Cardiovascular Anomalies during Chronic Inflammatory Rheumatic Disease in Yaoundé: A Cross-Sectional Study

ABSTRACT Background and rationale. Chronic inflammatory rheumatic disease represent a heterogeneous group of diseases associated to a high inflammatory state. There are associated to a huge morbidity mainly due to cardiovascular complications. Although cardiovascular risk factors associated to CIRD are well described, the major cardiovascular anomalies are largely unknown inour context. Aim. Identify the major cardiovascular anomalies in a Cameroonians population of patient with chronic inflammatory rheumatic disease. Methodology. We carried out a cross sectional study which included CIRD patients followed at the rheumatology unit of the Yaounde Central Hospital. The cardiovascular complications were diagnosed by determining Ankle to brachial systolic arterial pressure index (ABPI) and performing Electrocardiogram (ECG), transthoracic echocardiography (TTE) and supra aortic trunk ultrasound (SATU). Blood samples were done for evaluating lipid profile and cardiovascular risk were assessed by using the Framingham criteria. Results. In total, 52 patients with CIRD were included. The range of age was 14-82 years the female (71.15%) were more present. In our population, determination of ABPI 1.92% had obliterans arteriopathy of lower limb and 5.76% had mediacalcosis. In ECG, we observed 13 cases of branch block (25%) and 01 case of left ventricular hypertrophy (1.92%). TTE revealed 4.08% of pericarditis and 44.9% of valvulopathies. We found among patients who realized SATU 02 cases atheromatic plaques on 03 cases (7.89%) and 05 patients with calcification (13.15%). We did not found any associated factors to cardiovascular complications through univariate statistical analysis and the assessment of cardiovascular risk showed a globally low risk among the majority of our population. Conclusion. The cardiovascular anomalies in CIRD were numerous in our population instead of the fact that the assessment of the cardiovascular risk using Framingham showed low risk for the majority. We can therefore concluded that this tools underestimated the risk among CIRD. RESUME Contexte et justification. Les rhumatismes inflammatoires chroniques (RIC) representent un groupe heterogene de pathologies associees a un processus inflammatoire important. Elles sont la cause d’une grande morbidite chez ces patients par l’intermediaire des complications cardiovasculaires (CCV) qu’elles entrainent. Malgre le fait que les facteurs de risque cardiovasculaires (FDRCV) dans les RIC ont ete etudies dans notre contexte, des zones d’ombres subsistent toujours quant aux CCV majeurs retrouvees dans cette population. Objectifs. Identifier les CCV majeures retrouvees chez les patients atteints de RIC. Methodologie. Nous avons mene une etude transversale descriptive chez des patients suivis pour RIC au sein du service de Rhumatologie de l’Hopital Central de Yaounde. Les pathologies cardiovasculaires ont ete recherchees a travers la determination de l’index de pression systolique par la mesure automatique, la realisation de l’electrocardiogramme (ECG), l’echographie transthoracique (ETT), et de l’echographie des troncs supra aortiques (ETSA). Les prelevements sanguins etaient destines a la determination du profil lipidique et le risque cardiovasculaire a ete evalue en utilisant les criteres de Framingham. Resultats. Au total, notre population etait constituee 52 patients. Le sexe feminin etait majoritairement representee (71,15%) et les extremes d’âges etaient 14 et 84 ans. Aussi, 1’arteriopathie des membres inferieurs et la mediacalcose etaient retrouvees chez respectivement 1, 92% et 5,76% de nos participants. A l’ECG, nous avons observes 13 cas d’anomalies de la conduction (25%) at 01 cas hypertrophie ventriculaire gauche (1,92%). L’ETT a detecte des cas de pericardites (4,08%) et de valvulopathies (44,9%). Parmi les patients ayant realises l’ETSA, nous avons retrouve 03 cas de plaques atheromateuses (7,89%) et 05 cas de calcification arterielle (13,15%). Nous n’avons pas retrouve de facteurs associes CCV et notre population avait majoritairement un risque cardiovasculaire faible. Conclusion. Les CCV dans les RIC etaient diverses dans notre population malgre le faible risque cardiovasculaire retrouve. L’utilisation des criteres de Fragmingham aurait donc sous-evalue ce risque dans notre population.