0464 : Young heart failure: epidemiological, clinical and etiological aspects in the University Hospital Ibn Rochd of Casablanca

Abstract

The aim of the study was to analyze the epidemiologic, clinical and etiologic aspects of heart failure of the young age to 18 to 45 years. It consisted of an observational study realized in the day hospital unit (DHU) in the service of cardiology of the University Hospital Ibn Rochd of Casablanca during 60 months (January 2009 to December 2013) comparing young patients (to 18 to 45 years) to older. The completion of a Doppler echocardiography was necessary to include the patients in the study. The median age of the patients was of 37.12 ± 3 years with a sex ratio of 2/3.2 vs. 69.7 years and a sex ratio of 2/3.1. Young subjects were less frequently hypertensive, diabetic and dyslipidemic (p<0.001). The electrocardiogram found only 16.9% in complete arrhythmia by auricular fibrillation in younger vs. 11.3% in patients more than 45 years. Cardiac echography found a dilation of the left ventricle among 47.9% vs. 42.7%, a systolic dysfunction of left ventricle among 35% vs. 66.2%. We noted that heart failure with preserved ejection fraction (HFPEF) was predominant in this population (p<0.001). The etiologies were: hypertension 31.8% vs. 1.6% (p <0.001), heart valve diseases 17.1% vs. 10.3% (p =0.003), the peripartum cardiomyopathy 6.9% vs. 0.1% (p <0.0001), dilated cardiomyopathy 14.1% vs. 8.4 (p=0.0023), the alcoholism 2.8% vs. 1.2% (p =0.22), ischemic heart diseases 22.2% vs. 60.1% (p <0.001), arhythmia 2.8% vs. 0.3% (p <0.001), the cardiothyreosis 2.8% vs. 1.1% (p=0.19) and myocarditis 1.4% vs. 0.9% (p <0.001). Young subjects were poorly compliant with beta-blockers and Aldactone because of their side effects. Heart failure is a serious and frequent pathology in North Africa. It affects young and active subjects too with a predominance of HFPEF. Causes are dominated by hypertension.