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Heart Failure with Preserved Ejection Fraction: A Report about 64 Cases Followed at the Heart Institute of Abidjan

The concept of heart failure with preserved ejection fraction is relatively new. Historically, the diagnosis of heart failure was based primarily on clinical criteria, and patients described in the studies were likely to be a mixture of heart failure with altered ejection fraction and heart failure with preserved ejection fraction. For little work has been done on this type of heart failure in Africa, it is appropriate to describe the epidemiological and etiological features of this condition.

This was a retrospective study that was carried out over a 12-month period, from 1 January 2015 to 31 December 2015, in the hospitalization department of the Heart Institute of Abidjan. It was about patients hospitalized for heart failure who had received a dose of NT-proBNP and who had had an electrocardiogram and a Doppler echocardiography. Heart failure with preserved ejection fraction (HFPEF) was defined from the symptoms and signs of heart failure, the level of NT-proBNP and from echocardiography data based on the left ventricular ejection fraction (LVEF) > 50%, the dilatation of the left atrium. The diastolic dysfunction of the left ventricle was assessed by the ratio E/E’ > 13. We defined as heart failure with decreased ejection fraction (HFDEF) symptoms and signs of heart failure and left ventricular dysfunction LVEF < 40%. A computer file was completed. It included epidemiological and etiological data. 

The study involved sixty-four patients with heart failure with preserved ejection fraction out of 257 patients with heart failure that is a prevalence of 25%. The mean age was 57.3 ± 16 years old. There was a male predominance that was 52% of cases. Congestive heart failure was predominant in 67%. NT-proBNP levels were 365 pg/ml on average. The average length of stay was 5.5 ± 3.1. Intra-hospital deaths were 4.6%. The etiologies are dominated by high blood pressure in 85.9%, followed by obesity in 28.1%, then by ischemic heart disease in 4.6%. There were no diabetic patients in this group. 

In conclusion, heart failure with preserved ejection fraction is characterized in the regions by its frequent occurrence in the congestive mode in young hypertensive men. And complications of high blood pressure occur early and severe in the African black subject.

Article by Fatoumata Traore, et al, from Heart Institute of Abidjan, Abidjan, Côte d’Ivoire.

Full access: http://mrw.so/3eT72p

Image by Shannon Brien, from Flickr-cc.

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