An audit of Heart failure management among ambulatory adult patients at Queen Elizabeth Central Hospital (QECH), Malawi.

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Emmanuel S Mwabutwa, Steve Kateta, Louis Kinley, Tadala Ulemu, Patrick Goodson, Adamson S Muula, Johnstone Kumwenda
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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Abstract Image

对马拉维伊丽莎白女王中心医院(QECH)门诊成年患者心力衰竭管理的审计。
背景:关于马拉维心力衰竭患者的临床特征和使用指南指导药物治疗的数据有限。我们进行了一项研究,以评估马拉维伊丽莎白女王中心医院心力衰竭患者的特征和临床管理。方法:在一项横断面研究中,招募了在QECH成人胸科门诊随访的诊断为心力衰竭的患者,以确定他们的特征和接受的治疗。超声心动图和心电图检查异常。结果:共招募79例患者,其中62%(79例中有49例)为女性。中位年龄为60岁(IQR 40.5-70.5)。大多数患者为高血压,并伴有NYHA(纽约心脏协会)I级和II级症状。55%(36 / 65)患者发现左室收缩功能障碍,68%(39 / 65)患者有左室重构特征。大多数患者至少服用一种神经激素药物,77%(61 / 79)服用ACEI(血管紧张素转换酶抑制剂),52%(42 / 79)服用受体阻滞剂,34%(27 / 79)服用醛固酮拮抗剂。ACEI、受体阻滞剂和醛固酮拮抗剂分别达到推荐剂量的14%(61人中9人)、24%(42人中10人)和22%(27人中6人)。结论:高血压是心衰患者最常见的合并症,患者多为女性,伴有NYHA I级或II级症状。大多数患者有左室重构改变,并至少服用一种神经激素拮抗剂,但大多数患者仍未得到最佳治疗。
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来源期刊
Malawi Medical Journal
Malawi Medical Journal Medicine-General Medicine
CiteScore
1.50
自引率
0.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region. Topics covered in the journal include, but are not limited to: - Communicable diseases (HIV and AIDS, Malaria, TB, etc.) - Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.) - Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.) - Mental health - Environmental health - Nutrition - Health systems and health policy (Leadership, ethics, and governance) - Community systems strengthening research - Injury, trauma, and surgical disorders
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