THE IBADAN ACUTE AND CHRONIC HEART FAILURE PROJECT: RATIONALE AND DESIGN.

Introduction: Until recently, little was known about the emerging problem of non-communicable forms of heart failure supplementing traditional pathways to the syndrome in sub-Saharan Africa due to infections and infestations. Contemporary studies have built on historical reports to demonstrate that the aetiology and indeed case profile of heart failure (i.e., more women and younger individuals affected in the prime of their lives) is different from that of high-income countries.

Objective: This study will assess the long-term outcomes, risk factors, clinical phenotypes, and genomics of heart failure in Ibadan, Nigeria, estimate the healthcare cost associated with heart failure and how it affects evidence-based care, and understand the cultural and social conceptions of heart failure in the city and, by extension, in Nigeria.

Methodology: Data from each subject shall be obtained using a uniform and standardized case report form. A detailed clinical documentation on cases of heart failure will be undertaken. The following data shall be obtained: study identification number, centre code, demographic data, date of diagnosis of HF, and pre-admission history (previous heart failurerelated admissions). Others include New York Heart Association functional class, symptoms, signs, self-reported cardiovascular risk factors, aetiology of heart failure, comorbidities, blood investigations, point-of-care biomarker, Chest X-ray, 12-lead ECG, echocardiography, medications, barriers to care, quality of life data, etc. Blood samples will be obtained during enrollment for analysis of biochemical biomarkers.

Results: The primary outcome of the study will be mortality by any cause. Secondary outcomes will include non-fatal major events (both resulting in and not resulting in admission).

Conclusion: The project will provide data on the contemporary aetiology, clinical profile management and outcomes of heart failure in Ibadan, which may be extrapolated to other parts of the country.