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Clinical characteristics and one-year all-cause mortality outcomes in Africans with dilated cardiomyopathy

Nqoba Tsabedze1, Dineo Mpanya1, Claude Bailly2

  • 1Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, Gauteng, South Africa.

International Journal of Cardiology
|June 26, 2023
PubMed

Insights

Dilated cardiomyopathy in sub-Saharan Africa affects young males, leading to heart failure. This study found a 19% one-year mortality rate, highlighting the need for further research into its causes and outcomes.

Area of Science:

  • Cardiology
  • Public Health
  • Sub-Saharan African Medicine

Background:

  • Dilated cardiomyopathy (DCM) is a frequent cause of heart failure in sub-Saharan Africa (SSA).
  • Patients present with new-onset heart failure with reduced ejection fraction without a clear cause.
  • The clinical profile of this specific patient group remains under-characterized.

Purpose of the Study:

  • To describe the clinical characteristics of patients experiencing heart failure of unknown origin in SSA.
  • To identify potential predictors of mortality and rehospitalization in this cohort.

Main Methods:

  • Screening of 161 patients with heart failure of unknown origin.
  • Exclusion of known primary and secondary causes of DCM.
  • Comprehensive assessment including biochemical testing, echocardiography, cardiovascular magnetic resonance (CMR) imaging, and coronary angiography.

Main Results:

  • The study included 93 participants (mean age 47.5 years).
  • Late gadolinium enhancement (LGE) was observed in 56.1% of participants, often in the mid-wall.
  • A 19% all-cause mortality rate was recorded within a median follow-up of 13.4 months.
  • Non-survivors exhibited significantly higher left atrial volume index compared to survivors (p=0.017).
  • The rehospitalization rate was 29.3%, with most cases related to heart failure.

Conclusions:

  • Dilated cardiomyopathy in Africans predominantly affects young males.
  • The disease carries a substantial one-year mortality risk (19%) in this population.
  • There is a critical need for large, multicenter studies in SSA to elucidate the pathogenesis and outcomes of DCM.
Abstract

Keywords:
Dilated cardiomyopathyHeart failureIdiopathic dilated cardiomyopathyMortalitySub-Saharan Africa

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