First episode of heart failure at Teaching Hospital of Brazzaville (Congo)

Abstract

The management of heart failure (HF) is very difficult in Sub-Saharan Africa. To describe the epidemiological, clinical aspects and prognosis of patients during a first episode of heart HF. This cross-sectional study was achieved from 1st January 2014 to 31 December 2015 (1 year) in the cardiology and internal medicine department at the Teaching Hospital of Brazzaville. We had included the patients admitted for a first episode of HF. Four hundred and eighty-five patients were included, 274 women (56.5%). The frequency of HF was 38.2%. The mean age was 56 ± 17.5 years (range: 12 and 91 years). Hypertension was the predominant cardiovascular risk factor ( n = 222, 45.7%). The main functional signs were dyspnea ( n = 483, 99.5%), cough ( n = 171, 35.2%) and chest pain ( n = 38, 7.8%). HF was global in 290 cases (60%) and left exclusive in 155 cases (32%). Anemia was found in 126 cases (32.5%) and altered glomerular filtration rate in 70 cases (18.6%). LVEF was lowered (< 40%) in 258 cases (67.7%). The main causes of HF were dilated cardiomyopathy ( n = 147, 32.1%), hypertensive heart disease ( n = 83, 18.1%) and ischemic heart disease ( n = 54, 11.8%). The complications were severe kidney failure ( n = 33, 6.8%) and haemodynamic shock ( n = 15). The death was recorded in 52 cases (10.7%). Death was associated with male sex (OR = 1.9; 95% CI: 1.06–3.3; P = 0.01), anemia (OR = 3.5; 95% CI: 1.8–6.6; P < 0.001), acute kidney failure (OR 2.5, 95%CI: 1.2-5.2; P < 0.01) and heart rhythm disorders (OR = 2.6; 95% CI: 1.14–6.2; P = 0.01). The first episode of HF often involves young patients. Hypertension was the primary cardiovascular risk factor. Patients often have advanced heart disease. In our environment, prevention will be limit the occurrence of HF.