Abstract
BackgroundGlobally, heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. In Sub Saharan African countries, HF has turned out as a leading form of cardiovascular diseases, and has considerable socioeconomic impact. However, there are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF.MethodsA retrospective cohort study was carried out and we employed medical records of patient’s, admitted as a result of HF to the University of Gondar Referral Hospital in the period between December 02, 2010 and December 01, 2015 due to HF. Kaplan Meier curve was used to analyze the survival status and log rank test was used to compare the curves. Cox regression was used to analyze independent predictors of mortality in all HF patients.ResultsOf the 850 patients who were admitted due to HF, 311 patients met the inclusion criteria. Majority of the patients had HFpEF (52.73%) and tend to be women (76.22%). They predominantly had etiologies of valvular and hypertensive heart diseases, and took calcium channel blockers and anticoagulants. Conversely, patients with HFrEF had etiologies of ischemic heart disease and dilated cardiomyopathy and were prescribed angiotensine converting inhibitors (ACEI) and beta blockers. Kaplan Meier curves and Log rank test (p = 0.807) showed that there was no statistically significant difference in the mortality difference among patients with HFpEF and HFrEF. On the other hand, Cox regression analysis showed advanced age, lower sodium level, higher creatinine level and absence of medications like ACEI, spironolactone and statins independently predicted mortality in all HF patients.ConclusionsDifferent clinical characteristics were found in both groups of HF patients. There was no difference in survival outcome between patients with HFrEF and HFpEF.
Highlights
Heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact
Kaplan Meier survival curves (Fig. 1) shows there were no significant difference in survival status of patients with HF with reduced ejection fraction (HFrEF) and Heart Failure with preserved Ejection Fraction (HFpEF) (Log Rank test, P = 0.807)
Univariate Cox regression analysis showed that age, sodium level, creatinine level, Ischemic heart disease (IHD), Spironolactone, and digoxin were significantly associated with morality in patients with heart failure (HF) (Table 4)
Summary
Heart failure (HF) has been recognized as one of the major cardiovascular disorder with high morbidity, mortality and considerable social impact. There are differences in clinical characteristics and survival status among patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction. The aim of this study is to outline the clinical characteristics and medication profile, assess the survival status and prognostic factors of Ethiopian HF patients with HFrEF and HFpEF. Heart failure (HF) is one of the major cardiovascular disorder with high morbidity and mortality and rising costs, which account for 1–2% of the annual health budget of most developed nations [1, 2]. HF is usually considered typical when presenting in patients with dilated hearts and systolic dysfunction (ejection fraction (EF) < 40%). Most clinical trials excluded patients with HF with preserved ejection fraction (HFpEF > 50%) [11, 12]
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