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Published on: May 16, 2020
[Epidemioclinical and evolutionary profile of dilated cardiomyopathies at the University Hospital in Brazzaville,
Stéphane Méo Ikama1,2, Bijou Moualengue1, Jospin Makani1
1Service de Cardiologie et Médecine Interne, Centre Hospitalier Universitaire de Brazzaville, Congo.
Insights
Dilated cardiomyopathies (DCMs) are a frequent cause of heart failure in Brazzaville. Treatment protocols include diuretics and ACE inhibitors, but high loss to follow-up limits survival assessment.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Dilated cardiomyopathies (DCMs) are a significant cause of heart failure (HF).
- Understanding DCM prevalence and treatment patterns in Brazzaville is crucial for improving patient care.
Observation:
- A prospective study in Brazzaville included 100 hospitalized HF patients with DCM.
- The cohort comprised 62% women, with an average age of 52.9 years.
- Common ECG findings included left ventricular hypertrophy (40%) and normal sinus rhythm (95%).
Findings:
- Mean left ventricular ejection fraction was 33.4%, with a left ventricle end-diastolic diameter of 65.5 mm.
- Standard HF treatments were administered: 100% received loop diuretics and ACE inhibitors/ARBs.
- Beta-blockers were used in 38% of patients.
Implications:
- DCM is a leading cause of heart failure in Brazzaville.
- High loss to follow-up (41%) and a short follow-up period hinder survival rate assessment.
- Further research with longer follow-up is needed to evaluate long-term outcomes and refine treatment protocols.
Abstract:
This study aims to contribute to the improvement of treatment protocols for patients with dilated cardiomyopathies (DCMs) in Brazzaville. We conducted a prospective analytical study at the University Hospital in Brazzaville between 1 January 2014 and 30 June 2015. All patients hospitalized with heart failure (HF) associated with DCM in the Department of Cardiology were included in the study. The study involved 100 patients. Hospitalization rate for DCM was 32.1%: 38 men (38%) and 62 women (62%) with an average age of 52.9 ± 17.1 years. Seventy two patients had comprehensive heart failure (72%). ECG showing normal sinus rhythm (95%) objectified left ventricular hypertrophy (40%), left bundle-branch block (16%), atrial fibrillation (5%). Mean left ventricular ejection fraction (EF) was 33.4 ± 6.8% and left ventricle end-diastolic diameter was 65.5 ± 7.0 mm. Treatment was based on loop diuretic (100%), ACE Inhibitors, Angiotensin II Receptor Blockers (ARBs) (100%), beta blocker (38%), digitalis (30%), anti-aldosterone (16%) and anti-vitamin K (11%). After 12-month follow-up period, overall case-fatality rate was 9%, readmission rate was 12% and the rate of patient lost-to-follow-up was 41%. This study shows that DCM is frequent and it is one of the leading causes of heart failure. The short follow-up period and the high rate of people lost to follow up do not enable assessment of survival rate of patients at our Department.
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