardiologist. Former Provost, College of Health Sciences (2003-2007) Obafemi Awolowo University, Ile-Ife, Nigeria. Retired December 2019. Main research interests include Heart failure, Exercise testing, Echocardiography and Cardiovascular risk and epidemiology.
Background Pregnancy is a physiological process associated with an increased hemodynamic load and... more Background Pregnancy is a physiological process associated with an increased hemodynamic load and cardiac structural remodeling. Limited echocardiographic information exists on cardiac chambers, left ventricular (LV) systolic and diastolic functions, and LV mass during trimesters of normal pregnancy among African women. Materials and Methods Echocardiography was done at the beginning of the second trimester, beginning of the third trimester, and middle of the third trimester for 100 normal pregnant women and at one visit for age-matched 100 nonpregnant women. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 17 software. Analysis of variance was used to compare within trimesters, and a P value of <0.05 was considered significant. Results The mean (SD) ages of the patients and controls were 28.20 (±5.91) and 28.35 (±6.06) years, respectively (age range = 19-44 years, P = 0.86). Cardiac chambers, LV systolic function, and LV mass and its index ...
Diabetes, metabolic syndrome and obesity : targets and therapy, 2014
There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogra... more There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogram (Holter ECG) in the arrhythmic evaluation of hypertensive and diabetic patients. To evaluate indications, arrhythmic pattern of Holter ECG, and heart rate variability (HRV) among patients with hypertensive heart disease (HHD) with or without heart failure and type 2 diabetes mellitus (T2DM) seen in our cardiac care unit. Seventy-nine patients (32 males and 47 females) were studied consecutively over a year using Schiller type (MT-101) Holter ECG machine. Out of the 79 patients, 17 (21.5%) had HHD without heart failure, 33 (41.8%) had HHD with hypertensive heart failure (HHF), while 29 (36.7%) were T2DM patients. The mean (standard deviation) ages of HHD without heart failure, HHF and T2DM patients were 59.65 (±14.38), 65.15 (±14.30), and 54.66 (±8.88) respectively. The commonest indication for Holter ECG was palpitation (38%), followed by syncope (20.3%). Premature ventricular contract...
The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combinatio... more The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combination of oral enalapril (10 mg) prazosin (1 mg) and hydrochlorothiazide (50 mg) has been assessed in 12 Nigerians with severe hypertension (Diastolic BP &amp;amp;amp;amp;gt; or = 115 mmHg). The ages of the patients ranged from 30-60 years, and the serum creatinine from 52-732 mumol.l-1. The initial blood pressure was 200/130 mmHg. The combination significantly reduced systolic and diastolic blood pressure respectively. The hypotensive action appeared within 0.5 h and led to a fall in BP to 175/120 mmHg, and the peak action occurred at 4 h, when the BP was 138/99 mmHg, and it persisted upto 24 h (160/101 mmHg). Despite the significant fall in blood pressure, no reflex tachycardia was observed. Transient dizziness was seen in 2 patients, but otherwise all claimed improvement in clinical status and a clearer sensorium. The combination may be a useful oral treatment for the rapid control of severe hypertension in Blacks.
Cardiovascular responses to treadmill exercise were studied using the Bruce protocol in 40 patien... more Cardiovascular responses to treadmill exercise were studied using the Bruce protocol in 40 patients with essential hypertension (20 males; 20 females) and 36 normotensive controls (20 males; 16 females) with similar age, level of habitual physical activity, smoking and alcohol habits. Maximal heart rate (MHR) was significantly lower in hypertensives than normotensives but there was no significant difference when treated were compared with untreated male hypertensives. Rest -maximal change in heart rate (delta HR) was lower in hypertensives than normotensives (males P less than 0.02). The blood pressure (BP) response was significantly higher in hypertensives than normotensives and in untreated than treated hypertensive males. The delta SBP was not significantly different in hypertensives and normotensives. The mean PRP max was significantly higher in male hypertensives than normotensives, lower in treated vs untreated male hypertensives; similar in treated hypertensives and normotens...
Heart failure is a major public health concern. Prediction models in heart failure have employed ... more Heart failure is a major public health concern. Prediction models in heart failure have employed echo-cardiography and other advanced laboratory parameters in predicting the risk of mortality. However, most of the patients in the resource poor economies still do not have easy access to these advanced technology. To determine the clinical and echocardiographic correlates of patients with chronic heart failure (CHF) in the presence or mild renal disease (MRD). One hundred CHF patients were categorized based on their estimated glomerular filtration rates into either normal renal function or MRD. The clinical and echocardiographic variables of both groups were compared. There were 38 females and 62 males with an overall mean age of 54 years. A significantly greater proportion of patients with mild renal disease presented in New York Heart Association classes 3 and 4 (82.9% vs 27.1%). Patients with MRD had echocardiographic findings of a significantly larger left atrial dimension, lower ...
Left ventricular hypertrophy is independently associated with increased incidence of cardiovascul... more Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower myocardial function independent of age, sex, body size, and arterial blood pressure. The study is to investigate left ventricular geometry in Nigerians with Type II Diabetes mellitus. The study design was cross-sectional and it comprised 75 consecutive patients with type II diabetes mellitus with or without hypertension. Using a structured pre-evaluated questionnaire, the demographic and clinical data were obtained. All subjects had two dimensional (2D) and 2D derived M-mode echocardiography using Sonoline G60s Ultrasound imaging system with 4.2 MHZ transducer equipped with simultaneous ECG tracing. A total of 75 consecutive type II diabetic patients with or without hyper...
Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of ... more Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 2 ) in Chronic Heart Failure Patients (CHF) during exercise. Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor of V0 2 for the group. The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exercise supervision for patients with CHF. [VO2 ...
The heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) has been proposed as a ... more The heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) has been proposed as a risk factor for ventricular arrhythmias and death in apparently healthy populations, patients with myocardial infarction and diabetes mellitus. However, data on the significance of QTc prolongation in heart failure are scarce. Our objective was to examine the prevalence of QTc prolongation in adult Nigerians with heart failure and its association with arrhythmias. Ninety consecutive patients with heart failure were recruited along with 90 age-and sex-matched controls. All the subjects had a 12-lead ECG and a rhythm strip (lead II). The latter was used to calculate the QTc using the Bazett's formula. Left ventricular systolic and diastolic functions were assessed using a 2D guided m-mode and Doppler echocardiogram respectively. The mean age of the patients was 51.9 (16) years compared with 50.3 (15.2) years for the control group, p = 0.47. Mean left ventricular ejection fraction was s...
African journal of medicine and medical sciences, 1996
Hypertension is established as one of the major risk factors for congestive heart failure, renal ... more Hypertension is established as one of the major risk factors for congestive heart failure, renal failure, cerebrovascular accident and coronary artery disease. Left ventricular hypertrophy (LVH) is an adaptive response to the increased afterload in hypertension, and therefore serves to normalize wall stress. However, LVH has been established as an independent risk factor for adverse cardiovascular events and death in hypertension. For this reason, considerable attention has been directed towards a better understanding of LVH as a risk factor. As recognition of the risk associated with LVH has grown, investigators have increasingly focused attention on improving methods for the detection of LVH, assessing its effects on cardiac function, defining its relationship with myocardial ischaemia and sudden death, evaluating the role of antihypertensive treatment in the regression of LVH and assessing whether such regression is beneficial in the long term.
Thyroid hormone has effects on both the peripheral circulation and the myocardium. These include ... more Thyroid hormone has effects on both the peripheral circulation and the myocardium. These include a decline in the systemic vascular resistance and an increase in cardiac output and cardiac contractility. Exposure to excess thyroid hormone, as occurs in thyrotoxicosis, can not only aggravate preexisting cardiac disease but also by itself lead to cardiac disease. More patients are being reported with thyrotoxicosis in Nigeria while the facilities for diagnosis and treatment are improving and becoming more available. There should therefore be a greater awareness of the cardiac problems associated with thyrotoxicosis, especially atrial fibrillation and cardiac failure. Initial management of heart disease in thyrotoxicosis should focus on the prompt alleviation of hyperthyroidism combined with judicious use of diuretics, digoxin and beta-blockers.
Fifty-one native Nigerian patients with mild to moderate essential hypertension received Lisinopr... more Fifty-one native Nigerian patients with mild to moderate essential hypertension received Lisinopril ('Zestril') in doses of 10 mg to 40 mg once daily. All patients received an initial dose of 10 mg, which was titrated up to a maximum of 40 mg if normotensive diastolic blood pressure had not been achieved. Reduction in mean diastolic blood pressure, when compared with baseline data, was significant (p < 0.001) following 16 weeks of treatment. Of the 46 evaluable patients, 32 (70%) had their blood pressure controlled (i.e. diastolic blood pressure < or = 90 Hg). Lisinopril ('Zestril') was well tolerated, with 27% of patients reporting adverse reactions of which cough was the most common. In conclusion, this study shows that Lisinopril ('Zestril"), when administered to Nigerian patients, is a clinically effective and well-tolerated for mild to Customer to supply Mss.
Cardiovascular responses to maximal exercise testing with treadmill (TD) and bicycle ergometers (... more Cardiovascular responses to maximal exercise testing with treadmill (TD) and bicycle ergometers (BE) were compared in 60 healthy male Nigerians aged 20-45 years. The duration of exercise (DOE), maximal heart rate (MHR), peak systolic blood pressure (PSBP), and peak rate pressure product (PRPP) values were higher with TD than BE (P < 0.0001). The MHR correlated significantly with the DOE in both exercise modes (r = 0.5) but only with age in the TD mode (r = -0.4; P < 0.05). Twenty of these subjects (aged 20-26 years) were further randomized to commence with either TD or BE and afterwards to proceed with the second exercise. Haemodynamic responses were significantly higher as submaximal exercise on BE than TD, while during maximal exercise these responses were significantly higher on TD than BE. The rate of perceived exertion was different for two exercise modes. Seventeen subjects (85%) preferred the TD while 3 (15%) preferred the BE for their personal physical exercise program...
A seasonal ataxic syndrome occurs annually, predominantly among the Ijeshas of Western Nigeria, c... more A seasonal ataxic syndrome occurs annually, predominantly among the Ijeshas of Western Nigeria, characterized by intention tremors, cerebellar ataxia, nystagmus, and varying levels of impaired consciousness. There are evidences for intraethnic variations in susceptibility to the ataxic syndrome among the Ijeshas. The reasons for such intraethnic variations in susceptibility are unclear. To test the notion that the protein nutritional status of individuals may presage susceptibility to disease, we have undertaken a controlled study of serum albumin levels as an index of protein nutriture in patients presenting with the disease. Our study shows that the mean serum albumin level in susceptible individuals on admission was significantly lower than at discharge (Mann-Whitney test: P = .0019), was significantly lower than in controls (P = .0004), and was in no single case higher than 34 g/L (laboratory reference value 35 to 50 g/L). These results imply that the protein nutriture of indivi...
Background: Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertens... more Background: Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertensives and the structural classification of left ventricular (LV) geometry provides additional prognostic information. Ambulatory blood pressure (ABP) monitoring has been shown to be superior to office blood pressure (BP) in relation to hypertension LVH. We investigated ambulatory BP variables in relation to LV geometric patterns in Nigerian hypertensives. Materials and Methods: A total of 130 patients (males = 96, females = 34) with hypertension had their 24-hours ambulatory BP and trans-thoracic 2D/M- mode echocardiography. Data were analyzed with SPSS 13.0. P < 0.05 was considered statistically significant. Results: The mean age of the patients was 54.08±11.88 years. The prevalence rate of abnormal LV geometry was 48.4%. Mean ambulatory Systolic BP (day time, night time and 24-hour-average) was significantly higher in patients with LVH compared with those without LVH. Day-night systo...
BACKGROUND AND OBJECTIVES Prognostic survival studies for heart-rate corrected QT interval in pat... more BACKGROUND AND OBJECTIVES Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. MATERIALS AND METHOD Ninety-six consecutive patients with heart failure were recruited with 90 age and sex-matched controls. All the subjects had a 12-lead electrocardiogram at a paper speed of 25 mm/sec and a rhythm strip (lead II) at 50 mm/sec. The latter was used to calculate the QTc using the Bazett's formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively. They were followed-up for six months. RESULTS Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9 +/- 16 years) of the patients was similar to that of ...
OLUBUNMI PATTERN OF ARRHYTHMIA AND CARDIAC DYSFUNCTION IN PATIENTS WITH GOITER AT OBAFEMI AWOLOWO... more OLUBUNMI PATTERN OF ARRHYTHMIA AND CARDIAC DYSFUNCTION IN PATIENTS WITH GOITER AT OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITALS COMPLEX, ILE-IFE, NIGERIA 2015 Prof M. O. Balogun Prof B.A. Kolawole SUMMARY Background Goiter is endemic in iodine deficient areas of the world. Thyroid diseases are the second most common endocrine disorder in Nigeria. Cardiovascular changes are a major cause of morbidity and mortality in thyroid disease patients. Despite this, data are sparse on the pattern of arrhythmias and cardiac dysfunction among these patients.
BACKGROUND Formulae for predicting functional capacity during 6-minute walk are lacking and the a... more BACKGROUND Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. AIMS The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 2 ) in Chronic Heart Failure Patients (CHF) during exercise. METHODS Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. RESULTS The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor of V0 2 for the group. CONCLUSION The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exerci...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria, 2002
Sickle cell anaemia (SCA) is the commonest inherited haemoglobinopathy in Nigeria and is associat... more Sickle cell anaemia (SCA) is the commonest inherited haemoglobinopathy in Nigeria and is associated with high morbidity and mortality, particularly in early childhood in most of the affected population. The cardiac manifestations of SCA are a significant feature of the disease but there is a paucity of information on the cardiovascular involvement in SCA in Nigeria and Africa. The size of the sickle cell problem in the country is growing rapidly and there should therefore be a greater awareness of the cardiac problems associated with SCA. This review highlights the clinical features, changes in cardiac structure and function at rest and on exercise, cardiac pathology and associated heart diseases in SCA as well as the recent global progress made in the understanding of the cardiovascular changes in the disease. Emphasis is laid on data derived from Nigerian studies.
Background Pregnancy is a physiological process associated with an increased hemodynamic load and... more Background Pregnancy is a physiological process associated with an increased hemodynamic load and cardiac structural remodeling. Limited echocardiographic information exists on cardiac chambers, left ventricular (LV) systolic and diastolic functions, and LV mass during trimesters of normal pregnancy among African women. Materials and Methods Echocardiography was done at the beginning of the second trimester, beginning of the third trimester, and middle of the third trimester for 100 normal pregnant women and at one visit for age-matched 100 nonpregnant women. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 17 software. Analysis of variance was used to compare within trimesters, and a P value of <0.05 was considered significant. Results The mean (SD) ages of the patients and controls were 28.20 (±5.91) and 28.35 (±6.06) years, respectively (age range = 19-44 years, P = 0.86). Cardiac chambers, LV systolic function, and LV mass and its index ...
Diabetes, metabolic syndrome and obesity : targets and therapy, 2014
There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogra... more There are very limited published studies in Nigeria on the use of 24 hour Holter electrocardiogram (Holter ECG) in the arrhythmic evaluation of hypertensive and diabetic patients. To evaluate indications, arrhythmic pattern of Holter ECG, and heart rate variability (HRV) among patients with hypertensive heart disease (HHD) with or without heart failure and type 2 diabetes mellitus (T2DM) seen in our cardiac care unit. Seventy-nine patients (32 males and 47 females) were studied consecutively over a year using Schiller type (MT-101) Holter ECG machine. Out of the 79 patients, 17 (21.5%) had HHD without heart failure, 33 (41.8%) had HHD with hypertensive heart failure (HHF), while 29 (36.7%) were T2DM patients. The mean (standard deviation) ages of HHD without heart failure, HHF and T2DM patients were 59.65 (±14.38), 65.15 (±14.30), and 54.66 (±8.88) respectively. The commonest indication for Holter ECG was palpitation (38%), followed by syncope (20.3%). Premature ventricular contract...
The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combinatio... more The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combination of oral enalapril (10 mg) prazosin (1 mg) and hydrochlorothiazide (50 mg) has been assessed in 12 Nigerians with severe hypertension (Diastolic BP &amp;amp;amp;amp;gt; or = 115 mmHg). The ages of the patients ranged from 30-60 years, and the serum creatinine from 52-732 mumol.l-1. The initial blood pressure was 200/130 mmHg. The combination significantly reduced systolic and diastolic blood pressure respectively. The hypotensive action appeared within 0.5 h and led to a fall in BP to 175/120 mmHg, and the peak action occurred at 4 h, when the BP was 138/99 mmHg, and it persisted upto 24 h (160/101 mmHg). Despite the significant fall in blood pressure, no reflex tachycardia was observed. Transient dizziness was seen in 2 patients, but otherwise all claimed improvement in clinical status and a clearer sensorium. The combination may be a useful oral treatment for the rapid control of severe hypertension in Blacks.
Cardiovascular responses to treadmill exercise were studied using the Bruce protocol in 40 patien... more Cardiovascular responses to treadmill exercise were studied using the Bruce protocol in 40 patients with essential hypertension (20 males; 20 females) and 36 normotensive controls (20 males; 16 females) with similar age, level of habitual physical activity, smoking and alcohol habits. Maximal heart rate (MHR) was significantly lower in hypertensives than normotensives but there was no significant difference when treated were compared with untreated male hypertensives. Rest -maximal change in heart rate (delta HR) was lower in hypertensives than normotensives (males P less than 0.02). The blood pressure (BP) response was significantly higher in hypertensives than normotensives and in untreated than treated hypertensive males. The delta SBP was not significantly different in hypertensives and normotensives. The mean PRP max was significantly higher in male hypertensives than normotensives, lower in treated vs untreated male hypertensives; similar in treated hypertensives and normotens...
Heart failure is a major public health concern. Prediction models in heart failure have employed ... more Heart failure is a major public health concern. Prediction models in heart failure have employed echo-cardiography and other advanced laboratory parameters in predicting the risk of mortality. However, most of the patients in the resource poor economies still do not have easy access to these advanced technology. To determine the clinical and echocardiographic correlates of patients with chronic heart failure (CHF) in the presence or mild renal disease (MRD). One hundred CHF patients were categorized based on their estimated glomerular filtration rates into either normal renal function or MRD. The clinical and echocardiographic variables of both groups were compared. There were 38 females and 62 males with an overall mean age of 54 years. A significantly greater proportion of patients with mild renal disease presented in New York Heart Association classes 3 and 4 (82.9% vs 27.1%). Patients with MRD had echocardiographic findings of a significantly larger left atrial dimension, lower ...
Left ventricular hypertrophy is independently associated with increased incidence of cardiovascul... more Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower myocardial function independent of age, sex, body size, and arterial blood pressure. The study is to investigate left ventricular geometry in Nigerians with Type II Diabetes mellitus. The study design was cross-sectional and it comprised 75 consecutive patients with type II diabetes mellitus with or without hypertension. Using a structured pre-evaluated questionnaire, the demographic and clinical data were obtained. All subjects had two dimensional (2D) and 2D derived M-mode echocardiography using Sonoline G60s Ultrasound imaging system with 4.2 MHZ transducer equipped with simultaneous ECG tracing. A total of 75 consecutive type II diabetic patients with or without hyper...
Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of ... more Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 2 ) in Chronic Heart Failure Patients (CHF) during exercise. Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor of V0 2 for the group. The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exercise supervision for patients with CHF. [VO2 ...
The heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) has been proposed as a ... more The heart rate corrected QT interval (QTc) on the electrocardiogram (ECG) has been proposed as a risk factor for ventricular arrhythmias and death in apparently healthy populations, patients with myocardial infarction and diabetes mellitus. However, data on the significance of QTc prolongation in heart failure are scarce. Our objective was to examine the prevalence of QTc prolongation in adult Nigerians with heart failure and its association with arrhythmias. Ninety consecutive patients with heart failure were recruited along with 90 age-and sex-matched controls. All the subjects had a 12-lead ECG and a rhythm strip (lead II). The latter was used to calculate the QTc using the Bazett's formula. Left ventricular systolic and diastolic functions were assessed using a 2D guided m-mode and Doppler echocardiogram respectively. The mean age of the patients was 51.9 (16) years compared with 50.3 (15.2) years for the control group, p = 0.47. Mean left ventricular ejection fraction was s...
African journal of medicine and medical sciences, 1996
Hypertension is established as one of the major risk factors for congestive heart failure, renal ... more Hypertension is established as one of the major risk factors for congestive heart failure, renal failure, cerebrovascular accident and coronary artery disease. Left ventricular hypertrophy (LVH) is an adaptive response to the increased afterload in hypertension, and therefore serves to normalize wall stress. However, LVH has been established as an independent risk factor for adverse cardiovascular events and death in hypertension. For this reason, considerable attention has been directed towards a better understanding of LVH as a risk factor. As recognition of the risk associated with LVH has grown, investigators have increasingly focused attention on improving methods for the detection of LVH, assessing its effects on cardiac function, defining its relationship with myocardial ischaemia and sudden death, evaluating the role of antihypertensive treatment in the regression of LVH and assessing whether such regression is beneficial in the long term.
Thyroid hormone has effects on both the peripheral circulation and the myocardium. These include ... more Thyroid hormone has effects on both the peripheral circulation and the myocardium. These include a decline in the systemic vascular resistance and an increase in cardiac output and cardiac contractility. Exposure to excess thyroid hormone, as occurs in thyrotoxicosis, can not only aggravate preexisting cardiac disease but also by itself lead to cardiac disease. More patients are being reported with thyrotoxicosis in Nigeria while the facilities for diagnosis and treatment are improving and becoming more available. There should therefore be a greater awareness of the cardiac problems associated with thyrotoxicosis, especially atrial fibrillation and cardiac failure. Initial management of heart disease in thyrotoxicosis should focus on the prompt alleviation of hyperthyroidism combined with judicious use of diuretics, digoxin and beta-blockers.
Fifty-one native Nigerian patients with mild to moderate essential hypertension received Lisinopr... more Fifty-one native Nigerian patients with mild to moderate essential hypertension received Lisinopril ('Zestril') in doses of 10 mg to 40 mg once daily. All patients received an initial dose of 10 mg, which was titrated up to a maximum of 40 mg if normotensive diastolic blood pressure had not been achieved. Reduction in mean diastolic blood pressure, when compared with baseline data, was significant (p < 0.001) following 16 weeks of treatment. Of the 46 evaluable patients, 32 (70%) had their blood pressure controlled (i.e. diastolic blood pressure < or = 90 Hg). Lisinopril ('Zestril') was well tolerated, with 27% of patients reporting adverse reactions of which cough was the most common. In conclusion, this study shows that Lisinopril ('Zestril"), when administered to Nigerian patients, is a clinically effective and well-tolerated for mild to Customer to supply Mss.
Cardiovascular responses to maximal exercise testing with treadmill (TD) and bicycle ergometers (... more Cardiovascular responses to maximal exercise testing with treadmill (TD) and bicycle ergometers (BE) were compared in 60 healthy male Nigerians aged 20-45 years. The duration of exercise (DOE), maximal heart rate (MHR), peak systolic blood pressure (PSBP), and peak rate pressure product (PRPP) values were higher with TD than BE (P < 0.0001). The MHR correlated significantly with the DOE in both exercise modes (r = 0.5) but only with age in the TD mode (r = -0.4; P < 0.05). Twenty of these subjects (aged 20-26 years) were further randomized to commence with either TD or BE and afterwards to proceed with the second exercise. Haemodynamic responses were significantly higher as submaximal exercise on BE than TD, while during maximal exercise these responses were significantly higher on TD than BE. The rate of perceived exertion was different for two exercise modes. Seventeen subjects (85%) preferred the TD while 3 (15%) preferred the BE for their personal physical exercise program...
A seasonal ataxic syndrome occurs annually, predominantly among the Ijeshas of Western Nigeria, c... more A seasonal ataxic syndrome occurs annually, predominantly among the Ijeshas of Western Nigeria, characterized by intention tremors, cerebellar ataxia, nystagmus, and varying levels of impaired consciousness. There are evidences for intraethnic variations in susceptibility to the ataxic syndrome among the Ijeshas. The reasons for such intraethnic variations in susceptibility are unclear. To test the notion that the protein nutritional status of individuals may presage susceptibility to disease, we have undertaken a controlled study of serum albumin levels as an index of protein nutriture in patients presenting with the disease. Our study shows that the mean serum albumin level in susceptible individuals on admission was significantly lower than at discharge (Mann-Whitney test: P = .0019), was significantly lower than in controls (P = .0004), and was in no single case higher than 34 g/L (laboratory reference value 35 to 50 g/L). These results imply that the protein nutriture of indivi...
Background: Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertens... more Background: Left ventricular hypertrophy (LVH) is an independent cardiac risk factor in hypertensives and the structural classification of left ventricular (LV) geometry provides additional prognostic information. Ambulatory blood pressure (ABP) monitoring has been shown to be superior to office blood pressure (BP) in relation to hypertension LVH. We investigated ambulatory BP variables in relation to LV geometric patterns in Nigerian hypertensives. Materials and Methods: A total of 130 patients (males = 96, females = 34) with hypertension had their 24-hours ambulatory BP and trans-thoracic 2D/M- mode echocardiography. Data were analyzed with SPSS 13.0. P < 0.05 was considered statistically significant. Results: The mean age of the patients was 54.08±11.88 years. The prevalence rate of abnormal LV geometry was 48.4%. Mean ambulatory Systolic BP (day time, night time and 24-hour-average) was significantly higher in patients with LVH compared with those without LVH. Day-night systo...
BACKGROUND AND OBJECTIVES Prognostic survival studies for heart-rate corrected QT interval in pat... more BACKGROUND AND OBJECTIVES Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. MATERIALS AND METHOD Ninety-six consecutive patients with heart failure were recruited with 90 age and sex-matched controls. All the subjects had a 12-lead electrocardiogram at a paper speed of 25 mm/sec and a rhythm strip (lead II) at 50 mm/sec. The latter was used to calculate the QTc using the Bazett's formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively. They were followed-up for six months. RESULTS Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9 +/- 16 years) of the patients was similar to that of ...
OLUBUNMI PATTERN OF ARRHYTHMIA AND CARDIAC DYSFUNCTION IN PATIENTS WITH GOITER AT OBAFEMI AWOLOWO... more OLUBUNMI PATTERN OF ARRHYTHMIA AND CARDIAC DYSFUNCTION IN PATIENTS WITH GOITER AT OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITALS COMPLEX, ILE-IFE, NIGERIA 2015 Prof M. O. Balogun Prof B.A. Kolawole SUMMARY Background Goiter is endemic in iodine deficient areas of the world. Thyroid diseases are the second most common endocrine disorder in Nigeria. Cardiovascular changes are a major cause of morbidity and mortality in thyroid disease patients. Despite this, data are sparse on the pattern of arrhythmias and cardiac dysfunction among these patients.
BACKGROUND Formulae for predicting functional capacity during 6-minute walk are lacking and the a... more BACKGROUND Formulae for predicting functional capacity during 6-minute walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. AIMS The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 2 ) in Chronic Heart Failure Patients (CHF) during exercise. METHODS Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. RESULTS The result showed that the distance covered was highly correlated with the VO2 (0.65, p< 0.01). The regression analysis revealed that a linear equation model developed was a good predictor of V0 2 for the group. CONCLUSION The study concluded that in situation where sophisticated equipments are lacking, this equation might be useful during exerci...
Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria, 2002
Sickle cell anaemia (SCA) is the commonest inherited haemoglobinopathy in Nigeria and is associat... more Sickle cell anaemia (SCA) is the commonest inherited haemoglobinopathy in Nigeria and is associated with high morbidity and mortality, particularly in early childhood in most of the affected population. The cardiac manifestations of SCA are a significant feature of the disease but there is a paucity of information on the cardiovascular involvement in SCA in Nigeria and Africa. The size of the sickle cell problem in the country is growing rapidly and there should therefore be a greater awareness of the cardiac problems associated with SCA. This review highlights the clinical features, changes in cardiac structure and function at rest and on exercise, cardiac pathology and associated heart diseases in SCA as well as the recent global progress made in the understanding of the cardiovascular changes in the disease. Emphasis is laid on data derived from Nigerian studies.
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