Prognosis of heart failure in a tunisan cohort

Abstract

Inspite of therapeutic progress, chronic heart failure (HF) was associated to poor prognosis due to high mortality, and an important rate of réhospitalisations. The aim of our study was s to describe the epidemiological, clinical, therapeutic and evolutionary characteristics of HF and to release the predictive factors of mortality and rehospitalizations. A prospective study of 110 patients hospitalized for first episode of HF. Data were collected from adut cardioly department of la Rabta hospital, during the period from October 2013 to October 2015. We included patients with reduced left ejection fraction function ≤ 40%. Multivariate analysis was performed, using logistic regression model incorporating in order to determinate predictor factors of mortality and rehospitalisation during HF. The average age was 63.6 ± 11.9 years with sex-ratio of 2.6. Clinically 55% of patients were admitted for left-sided heart failure, The mean ejection fraction was estimated at 33,6 ± 5,8% patients. Dominant etiology was ischemic heart disease (45%). Angiotensin converting enzyme was prescribed in 88% of cases, beta-blockers in (91%) case, spironolactone in 48% of cases, hospital mortality and at 6 months was respectively l4%, and 17%. The rate of re-hospitalization for cardiac decompensation was 35%. In multivariate analysis, diabetes, longitunal global strain,TAPSE and hyperuricemia were independent predictors factors of mortality. Valvular etiology and atrial fibrillation were associated with a high risks for hospitalization. In spite of all the therapeutic advances, the prognosis of the heart failure is still dark, incite to a prevention which consist on an early and effective management of the causal pathology before the deterioration of the left-ventricular function.