100 Cases of Clinical and Etiological Aspects of Cardiac Insufficiency in N’Djamena, Chad

DOI: 10.4236/wjcd.2019.98053, PP. 612-619

Keywords: Cardiac Insufficiency, Etiology, Echocardiography, N’Djamena, Chad

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Abstract:

Introduction: Cardiac Insufficiency is progressively taking over as the leading cause of morbidity and mortality in the world and a major public health problem in Chad. Our study was to contribute and provide a deeper understanding of the clinical and etiological aspects concerning the etiology and management of Cardiac Insufficiency in N’Djamena, Chad. Due to having no published data to distinctly understand this pathology in this part of the world, we represent here a summary of available data which could be used to describe the clinical and etiological aspects of Cardiac Insufficiency and to help in changing practices for an optimal management as a baseline for comparison in future studies. Patients and Methods: This was a prospective, descriptive study conducted from November 30th 2011 to May 30th 2013 at the Good Samaritan Hospital of N’Djamena. Results: 100 hospitalized patients were included consecutively. The sex ratio was 1.08 with an average age of 40.21 ± 21.30 years. The main cardiovascular risk factors were high blood pressure (15%), obesity (12%) and diabetes (11%). Clinically, exertional dyspnea was found in 95% of cases, and signs of congestive heart failure in 61% of cases. The etiologies were 50% of Rheumatic valvulopathy, 22% of Dilated cardiomyopathy, 13% of Hypertensive cardiomyopathy and 12% of Congenital heart disease. Conclusion: The most common etiologies were Rheumatic valvulopathy, Congenital heart disease, Dilated cardiomyopathy and Hypertensive cardiomyopathy.

References

[1]	Ponikowski, P., Voors, A.A., Anker, S.D., et al. (2016) ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). Developed with the Special Contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal, 18, 891-975. https://doi.org/10.1093/eurheartj/ehw128
[2]	Vos, T., Allen, C., Arora, M., et al. (2016) Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 310 Diseases and Injuries, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015. The Lancet, 388, 1545-1602. https://doi.org/10.1016/S0140-6736(16)31678-6
[3]	Roger, V.L. (2013) Epidemiology of Heart Failure. Circulation Research, 113, 646-659. https://doi.org/10.1161/CIRCRESAHA.113.300268
[4]	Mosterd, A. and Hoes, A.W. (2007) Clinical Epidemiology of Heart Failure. Heart, 93, 1137-1146. https://doi.org/10.1136/hrt.2003.025270
[5]	Ohlmeier, C., Mikolajczyk, R., Frick, J., Prütz, F., Haverkamp, W. and Garbe, E. (2015) Incidence, Prevalence and 1-Year All-Cause Mortality of Heart Failure in Germany: A Study Based on Electronic Healthcare Data of More than Six Million Persons. Clinical Research in Cardiology, 104, 688-696. https://doi.org/10.1007/s00392-015-0841-4
[6]	Bui, A.L., Horwich, T.B. and Fonarow, G.C. (2011) Epidemiology and Risk Profile of Heart Failure. Nature Reviews Cardiology, 8, 30-41. https://doi.org/10.1038/nrcardio.2010.165
[7]	Mayosi, B.M. (2007) Contemporary Trends in the Epidemiology and Management of Cardiomyopathy and Pericarditis in Sub-Saharan Africa. Heart, 93, 1176-1183. https://doi.org/10.1136/hrt.2007.127746
[8]	WHO (2016) Global Health Estimates 2015: Death by Cause, Age, Sex, Country and Region, 2000-2015. World Health Organization, Geneva.
[9]	Dunlay, S.M. and Roger, V.L. (2014) Understanding the Epidemic of Heart Failure: Past, Present, and Future. Current Heart Failure Reports, 11, 404-415. https://doi.org/10.1007/s11897-014-0220-x
[10]	Barasa, A., Schaufelberger, M., Lappas, G., Swedberg, K., Dellborg, M. and Rosengren, A. (2014) Heart Failure in Young Adults: 20-Year Trends in Hospitalization, Aetiology, and Case Fatality in Sweden. European Heart Journal, 35, 25-32. https://doi.org/10.1093/eurheartj/eht278
[11]	Stewart, S., Ekman, I., Ekman, T., Odén, A. and Rosengren, A. (2010) Population Impact of Heart Failure and the Most Common Forms of Cancer: A Study of 1 162 309 Hospital Cases in Sweden (1988 to 2004). Circulation: Cardiovascular Quality and Outcomes, 3, 573-580. https://doi.org/10.1161/CIRCOUTCOMES.110.957571
[12]	Fofana, M., Toure, S., Dadhi, B.M., Sow, T., Yassima, C.A. and Damby, B.O. (1988) Considérations étiologiques Et Nosologiques à propos de 574 cas de décompensationcardiaque à Conakry. Annales de Cardiologie et d’Angéiologie, 37, 419-424.
[13]	Thiam, M. (2003) Insuffisancecardiaque en milieu cardiologiqueafricain. Bulletin de la Société de Pathologie Exotique, 96, 217-218.
[14]	Kingue, S., Dzudie, A., Menanga, A., Akono, M., Ouankou, M. and Muna, W. (2005) A New Look of the Adult Chronic Heart Failure in Africa in the Age of the Doppler Echocardiography: Experience of the Medicine Department at Yaoundé General Hospital. Annales de Cardiologie et d’Angéiologie (Paris), 54, 276-283. https://doi.org/10.1016/j.ancard.2005.04.014
[15]	Pousset, F., Isnard, R. and Komajda, M. (2003) Insuffisance Cardiaque: Aspects épidémiologiques, cliniques et pronostiques. Encycl Méd Chir (Editions Scientifiqueset Médicales Elsevier SAS, Paris, tousdroitsréservés), Cardiologie, 11-036-G-20, 17 p.
[16]	Beguin, M., Houpe, D., Peltier, M., Chalpelain, K., Lesbre, J.P. and Tribouilloy, C. (2004) Epidemiology and Aetiology of Cardiac Failure in the Somme. Archives des Maladies du Coeuret des Vaisseaux, 97, 113-119.
[17]	Dzudie, A., Kengne, A.P., Mbahe, S., Menanga, A., Kenfack, M. and Kingue, S. (2008) Chronic Heart Failure, Select Risk Factors and Co-Morbidity among Adults Treated for Hypertension in Cardiac Referral Hospital in Cameroon. European Journal of Heart Failure, 10, 367-372. https://doi.org/10.1016/j.ejheart.2008.02.009
[18]	Bertrand, E., Muna, W.F., Diouf, S.M., et al. (2006) Urgences Cardiovasculaires en Afrique Subsaharienne. Archives des Maladies du Coeur et des Vaisseaux, 99, 1159-1165.
[19]	Paule, P., Braem, L., Mioulet, D., Gil, J.M., Theron, A., Heno, P., et al. (2007) Insuffisance Cardiaque origine non infectieuse en zone tropicale: Approche écologique et principesthérapeutiques. Revue générale. Médicine Tropicale, 67, 579-586.
[20]	Kwan, G.F., Bukhman, A.K., Miller, A.C., Ngoga, G., Mucumbitsi, J., Bavuma, C., et al. (2013) A Simplified Echocardiographic Strategy for Heart Failure Diagnosis and Management within an Integrated Non Communicable Disease Clinic at District Hospital Level for Sub-Saharan Africa. JACC: Heart Failure, 1, 230-236. https://doi.org/10.1016/j.jchf.2013.03.006
[21]	Tantchou Tchoumi, J.C., Ambassa, J.C., Kingue, S., Giamberti, A., Cirri, S., Frigiola, A., et al. (2011) Occurrence, Aetiology and Challenges in the Management of Congestive Heart Failure in Sub-Saharan Africa: Experience of the Cardiac Centre in Shisong, Cameroon. Pan African Medical Journal, 8, 11. https://doi.org/10.4314/pamj.v8i1.71059
[22]	Callender, T., Woodward, M., Roth, G., Farzadfar, F., Lemarie, J.C., Gicquel, S., et al. (2014) Heart Failure Care in Low and Middle Income Countries: A Systematic Review and Meta-Analysis. PLOS Medicine, 11, e1001699. https://doi.org/10.1371/journal.pmed.1001699
[23]	Agbor, V.N., Essouma, M., Ntusi, N.A.B., Nyaga, U.F., Bigna, J.J. and Noubiap, J.J. (2018) Heart Failure in Sub-Saharan Africa: A Contemporaneous Systematic Review and Meta-Analysis. International Journal of Cardiology, 257, 207-215. https://doi.org/10.1016/j.ijcard.2017.12.048

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