[Acute heart failure with altered ejection fraction : Electrocardiographic signs with mortality at the Abidjan cardiology institute]. / Insuffisance cardiaque aiguë à fraction d'éjection altérée : signes électrocardiographiques associés à la mortalité à l'institut de cardiologie d'Abidjan.
Ann Cardiol Angeiol (Paris)
; 73(1): 101628, 2024 Feb.
Article
em Fr
| MEDLINE
| ID: mdl-37984237
ABSTRACT
INTRODUCTION:
Heart failure with impaired ejection fraction (HFIEF) represents the end-stage of most cardiac diseases, and is responsible for a high mortality rate. In order to identify patients at risk, numerous clinical and paraclinical prognostic factors have been proposed. The electrocardiogram (ECG), easy to perform and inexpensive, retains a powerful role in the prognostic evaluation of heart failure patients. The aim was to evaluate ECG signs associated with mortality in a retrospective cohort of patients with ICFEA.METHODOLOGY:
The study was observational and analytical based on retrospective data collected from patients benefiting from a primary hospitalization for ICFEA at the Abidjan Heart Institute from January 2018 to July 2020.RESULTS:
Of the 370 patients included, 197 had died by August 1, 2020, representing an overall mortality of 53%. Mortality progressed gradually up to one year, then remained unchanged up to 30 months. In multivariate Cox regression including ECG variables only, the presence of intra-ventricular conduction disorders (OR 1.80; 95% CI [1.01-3.25]), microvoltage (OR 1.82; 95% CI [1.05-16]), and pathological Q waves (OR 1.70; 95% CI [1.02-2.83]), were significantly associated with overall mortality. When ECG variables and clinical, paraclinical and therapeutic demographic variables were included, only the presence of pathological Q waves (OR1.74; 95% CI [1.01-3.01]) persisted as a risk factor for mortality. Hypertension and treatment of heart failure, in particular ACEI/ARII, beta-blockers and ARM, were protective factors. The presence of Q waves was associated with a significant reduction in survival, based on curves obtained using the Kaplan-Meier model.CONCLUSION:
ICFEA is responsible for high mortality, mainly in the year following the 1st hospitalization for cardiac decompensation. The presence of pathological Q waves is the only electrocardiographic sign that remains statistically associated with a poor prognosis, after adjustment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Cardiologia
/
Insuficiência Cardíaca
Limite:
Humans
País/Região como assunto:
Africa
Idioma:
Fr
Revista:
Ann Cardiol Angeiol (Paris)
Ano de publicação:
2024
Tipo de documento:
Article