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Heart of Africa

In January 2006 a prospective registry of more than 9,000 men and women, with heart disease, from Soweto presenting to the Baragwanath Hospital, was initiated (The Heart of Soweto Study). So far information on 8000 patients has been collected and several intervention trials have been initiated and published. Details are available at www.socru.org. See also PROTECT-Africa project ( Cardiac Disease in Maternity Research, www.hatter.uct.ac.za). Prof. Sliwa is currently also the co-director of the Soweto Cardiovascular Research Unit (2006-2016, ongoing).

This project is now being extended to research the wider African community – The Heart of Africa Studies.

Through innovative pathways, we were successful in obtaining funding for the running of a number of larger studies (under the umbrella of the ‘Heart of Africa studies’) to other African countries by linking up with like-minded colleagues on the continent and thereby forming a stronger network of researchers. The Pan-African Society of Cardiology (PASCAR), established in 1981, is an organization of physicians from across Africa involved in the prevention and treatment of cardiovascular disease. In the past few years, under the leadership Prof. Bongani Mayosi and the Executive Board, PASCAR has strengthened its role in promoting research. The PASCAR-Heart failure task force (Chair K. Sliwa) had several meetings and symposia in Sub-Saharan Africa which formed the basis of a number of heart failure research projects.

The Pan African Pulmonary Hypertension Cohort (PAPUCO) Study

The main objective of this research is to describe the epidemiology of pulmonary hypertension (PHT) in patients from a number of African countries. The study has recently be published. Thienemann et al. 2016.

Pulmonary hypertension (PH) is a condition of varying aetiologies that is primary characterised by narrowing of the pulmonary vasculature and consequential right heart failure (RHF). It is a devastating, progressive disease associated with increasingly debilitating symptoms and a poor prognosis. However, the majority of reports emanate from high-income countries. Based on the hypothesis that the underlying pathways to this deadly condition in Africa would be many and varied and produce a high burden of disease (relative to high-income countries), we initiated the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry Study; a unique study in the African context. The study provides prospective, standardised profiling and outcome data (including 6-month survival profiles) in a series of consecutive African patients newly diagnosed with PH from participating centres across the African continent. Our data provide new insights into PH from a developing world perspective; with clear opportunities to improve its prevention, treatment and outcomes taking into account the relative lack of health resources and the particular need to provide practical guidelines for its rapid detection and optimal management in the African context.

 

B-A-HEF STUDY

Recent research in cardiovascular disease in African populations (Heart ofSoweto Study), specifically of heart failure (THESUS Study – Damasceno A, Sliwa K, et al. The causes, treatment and outcome of acute heart failure n 1006 Africans from 9 countries. Arch Intern Med, 2012) has shown that heart failure is not treated optimally in Africa. Prof Sliwa has been the principle investigator of a the prospective, placebo-controlled, double-blind, randomized study to compare treatment with Hydralazine-Isosorbide–Dinitrate (HYIS) versus placebo on top of standard care in African patients admitted with Acute Heart Failure (AHF) and left ventricular dysfunction- the BA-HEF study. This study commenced in January 2013 and the results were reported at the European Cardiac Society meeting in Florence, Italy May 2016  and simultaneously published in the Europ J Heart Failure.

The use of different medications, such as ACEi and hydralazine/nitrates, has never been examined in patients admitted with AHF. Principal Investigators at the various sites were: Prof. Karen Sliwa (South Africa); Dr Mahmoud Sani (Nigeria); Dr Okechukwu Ogah (Nigeria); Dr Dike Ojji (Nigeria); Prof. Elijah Ogola (Kenya); Prof. Gerald Yonga (Kenya); Dr Charles Mondo (Uganda); Dr Anastase Dzudie (Cameroon); Dr Charles Kouam Kouam (Cameroon); Prof. Albertino Damasceno (Mozambique); Prof. Sergine Abdou Ba (Senegal) and Dr Fikru Maru (Ethiopia).

 

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