0336 : Gender -related dissociation in outcomes in chronic heart failure in Moroccan woman: clinical, biological and echocardiographic features

Abstract

Chronic heart failure (CHF) is a major cause of morbidity and mortality in the world. Few studies have examined the difference between the two gender and features in African woman. We conducted a retrospective study of patients with chronic heart failure followed between 2006- 2012 at the daily hospital Ibn Rochd in Casablanca. Of the 1613 patients, 603 were women. We studied the prevalence of cardiovascular risk factors, the severity of clinical symptoms and major cardiovascular events (acute coronary syndrom, stroke and acute heart failure). We also collected biological parameters (serum sodium, serum potassium, hemoglobin and creatinine) and echocardiographic criteria with poor prognosis (dilated left ventricular>60mm, ejection fraction<35%, pulmonary hypertension, severe mitral regurgitation). We compared our results with statistical analysis to the men of our population to identify prognostic markers in women with CHF. Mean age was 68,3 years. Woman is more likely to hypertension (49% vs 33%) and diabetes (39% vs 27%). Smoking is less common in women (with 3.4% vs 48%). Further, metabolic disorder dominates in the male population specially anemia. There is no significant difference in the severity of clinical symptoms. The etiology of CHF is dominated in women by valvulopathy, but man ischemic etiology dominates as in the developed countries. For echocardiographic features, half women has ejection fraction less than 35%. In addition, pulmonary arterial hypertension beyond 40 mmHg was significantly elevated in women. We find a higher acute cardiac decompensation rate at 9.9% vs. 7.7% (p = 0.01). Otherwise, the occurrence of major cardiovascular events is lower in women such as myocardial infraction (29% vs 40.3%) and stroke (5.9% vs 19%) p<0,001. Moroccan woman with chronic heart failure is more predisposed to cardiovascular risk factors and acute heart decompensation. Nevertheless, she has fewer major cardiovascular events.