[Coronarography and etiologies of heart failure with impaired left ventricular ejection fraction in Senegal]

Heart failure is a major public health problem because of the number and duration of hospitalizations. Patients with heart failure may have mixed etiologies that are not mutually exclusive, and etiologies vary between high-income and developing countries. The aim of our work was to study the contribution of coronary angiography in the etiological investigation of heart failure with impaired LVEF in the cardiology department of HPD.

This was a descriptive and analytical cross-sectional study with retrospective data collection on 103 patients hospitalized in the cardiology department of DAKAR's Hospital Principal presenting with heart failure with impaired LVEF and who underwent coronary angiography from January 2019 to December 2022.

Our study included 103 patients with a clear male predominance 79.6% and a sex ratio of 3.7. Their mean age was 64±13.5 years. Diabetes was prevalent at 24.3% (p=0.033). All patients had impaired segmental and/or global left ventricular kinetics. Mean ejection fraction was 28.1±6.8. The right radial route was predominantly used 83.7% of the time, and there were no procedural incidents or accidents. Diabetes was significantly associated with coronary involvement (p=0.033). Coronary angiography was normal in 37.8% of patients and showed tri-truncular lesions in 19.4% of patients and bi-truncular lesions in 17.4%. We found 91 significant lesion and 67 non-significant lesion. A total of 41 patients had ischemic heart disease, equivalent to 39.8%.

Our study shows that ischemic heart disease plays an important role in the etiology of heart failure with impaired LVEF, and that coronary angiography should be performed routinely.