Cardiovascular Involvement in Tuberculosis Patients Treated in Southern Africa

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) is a leading cause of death globally, especially among individuals with HIV.
• Subclinical cardiovascular complications of TB are under-researched in high-burden regions.
• Understanding TB's cardiac impact is crucial for public health initiatives.

Purpose of the Study:

• To determine the prevalence of cardiovascular involvement in TB patients.
• To assess changes in cardiac status after anti-TB treatment.

Main Methods:

• Transthoracic echocardiography (TTE) was used to evaluate 286 TB patients (HIV-positive and HIV-negative) in Zambia and South Africa.
• Cardiac assessments were performed at TB diagnosis and after 6 months of treatment.
• Analyses focused on pericardial effusion, thickening, calcification, and constriction.

Main Results:

• At diagnosis, 47% of TB patients had pericardial effusions and 30% had thickening.
• Following TB treatment, pericardial effusions decreased from 47% to 16% (P < 0.001) and thickening from 30% to 15% (P = 0.002).
• Pericardial calcifications and constriction signs remained similar before and after treatment.

Conclusions:

• Cardiac involvement, particularly pericardial abnormalities, is common in newly diagnosed TB patients.
• Early pericardial changes associated with TB can be reversed with successful anti-TB therapy.
• Echocardiography is valuable for detecting and managing cardiovascular complications in TB patients.