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Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective

Received: 22 November 2022    Accepted: 15 December 2022    Published: 27 December 2022
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Abstract

Introduction. The impact of heart failure in Africa is worthy of attention owing to its economic and social impact on life expectancy in individuals who are young and economically active, and thus, identification of the aetiology of heart failure is important as some of the causes are potentially treatable. Methods. A total of one hundred and sixty heart failure patients in the Cardiology clinic and medical wards were recruited. Basic demographic information was obtained, and a clinical examination was performed. All patients underwent a resting Electrocardiography and Echocardiography. Results. The mean age of the respondents was 52.49±13.89 years and 52.5% were female. The commonest cause of HF was hypertension which was the causative factor in 51.3% of the cases, while dilated cardiomyopathy and Rheumatic heart disease, which had 16.3% each, distantly followed this. Ischaemic heart disease was present in 5.0%. There was a significant difference in age group representation with hypertension, dilated cardiomyopathy and ischaemic heart disease being more predominant in the middle-aged group while rheumatic heart disease and pericardial disease occurred in the young (p<0.001). There was also a difference in the sex representation with hypertension and ischaemic heart disease affecting more males than females (p=0.018). Conclusion. Hypertension, dilated cardiomyopathy and rheumatic heart disease are the major aetiologies of heart failure while ischemic heart disease is assuming a greater prominence as a cause of HF in our environment.

Published in Cardiology and Cardiovascular Research (Volume 6, Issue 4)
DOI 10.11648/j.ccr.20220604.15
Page(s) 118-123
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Heart Failure, Aetiology, Nigeria, Hypertension

References
[1] Jessup M, Brozena S. Heart failure. N Engl J Med. 2003 May 15; 348 (20): 2007-18. doi: 10.1056/NEJMra021498. PMID: 12748317.
[2] Davis RC, Hobbs FD, Lip GY. ABC of heart failure. History and epidemiology. BMJ. 2000 Jan 1; 320 (7226): 39-42. doi: 10.1136/bmj.320.7226.39. PMID: 10617530; PMCID: PMC1117316.
[3] Mendez GF, Cowie MR. The epidemiological features of heart failure in developing countries: a review of the literature. Int J Cardiol. 2001 Sep-Oct; 80 (2-3): 213-9. doi: 10.1016/s0167-5273(01)00497-1. PMID: 11578717.
[4] Tantchou Tchoumi JC, Ambassa JC, Kingue S, Giamberti A, Cirri S, Frigiola A, Butera G. Occurrence, aetiology and challenges in the management of congestive heart failure in sub-Saharan Africa: experience of the Cardiac Centre in Shisong, Cameroon. Pan Afr Med J. 2011; 8: 11. doi: 10.4314/pamj.v8i1.71059. Epub 2011 Feb 17. PMID: 22121420; PMCID: PMC3201578.
[5] Amoah AG, Kallen C. Aetiology of heart failure as seen from a National Cardiac Referral Centre in Africa. Cardiology. 2000; 93 (1-2): 11-8. doi: 10.1159/000006996. PMID: 10894901.
[6] Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14; 119 (14): e391-479. doi: 10.1161/CIRCULATIONAHA.109.192065. Epub 2009 Mar 26. Erratum in: Circulation. 2010 Mar 30; 121 (12): e258. PMID: 19324966.
[7] Mayosi BM. Contemporary trends in the epidemiology and management of cardiomyopathy and pericarditis in sub-Saharan Africa. Heart. 2007 Oct; 93 (10): 1176-83. doi: 10.1136/hrt.2007.127746. PMID: 17890693; PMCID: PMC2000928.
[8] Akinkugbe OO, Nicholson GD, Cruickshank JK. Heart disease in blacks of Africa and the Caribbean. Cardiovasc Clin. 1991; 21 (3): 377-91. PMID: 2044116.
[9] Damasceno A, Cotter G, Dzudie A, et al. Heart Failure in Sub-Saharan Africa: Time for Action. J Am Coll Cardiol. 2007 Oct, 50 (17) 1688–1693. https://doi.org/10.1016/j.jacc.2007.07.030
[10] Mayosi BM, Burgess LJ, Doubell AF. Tuberculous pericarditis. Circulation. 2005 Dec 6; 112 (23): 3608-16. doi: 10.1161/CIRCULATIONAHA.105.543066. PMID: 16330703.
[11] Ogah OS, Sliwa K, Akinyemi JO, Falase AO, Stewart S. Hypertensive heart failure in Nigerian Africans: insights from the Abeokuta Heart Failure Registry. J Clin Hypertens (Greenwich). 2015 Apr; 17 (4): 263-72. doi: 10.1111/jch.12496. Epub 2015 Feb 16. PMID: 25688932; PMCID: PMC8031496.
[12] Oyan, Boma & Abere, Sarah. (2022). Prevalence and risk factors for peripheral arterial disease in adults with systemic hypertension in Southern Nigeria. GSC Advanced Research and Reviews. 10. 10.30574/gscarr.2022.10.3.0082.
[13] Magula NP, Mayosi BM. Cardiac involvement in HIV-infected people living in Africa: a review. Cardiovasc J S Afr. 2003 Sep-Oct; 14 (5): 231-7. PMID: 14610610.
[14] McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012; 14: 803–69.
[15] Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec; 58 (6): 1072-83. doi: 10.1161/01.cir.58.6.1072. PMID: 709763.
[16] Dokainish H, Teo K, Zhu J, Roy A, AlHabib KF, ElSayed A, Palileo-Villaneuva L, Lopez-Jaramillo P, Karaye K, Yusoff K, Orlandini A, Sliwa K, Mondo C, Lanas F, Prabhakaran D, Badr A, Elmaghawry M, Damasceno A, Tibazarwa K, Belley-Cote E, Balasubramanian K, Yacoub MH, Huffman MD, Harkness K, Grinvalds A, McKelvie R, Yusuf S; INTER-CHF Investigators. Heart Failure in Africa, Asia, the Middle East and South America: The INTER-CHF study. Int J Cardiol. 2016 Feb 1; 204: 133-41. doi: 10.1016/j.ijcard.2015.11.183. Epub 2015 Dec 2. PMID: 26657608.
[17] Chansa P, Lakhi S, Andrews B, Kalinchenko S, Sakr R. Factors Associated with Mortality in Adults Admitted with Heart Failure at the University Hospital in Lusaka, Zambia. Medical Journal of Zambia. 2012; 41 (1): 4-12.
[18] Onwuchekwa AC, Asekomeh GE. Pattern of heart failure in a Nigerian teaching hospital. Vasc Health Risk Manag. 2009; 5: 745-50. doi: 10.2147/vhrm.s6804. Epub 2009 Sep 18. PMID: 19774215; PMCID: PMC2747392.
[19] Michael M. Givertz, and Mandeep R. Mehra. Heart Failure: Pathophysiology and Diagnosis. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. Harrison’s Principles of Internal Medicine. 21st Ed. New York: McGraw-Hill Education. 2022: 1930-1940.
[20] Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pract. 2000 Feb; 49 (2): 147-52. PMID: 10718692.
[21] Oyati IA, Danbauchi SS, Alhassan MA, Isa MS. Diastolic dysfunction in persons with hypertensive heart failure. J Natl Med Assoc. 2004 Jul; 96 (7): 968-73. PMID: 15253329; PMCID: PMC2568427.
[22] P. M. Kolo, A. B. O. Omotoso, P. O. Adeoye, A. J. Fasae, U. G. Adamu, J. Afolabi, I. F. Aigbe and J. A. Ogunmodede, 2009. Echocardiography at the University of Ilorin Teaching Hospital, Nigeria: A Three Years Audit. Research Journal of Medical Sciences, 3: 141-145.
[23] Ojji DB, Alfa J, Ajayi SO, Mamven MH, Falase AO. Pattern of heart failure in Abuja, Nigeria: an echocardiographic study. Cardiovasc J Afr. 2009 Nov-Dec; 20 (6): 349-52. PMID: 20024475; PMCID: PMC3721294.
[24] Adebayo, A. K., Adebiyi, A. A., Oladapo, O. O. et al. Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria. BMC Cardiovasc Disord 9, 52 (2009). https://doi.org/10.1186/1471-2261-9-52
[25] Vasan RS, Benjamin EJ, Levy D. Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective. J Am Coll Cardiol. 1995 Dec; 26 (7): 1565-74. doi: 10.1016/0735-1097 (95)00381-9. PMID: 7594087.
[26] Lenzen MJ, Scholte op Reimer WJ, Boersma E, Vantrimpont PJ, Follath F, Swedberg K, Cleland J, Komajda M. Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur Heart J. 2004 Jul; 25 (14): 1214-20. doi: 10.1016/j.ehj.2004.06.006. PMID: 15246639.
[27] Rheumatic fever and rheumatic heart disease. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1988; 764: 1-58. PMID: 3131967.
[28] Massell BF, Chute CG, Walker AM, Kurland GS. Penicillin and the marked decrease in morbidity and mortality from rheumatic fever in the United States. N Engl J Med. 1988 Feb 4; 318 (5): 280-6. doi: 10.1056/NEJM198802043180504. PMID: 3336421.
Cite This Article
  • APA Style

    Okechukwu Iheji, Boma Oyan, Nkemegbunam Okoli, Rosemary Stanley, Ngozi Pauline Onwueme. (2022). Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective. Cardiology and Cardiovascular Research, 6(4), 118-123. https://doi.org/10.11648/j.ccr.20220604.15

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    ACS Style

    Okechukwu Iheji; Boma Oyan; Nkemegbunam Okoli; Rosemary Stanley; Ngozi Pauline Onwueme. Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective. Cardiol. Cardiovasc. Res. 2022, 6(4), 118-123. doi: 10.11648/j.ccr.20220604.15

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    AMA Style

    Okechukwu Iheji, Boma Oyan, Nkemegbunam Okoli, Rosemary Stanley, Ngozi Pauline Onwueme. Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective. Cardiol Cardiovasc Res. 2022;6(4):118-123. doi: 10.11648/j.ccr.20220604.15

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  • @article{10.11648/j.ccr.20220604.15,
      author = {Okechukwu Iheji and Boma Oyan and Nkemegbunam Okoli and Rosemary Stanley and Ngozi Pauline Onwueme},
      title = {Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective},
      journal = {Cardiology and Cardiovascular Research},
      volume = {6},
      number = {4},
      pages = {118-123},
      doi = {10.11648/j.ccr.20220604.15},
      url = {https://doi.org/10.11648/j.ccr.20220604.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20220604.15},
      abstract = {Introduction. The impact of heart failure in Africa is worthy of attention owing to its economic and social impact on life expectancy in individuals who are young and economically active, and thus, identification of the aetiology of heart failure is important as some of the causes are potentially treatable. Methods. A total of one hundred and sixty heart failure patients in the Cardiology clinic and medical wards were recruited. Basic demographic information was obtained, and a clinical examination was performed. All patients underwent a resting Electrocardiography and Echocardiography. Results. The mean age of the respondents was 52.49±13.89 years and 52.5% were female. The commonest cause of HF was hypertension which was the causative factor in 51.3% of the cases, while dilated cardiomyopathy and Rheumatic heart disease, which had 16.3% each, distantly followed this. Ischaemic heart disease was present in 5.0%. There was a significant difference in age group representation with hypertension, dilated cardiomyopathy and ischaemic heart disease being more predominant in the middle-aged group while rheumatic heart disease and pericardial disease occurred in the young (pConclusion. Hypertension, dilated cardiomyopathy and rheumatic heart disease are the major aetiologies of heart failure while ischemic heart disease is assuming a greater prominence as a cause of HF in our environment.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Heart Failure in a Tertiary Hospital in Southern Nigeria - An Aetiological Perspective
    AU  - Okechukwu Iheji
    AU  - Boma Oyan
    AU  - Nkemegbunam Okoli
    AU  - Rosemary Stanley
    AU  - Ngozi Pauline Onwueme
    Y1  - 2022/12/27
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ccr.20220604.15
    DO  - 10.11648/j.ccr.20220604.15
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 118
    EP  - 123
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20220604.15
    AB  - Introduction. The impact of heart failure in Africa is worthy of attention owing to its economic and social impact on life expectancy in individuals who are young and economically active, and thus, identification of the aetiology of heart failure is important as some of the causes are potentially treatable. Methods. A total of one hundred and sixty heart failure patients in the Cardiology clinic and medical wards were recruited. Basic demographic information was obtained, and a clinical examination was performed. All patients underwent a resting Electrocardiography and Echocardiography. Results. The mean age of the respondents was 52.49±13.89 years and 52.5% were female. The commonest cause of HF was hypertension which was the causative factor in 51.3% of the cases, while dilated cardiomyopathy and Rheumatic heart disease, which had 16.3% each, distantly followed this. Ischaemic heart disease was present in 5.0%. There was a significant difference in age group representation with hypertension, dilated cardiomyopathy and ischaemic heart disease being more predominant in the middle-aged group while rheumatic heart disease and pericardial disease occurred in the young (pConclusion. Hypertension, dilated cardiomyopathy and rheumatic heart disease are the major aetiologies of heart failure while ischemic heart disease is assuming a greater prominence as a cause of HF in our environment.
    VL  - 6
    IS  - 4
    ER  - 

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Author Information
  • Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria

  • Department of Internal Medicine, Rivers State University Teaching Hospital, Port Harcourt, Nigeria

  • Department of Internal Medicine, National Orthopaedic Hospital, Igbobi, Nigeria

  • Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

  • Department of Internal Medicine, Asaba Specialist Hospital, Asaba, Nigeria

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