[Epidemioclinical and evolutionary profile of dilated cardiomyopathies at the University Hospital in Brazzaville, Congo]. / Profil épidémio-clinique et évolutif des cardiomyopathies dilatées au Centre Hospitalier Universitaire de Brazzaville, Congo.

This study aims to contribute to the improvement of treatment protocols for patients with dilated cardiomyopathies (DCMs) in Brazzaville. We conducted a prospective analytical study at the University Hospital in Brazzaville between 1 January 2014 and 30 June 2015. All patients hospitalized with heart failure (HF) associated with DCM in the Department of Cardiology were included in the study. The study involved 100 patients. Hospitalization rate for DCM was 32.1%: 38 men (38%) and 62 women (62%) with an average age of 52.9 ± 17.1 years. Seventy two patients had comprehensive heart failure (72%). ECG showing normal sinus rhythm (95%) objectified left ventricular hypertrophy (40%), left bundle-branch block (16%), atrial fibrillation (5%). Mean left ventricular ejection fraction (EF) was 33.4 ± 6.8% and left ventricle end-diastolic diameter was 65.5 ± 7.0 mm. Treatment was based on loop diuretic (100%), ACE Inhibitors, Angiotensin II Receptor Blockers (ARBs) (100%), beta blocker (38%), digitalis (30%), anti-aldosterone (16%) and anti-vitamin K (11%). After 12-month follow-up period, overall case-fatality rate was 9%, readmission rate was 12% and the rate of patient lost-to-follow-up was 41%. This study shows that DCM is frequent and it is one of the leading causes of heart failure. The short follow-up period and the high rate of people lost to follow up do not enable assessment of survival rate of patients at our Department.

Prevalence of anaemia among patients with heart failure at the Brazzaville University Hospital.

BACKGROUND: Heart failure (HF) is a frequent cause of ospitalisation in cardiology. Its prognosis depends on several risk factors, one of which is anaemia. OBJECTIVES: We aimed to determine the prevalence of anaemia in patients with heart failure, and evaluate its impact on their prognosis. METHODS: This article describes a cross-sectional study with prospective collection of data, carried out from 1 January to 31 December 2010 in the Department of Cardiology at Brazzaville University Hospital, Congo. Patients admitted for heart failure were included. Anaemia was defined as a haemoglobin level < 12 g/dl for men and < 11 g/dl for women. RESULTS: In total, 130 men (47.8%) and 142 women (52.2%) were recruited, mean age 56.9 ± 16.5 years. The prevalence of anaemia was 42%. Average levels of haemoglobin were 9.4 ± 1.8 and 13.8 ± 4.9 g/dl for the anaemic (A) and non-anaemic (NA) patients, respectively (p = 0.0001). Two hundred and forty-nine patients (91.5%) were in NYHA functional class III-IV. Forty-seven patients (17.3%) were on oral anticoagulation and 15 (5.5%) were on aspirin. The average duration of hospital stay was 19.1 ± 16.7 days, without a significant difference between the A and NA groups (19.4 ± 12 vs 18.8 ± 13.8 days; p = 0.79, respectively). Total mortality rate was 17%, with a significant difference between the A and NA groups (26 vs 10%; p = 0.001). CONCLUSION: This preliminary study showed a high prevalence of anaemia in patients with heart failure, and it had a negative effect on the prognosis.