Heart failure subjects among Africans: Any contributions from coronary artery diseases? An electrocardiographic and echocardiographic analysis

Abstract

Background: Despite the rise in risk factor burden for coronary artery disease (CAD) and heart failure among Africans, post myocardial infarction heart failure is rarely reported. Aim and Objectives: We aim to use major electrocardiographic indices suggesting old myocardial infarction and echocardiographic evidence of relative wall motion abnormalities to determine the possible contribution of CAD to the aetiology of heart failure among Africans. Study Design: Prospective observational study. Setting: Goshen Heart Clinic, Osogbo, Nigeria. Methods: 129 consecutive subjects with heart failure diagnosed using the Framinghams’s criteria were included in this study seen at the Goshen Heart Clinic, Osogbo, Nigeria. They had ECG and echocardiography among other investigations. Old Myocardial infarction (MI) on ECG was assessed using standardized criteria using the Third Universal definition of MI while relative wall motion abnormalities were assessed during echocardiography. Statistics: Statistical Package for Social Sciences 17.0 was used for statistical analysis. Results: The mean age of the study participants was 62.1 ± 13.7 years. There were 57 females (44.2%). Possible CAD was identified in 18 (13.95%) of study participants and they were more likely to be significantly older, had a lower ejection fraction , a higher fasting blood sugar and a higher left ventricular chamber walls dimensions compared to those without possible CAD. Conclusion: CAD may be a significant contributor to the aetiology of heart failure subjects among Africans and it is important to look for possible significant coronary atherosclerosis and treat appropriately even among Africans with heart failure. Concerted treatment for CAD risk factors is an important way to reduce the increasing burden of CAD among Nigerians.