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当代尼日利亚南部急性心力衰竭的特征:来自阿贝奥库塔心力衰竭临床登记处的数据。

Contemporary profile of acute heart failure in Southern Nigeria: data from the Abeokuta Heart Failure Clinical Registry.

机构信息

Division of Cardiology, Department of Medicine, University College Hospital, Ibadan, Nigeria; Soweto Cardiovascular Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.

出版信息

JACC Heart Fail. 2014 Jun;2(3):250-9. doi: 10.1016/j.jchf.2013.12.005. Epub 2014 Apr 30.

Abstract

OBJECTIVES

The aim of this study was to determine the contemporary profile, clinical characteristics, and intrahospital outcomes of acute heart failure (AHF) in an African urban community.

BACKGROUND

There are limited data on the current burden and characteristics of AHF in Nigerian Africans.

METHODS

Comprehensive and detailed clinical and sociodemographic data were prospectively collected from 452 consecutive patients presenting with AHF to the only tertiary hospital in Abeokuta, Nigeria (population about 1 million) over a 2-year period.

RESULTS

The mean age was 56.6 ± 15.3 years (57.3 ± 13.4 years for men, 55.7 ± 17.1 years for women), and 204 patients (45.1%) were women. Overall, 415 subjects (91.8%) presented with de novo AHF. The most common risk factor for heart failure was hypertension (pre-existing in 64.3% of patients). Type 2 diabetes mellitus was present in 41 patients (10.0%). Hypertensive heart failure was the most common etiological cause of heart failure, responsible for 78.5% of cases. Dilated cardiomyopathy (7.5%), cor pulmonale (4.4%), pericardial disease (3.3%), rheumatic heart disease (2.4%), and ischemic heart disease were less common (0.4%) causes. The majority of subjects (71.2%) presented with left ventricular dysfunction (mean left ventricular ejection fraction 43.9 ± 9.0%), with valvular dysfunction and abnormal left ventricular geometry frequently documented. The mean duration of hospital stay was 11.4 ± 9.1 days, and intrahospital mortality was 3.8%.

CONCLUSIONS

Compared with those in high-income countries, patients presenting with AHF in Abeokuta, Nigeria, are relatively younger and still of working age. It is also more common in men and associated with severe symptoms because of late presentation. Intrahospital mortality is similar to that in other parts of the world.

摘要

目的

本研究旨在确定非洲城市社区中急性心力衰竭(AHF)的当代特征、临床特征和院内结局。

背景

关于尼日利亚非洲人中当前 AHF 的负担和特征,数据有限。

方法

在 2 年期间,从尼日利亚阿贝奥库塔唯一的三级医院连续收治的 452 例 AHF 患者中前瞻性收集全面和详细的临床及社会人口学数据。

结果

平均年龄为 56.6±15.3 岁(男性为 57.3±13.4 岁,女性为 55.7±17.1 岁),204 例(45.1%)为女性。总体而言,415 例(91.8%)为新发 AHF。心力衰竭的最常见危险因素是高血压(64.3%的患者存在)。2 型糖尿病患者有 41 例(10.0%)。高血压性心力衰竭是心力衰竭最常见的病因,占 78.5%的病例。扩张型心肌病(7.5%)、肺心病(4.4%)、心包疾病(3.3%)、风湿性心脏病(2.4%)和缺血性心脏病(0.4%)较少见。大多数患者(71.2%)存在左心室功能障碍(平均左心室射血分数为 43.9±9.0%),经常记录到瓣膜功能障碍和左心室几何结构异常。平均住院时间为 11.4±9.1 天,院内死亡率为 3.8%。

结论

与高收入国家相比,尼日利亚阿贝奥库塔出现 AHF 的患者相对较年轻,仍处于工作年龄。男性更常见,由于就诊较晚,症状更严重。院内死亡率与世界其他地区相似。

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