Ikama M S, Kimbally-Kaky G, Gombet T, Ellenga-Mbolla B F, Dilou-Bassemouka L, Mongo-Ngamani S, Ekoba J, Nkoua J L
Service de cardiologie et médecine interne, Centre hospitalier et universitaire de Brazzaville, Congo.
Med Trop (Mars). 2008 Jun;68(3):257-60.
The aim of the study is to report clinical, etiologic aspects and the outcome of heart failure in elderly hospital patients treated in Brazzaville, Congo. This retrospective study was carried out over a 20-month period from January 1, 2005 to August 31, 2006. In addition to age over 60 years, the main inclusion criteria was diagnosis of heart failure based on clinical, radiological, electrocardiographic, and echocardiographic evidence. A total of 223 patients, i.e., 50.0% of 446 patients over the age of 60 years evaluated, were included in the study. There were 125 women (56.1%) and 98 men (43.9%) (p = 0.0105). Mean age in the overall population was 70.4 +/- 6.2 years (range, 60 to 100 years). Heart failure was global in 148 cases (66.4%), left sided in 49 (22.0%), and right sided in 26 (11.6%). Left ventricular dysfunction was systolic in 93 cases (47.2%) and diastolic in 83 (42.1%) (p = 0.31). Underlying causes were hypertension in 77 cases (34.5%), coronary disease in 57 (25.6%), valvulopathy in 21 (9.4%), and myocardiopathy in 17 (7.6%). Chronic pulmonary heart disease was diagnosed in 25 cases (11.2%). Other cardiac diseases were found in 8 cases (3.6%). All patients underwent medical treatment. Thrombolytics were not used in cases involving myocardial infarction. The death rate was 20.2% (n = 45), i.e., 12 cases involving hypertensive cardiopathy, 8 involving coronary artery disease, 3 involving valvular cardiopathy, and 5 involving chronic pulmonary heart disease. The type of cardiopathy was undetermined in 17 cases. Heart failure is common in the elderly. Prevention depends on reducing cardiovascular risk factors especially arterial hypertension.
本研究旨在报告刚果布拉柴维尔老年住院患者心力衰竭的临床、病因学情况及转归。这项回顾性研究在2005年1月1日至2006年8月31日的20个月期间进行。除年龄超过60岁外,主要纳入标准是基于临床、放射学、心电图和超声心动图证据诊断为心力衰竭。共有223例患者(即60岁以上接受评估的446例患者中的50.0%)被纳入研究。其中有125名女性(56.1%)和98名男性(43.9%)(p = 0.0105)。总体人群的平均年龄为70.4±6.2岁(范围为60至100岁)。心力衰竭为全心衰的有148例(66.4%),左心衰49例(22.0%),右心衰26例(11.6%)。左心室功能障碍为收缩性的有93例(47.2%),舒张性的有83例(42.1%)(p = 0.31)。潜在病因包括高血压77例(34.5%),冠心病57例(25.6%),瓣膜病21例(9.4%),心肌病17例(7.6%)。诊断为慢性肺心病的有25例(11.2%)。发现其他心脏病8例(3.6%)。所有患者均接受了药物治疗。心肌梗死患者未使用溶栓药物。死亡率为20.2%(n = 45),即高血压性心脏病12例,冠状动脉疾病8例,瓣膜性心脏病3例,慢性肺心病5例。17例患者的心脏病类型未明确。心力衰竭在老年人中很常见。预防措施取决于降低心血管危险因素,尤其是动脉高血压。