Heart Failure Characteristics and Difficulties of the Long-Term Follow-Up in Semi-Urban African Area: About A Prospective Study at the Hospital De La Paix in Ziguinchor (Southern Senegal)

Abstract

Background: Heart failure is a major public health problem in Africa where it is the main circumstance for the discovery of cardiovascular diseases. The objective of this work was to analyze the characteristics of heart failure in the African semi-urban zone and to identify the difficulties related to the long-term follow-up of heart failure patients at the hospital de la Paix in Ziguinchor (southern Senegal). Method: We conducted a 1-year prospective study (March 2017 to March 2018) in the cardiology department of the hospital de la Paix in Ziguinchor (southern Senegal). We included in the study all patients of both sexes hospitalized for heart failure. The studied parameters were recorded on a data collection sheet. Results: The mean age was 54.5 ± 19.1 years with male predominance (53.6%). The majority of our patients were of low socioeconomic status (38.3%). High blood pressure was the most common cardiovascular risk factor (37.4%). This was most commonly an overall heart failure (52%) and the most common clinical signs were NYHA dyspnea III and IV (96%), hepatopathies (51.5%), cough (50.6%) and edema of the lower limbs (72.8%). Electrocardiographic abnormalities were dominated by left ventricular hypertrophy (39.6%) and left ventricular function was impaired in 59.1% of cases on cardiac ultrasound. Isolated high blood pressure was the leading cause of heart failure (26.3%), followed by dilated cardiomyopathies (20.4%) and chronic lung hearts (13.1%). The in-hospital mortality rate was 20.9% and the overall mortality was 27.2%. Patients rehospitalized during follow-up accounted for 31.9% of cases while 17% of our patients were lost to follow-up. The main cause of cardiac decompensation in rehospitalized patients was therapeutic disruption. Conclusion: Syndrome with multiple etiologies, heart failure is the evolutionary term of most heart disease. Prevention requires better management of cardiovascular risk factors and good education of patients with heart failure.