Abstract
Much of the global burden of cardiovascular disease is now carried by low and middle income countries. Unfortunately, many of these regions are still grappling with poverty and infection-related cardiovascular diseases, such as endomyocardial fibrosis, tuberculous pericarditis and rheumatic heart disease. In addition, Africa has its unique diseases that occur more commonly in Africans as peripartum cardiomyopathy or, almost uniquely in Africa, as subvalvular aneurysm. We present our perspective on forgotten cardiovascular disease in Africa in the context of the epidemic of cardiovascular disease due to global changes in life style.
Similar content being viewed by others
References
Abdel-Moula AM, Sherif AA, Sallam SA, Mandil AM, Kassem AS, Zaher SR (1998) Prevalence of rheumatic heart disease among school children in Alexandria, Egypt: a prospective epidemiological study. J Egypt Public Health Assoc 73(3–4):233–254
Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K (2007) The burden and costs of chronic diseases in low-income and middle-income countries. Lancet 370:1929–1938
Albert MA (2008) Heart failure in the urban African enclave of Soweto: a case study of contemporary epidemiological transition in the developing world. Circulation 118:2323–2325
Amoah AG, Kallen C (2000) Aetiology of heart failure as seen from a national cardiac referral centre in Africa. Cardiology 93(1–2):11–18
Ansa VO, Ekott JU, Bassey EO (2008) Profile and outcome of cardiovascular admissions at the University of Uyo Teaching Hospital, Uyo—a five year review. Niger J Clin Pract 11(1):22–24
Buckman G, Ziegler J, Parry E (2008) Endomyocardial fibrosis: still a mystery after 60 years. PLoS Negl Trop Dis 2(2):e97. doi:10.1371/journal.pntd.0000097
Cherian KM, John TA, Abraham KA, Ayanavaram DM (1982) Endomyocardial fibrosis: clinical profile and role of surgery in management. Am Heart J 105(4):706–709
Cherian G, Vijayaraghavan G, Krishnaswami S, Sukumar IP, John MS, Jairaj PS, Bhaktaviziam A (1982) Endomyocardial fibrosis: report on the hemodynamic data in 29 patients and review of results of surgery. Am Heart J 105(4):659–666
Chestler E, Mitha AS, Edwards JE (1982) Congenital aneurysm adjacent to the annuli of the aortic and/or mitral valves. Chest 82(3):334–337
Corbacho AM, Martinez De La Escalera G, Clapp C (2002) Roles of prolactin and related members of the prolactin/growth hormone/placental lactogen family in angiogenesis. J Endocrinol 173:219–238
Dajani AS, Ayoub E, Bierman FZ et al (1993) Guidelines for the diagnosis of rheumatic fever: Jones criteria updated 1992. Circulation 87:302–307
Deneux-Tharaux C, Berg C, Bouvier-Colle MH et al (2005) Under-reporting of pregnancy-related mortality in the United States or Europe. Obstet Gynaecol 106:684–692
Dubost C, Chapelon C, Deloche A, Piette JC, Chauvaud S, Fabiani JN, Carpentier A (1990) Chirurgie des fibroses endomyocardiques: a propos de 32 cas. Arch Mal Coeur 83:481–486
Elkayam U, Akhter MW, Singh H et al (2005) Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation 111:2050–2055
Elliot P, Anderson B, Arbustini E, Biliniska Z et al (2008) Classification of the cardiomyopathies: a position statement from the European Society of Cardiology working group on myocardial and pericardial diseases. Eur Heart J 29:270–276
Ferrieri P, for the Jones Criteria Working Group (2002) Proceedings of the Jones Criteria Workshop. Circulation 106:2521–2523
Fett JD, Christie LG, Carraway RD, Murphy JG (2005) Five year prospective study of incidence and prognosis of peripartum cardiomyopathy in a single institution. Mayo Proceed 80:1602–1606
Freers J, Mayanja-Kizza H, Ziegler JL, Ritakingirwa M (1996) Echocardiographic diagnosis of heart disease in Uganda. Trop Doct 26(3):125–128
Gaziano TA (2005) Cardiovascular disease in the developing world and its cost-effective management. Circulation 112:3547–3553
Gaziano TA (2007) Reducing the growing burden of cardiovascular disease in the developing world. Health Aff (Millwood) 26:13–24
Hakim JG, Manyemba J (1998) Cardiac disease distribution among patients referred for echocardiography in Harare. Zimbabwe Cent Afr J Med 44(6):140–144
Hilfiker-Kleiner D, Kaminski K, Podewski E, Bonda T, Schaefer A, Sliwa K, Forster O, Quint A, Landmesser U, Doerries C, Drexler H (2007) A Cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy. Cell 128:589–600
Hilfiker-Kleiner D, Meyer GP, Schieffer E, Goldmann B, Podewski E, Struman I et al (2007b) Recovery from postpartum cardiomyopathy in 2 patients by blocking prolactin release with bromocriptine. J Am Coll Cardiol 11;50(24):2354–2355
Hilfiker-Kleiner D, Sliwa K, Drexler H (2008) Peripartum cardiomyopathy: recent insights in its pathophysiology. Trends Cardiovasc Med 18:173–179
Ike SO (2008) Echocardiographic analysis of valvular heart diseases over one decade in Nigeria. Trans R Soc Trop Med Hyg 102(12):1214–1218
Jahns BG, Stein W, Hilfiker-Kleiner D, Pieske B, Emons G (2008) Peripartum cardiomyopathy—a new treatment option by inhibition of prolactin secretion. Am J Obstet Gynaecol 199(4):e5–e6
Kontozis L, Skoularigis Skudicky D, Sareli P (1998) Submitral aneurysm. Circulation 98:1698
Longo-Mbenza B, Bayekula M, Ngiyulu R, Kintoki VE, Bikangi NF, Seghers KV, Lukoki LE, Mandundu MF, Mazanza M, Nlandu Y (1998) Survey of rheumatic heart disease in school children of Kinshasa town. Int J Cardiol 63(3):287–294
Marijon E, Ou P, Celermajer DS, Ferreira B, Mocumbi AO, Jani D, Paquet C, Jacob S, Sidi D, Jouven X (2007) Prevalence of rheumatic heart disease detected by echocardiographic screening. N Eng J Med 357(5):470–476
Mayosi B, Robertson K, Volmink J et al (2006) The Drakensberg declaration on the control of rheumatic fever and rheumatic heart disease in Africa. S Afr Med J 96:246
Mocumbi AO, Ferreira MB, Sidi D, Yacoub MH (2008) A population study of endomyocardial fibrosis in a rural area of Mozambique. N Eng J Med 369:43–49
Mocumbi AO, Sidi D, Vouhe P, Yacoub M (2007) An innovative technique for the relief of right ventricular trabecular cavity obliteration in endomyocardial fibrosis. J Thorac Cardiovasc Surg 134(4):1070–1072
Mocumbi AO, Yacoub S, Yacoub M (2008) Neglected tropical cardiomyopathies: I. Endomyocardial fibrosis: myocardial disease. Heart 94(3):384–390
Mohanty A, Saxena A (2003) Submitral aneurysm: unusual echocardiographic features. Heart 89:552
Moraes F, Lapa C, Hazin S, Tenorio E, Gomes C, Moraes CR (1999) Surgery for endomyocardial fibrosis revisited. Eur J Cardio-Thoracic Surg 15:309–313
Murray CJ, Lopez AD (1996) Evidence-based health policy—lessons from the Global Burden of Disease Study. Science 274:740–743
Narula J, Chandrasekhar Y, Rahimtoola S (1999) Diagnosis of active rheumatic carditis: the echoes of change. Circulation 100:1576–1581
Ntusi NB, Mayosi BM (2009) Aetiology and risk factor in peripartum cardiomyopathy: a systematic review. Int J Cardiol 131:168–179
Oli K, Porteous J (1999) Prevalence pof rheumatic heart disease among school children in Addis Ababa. East Afr Med J 76(11):601–605
Oyoo GO, Ogola EN (1999) Clinical and socio-demographic aspects of congestive heart failure at Kenyatta National Hospital, Nairobi. East Afr Med J 76(1):23–27
Pearson GD, Veille JC, Rahimtoola S et al (2000) Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA 283:1183–1188
Reuter H, Burgess LJ, Schneider J, Van Vuuren W, Doubell AF (2006) The role of histopathology in establishing the diagnosis of tuberculous pericardial effusions in the presence of HIV. Histopathology 48(3):295–302
Reuter H, Burgess L, van Vuuren W, Doubell AF (2006) Diagnosing tuberculous pericarditis. QMJ 99(12):827–839
Reuter H, Burgess LJ, Louw VJ, Doubell AF (2007) The management of tuberculous pericardial effusion: experience in 233 consecutive patients. Cardiovasc J Afr 18(1):20–25
Sani MU, Karaye KM, Borodo MM (2007) Prevalence and pattern of rheumatic heart disease in the Nigerian savannah: an echocardiographic study. Cardiovasc J Afr 18(5):295–299
Sivansakaran S (2009) Restrictive myocardiopathy in India: the story of a vanishing mystery. Heart 95:9–14
Sliwa K, Forster O, Libhaber E et al (2006) Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J 27:441–446
Sliwa K, Fett J, Elkayam U (2006) Peripartum cardiomyopathy. Lancet 368:687–693
Sliwa K, Tibazarwa H, Hilfiker-Kleiner D (2008) Management of peripartum cardiomyopathy. Curr Heart Fail Rep 5(4):238–244
Sliwa K, Wilkinson D, Hansen C, Ntyinyane L, Tibazarwa K, Becker A, Stewart S (2008) Spectrum of heart disease and risk factors in a black urban population in South Africa (the Heart of Soweto Study): a cohort study. Lancet 371:915–922
Soliman EZ, Zuma H (2008) Cardiac disease in northern Malawi: epidemiologic transition perspective. J Epidemiol 18(5):204–208
Stewart S, Wilkinson D, Becker A, Askew D, Ntyintyane, McMurray J, Sliwa K (2006) Mapping the emergence of heart disease in a black, urban population in Africa: the Heart of Soweto Study. Int J Cardiol 108:101–108
Stewart S, Wilkinson D, Hansen C, Vaghela J, Mvungi R, McMurray J, Sliwa K (2008) Predominance of heart failure in the Heart of Soweto Study cohort: emerging challenges for urban African communities. Circulation 118:2360–2367
Stewart S, Sliwa K (2009) Preventing CVD in resource-poor areas: perspectives from the ‘real-world’. Nat Rev Cardiol. doi:10.1038/nrcardio.2009.79
Strang JI, Nunn AJ, Johnson DA, Casbard A, Gibson DG, Girling DJ (2004) Management of tuberculous constrictive pericarditis and tuberculous pericardial effusion in Transkei: results at 10 years follow-up. QMJ 97(8):525–535
Syed FF, Aje A, Ntshekhe M, Mayosi BM, Moosa S, Tshifularo M, Smedema JP (2008) Resolution of nodular myocardial tuberculosis demonstrated by contrast-enhanced magnetic resonance imaging. Cardiovasc J Afr 19(4):198–199
Licht J, Dieffenbach C, Stang A, Hartmann V, Bolte J, Kirsten D (2009) Tuberculoma of the myocardium: a rare case of intra-vitam diagnosis. Clin Res Cardiol 98(5):331–333
Tabruyn SP, Sabatel C, Nguyen NQ et al (2007) The angiostatic 16 K human prolactin overcomes endothelial cell energy and promotes leukocyte infiltration via nuclear factor-kappaB activation. Mol Endocrinol 21:1422–1429
Tibazarwa K, Ntyinyane L, Sliwa K, Gerntholz T, Wilkinson D, Stewart S (2009) A time bomb of cardiovascular risk factors in South Africa: results from the Heart of Soweto Study “Heart Awareness Days”. Int J Cardiol 132:233–239
Tibazarwa KB, Volmink JA, Mayosi BM (2008) Incidence of acute rheumatic fever in the world: a systematic review of population-based studies. Heart 94(12):1534–1540
Valiathan MS, Balakrishnan KG, Sankarkumar R, Kartha CC (1987) Surgical treatment of endmyocardial fibrosis. Ann Thorac Surg 43:68–73
Valiathan MS, Shymkrishnan KG (1993) Surgical treatment of endomyocardial fibrosis: Kerala experience. In: Valiathan MS, Somers K, Kartha CC (eds) Endomyocardial fibrosis. Oxford University Press, Dehli, pp 220–227
Vedanthan R, Fuster V (2008) Cardiovascular disease in Sub-Saharan Africa: a complex picture demanding a multi-faceted response. Nat Clin Pract Cardiovasc Med 5:516–517
Virchow R (1880) Sitzung der Berliner Geburtshaelfer Gesellschaft, cited by Porak, C. De l’influence reciproque de la grossesses et des maladies du Coer, thesis, Paris
Wiysonge C, Ntsekhe M, Gumedze F, Sliwa K, Ngu Blackett K, Commerford PJ, Volmink JA, Mayosi BM (2008) Contemporary use of adjunctive corticosteroids in tuberculous pericarditis. Int J Cardiol 124:388–390
World Health Organization (2008) 2008–2013 Action plan for the global strategy for the prevention and control of non-communicable diseases. World Health Organization (online). http://www.who.int/nmh/actionplan-PC-NCD-2008.pdf
Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases. Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 104:2855–2864
Yusuf S, Reddy S, Ounpuu S, Anand S (2001) Global burden of cardiovascular diseases. Part II: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 1004:2746–2753
Acknowledgment
We would like to thank Dr. Elias Zigiriadis for providing the intra-operative photographs from the submitral aneurysm.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sliwa, K., Mocumbi, A.O. Forgotten cardiovascular diseases in Africa. Clin Res Cardiol 99, 65–74 (2010). https://doi.org/10.1007/s00392-009-0094-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00392-009-0094-1