TITLE:
Contribution of Stress Testing to the Management of Ischemic Heart Disease in Mali
AUTHORS:
Youssouf Camara, Hamidou Oumar Ba, Ibrahima Sangaré, Boubacar Sonfo, Coumba Adiaratou Thiam, Mahamadou Sékou Diakité, Koniba Diarra, Karamba Touré, Massama Konaté, Ichaka Menta
KEYWORDS:
Stress Test, Ischemic Heart Disease, Mali
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.14 No.2,
February
29,
2024
ABSTRACT: Introduction: Exercise stress testing (on a treadmill
or ergometer bicycle) is an important test in cardiology for diagnosing
myocardial ischemia. This test in Mali is still in its beginning compared to
other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to
evaluate the indications of this activity and its diagnostic contribution to
cardiology in Mali. Materials and Methods: This was a retrospective,
descriptive study. The study was conducted at the “TOUCAM” medical clinic in
Kati based on the analysis of stress test reports between January 2016 and
August 2022. Result: During the study period, we documented 73 patients
who underwent exercise testing on a bicycle ergometer for suspected coronary
heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79
years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More
than half of our patients were overweight or obese (77.1%). Hypertension and
diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients
had coronary artery disease. renin-angiotensin-aldosterone system blockers
(56.8%) and beta-blockers (51.3%). The main
indications were chest pain (63.0%) and ischemia detection (15.1%). A
modified STEEP protocol was used. The majority of our patients (71.2%) achieved
at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was
11.3 ± 4.2 minutes. 24.7% thought the stress tests
were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and
treatment of ischemic heart disease, especially in settings where we have very
limited access to coronary angiography.