Department of Medicine, School of Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.
Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Malawi Med J. 2022 Sep;34(3):170-175. doi: 10.4314/mmj.v34i3.5.
There are limited data on the clinical characteristics and use of guideline directed medical therapy among patients with heart failure in Malawi. We conducted a study to assess patient characteristics and clinical management given to heart failure patients at Queen Elizabeth Central hospital in Malawi.
In a cross sectional study, patients with a diagnosis of heart failure who were followed up in the adult chest clinic at QECH were recruited to ascertain their characteristics and the therapy they were receiving. Echocardiograms and electrocardiograms were performed to identify abnormalities.
A total of 79 patients were recruited and 62% (49 out of 79) were female. The median age was 60 years (IQR 40.5-70.5). Most patients were hypertensive with NYHA (New York Heart Association) class I and II symptoms. Left ventricular(LV) systolic dysfunction was found in 55% (36 out of 65), with 68% (39 out of 65) having features of left ventricular remodeling. Most patients were on at least a single neurohormonal drug with 77% (61 out of 79) on ACEI (angiotensin converting enzyme inhibitor), 52% (42 out of 79) on a beta blocker and 34%(27 out of 79) on aldosterone antagonists. The recommended doses of medications were achieved in 14% (9 out 61), 24% (10 out 42), 22% (6 out of 27) on ACEI, beta blockers and aldosterone antagonists respectively.
Hypertension is the commonest comorbidity in patients with heart failure, who are mostly females with NYHA class I or II symptoms. Most had LV remodeling changes and are on at least one neurohormonal antagonist but most remain sub optimally treated.
马拉维心力衰竭患者的临床特征和指南导向的医学治疗应用数据有限。我们进行了一项研究，以评估马拉维伊丽莎白女王中央医院心力衰竭患者的患者特征和临床管理。
在一项横断面研究中，我们招募了在 QECH 成人胸部诊所接受随访的心力衰竭诊断患者，以确定他们的特征和接受的治疗方法。进行了超声心动图和心电图检查以识别异常。
共招募了 79 名患者，其中 62%（49 名/79 名）为女性。中位年龄为 60 岁（IQR 40.5-70.5）。大多数患者患有高血压，NYHA（纽约心脏协会）分级 I 和 II 症状。55%（36 名/65 名）发现左心室（LV）收缩功能障碍，68%（39 名/65 名）有左心室重构特征。大多数患者至少使用了一种神经激素药物，77%（61 名/79 名）使用 ACEI（血管紧张素转换酶抑制剂），52%（42 名/79 名）使用β受体阻滞剂，34%（27 名/79 名）使用醛固酮拮抗剂。药物的推荐剂量在 14%（9 名/61 名）、24%（10 名/42 名）和 22%（6 名/27 名）的 ACEI、β受体阻滞剂和醛固酮拮抗剂中得到了实现。
高血压是心力衰竭患者最常见的合并症，这些患者大多为女性，NYHA 分级 I 或 II 症状。大多数患者有 LV 重塑改变，至少使用一种神经激素拮抗剂，但大多数患者仍未得到最佳治疗。
