Comparative Analysis of the Clinical Presentations, Cardiovascular & Laboratory Findings & Treatment of Heart Failure with Preserved & Reduced Ejection Fractions in Cameroon: A Multicenter Cross-Sectional Study

Abstract

Background: Contrarily to past concepts, heart failure with preserved ejection fraction (HFpEF) has become more prevalent than heart failure with reduced ejection fraction (HFrEF). Our objective was to study the clinical, cardiovascular and laboratory findings and therapeutic aspects of HFpEF, compared with those of HFrEF in Yaounde, Cameroon. Method: This was an analytical cross-sectional study carried-out at the Central Hospital, General Hospital and Military Hospital of Yaounde, from January to April 2018 (4 months). 201 patients aged at least 18 years old with an echocardiography confirmed diagnosis of heart failure had been enrolled. We excluded 12 patients because they had a congenital ventricular septal defect (2), chronic cor pulmonale (4), mitral stenosis (5), and pericarditis (1). Results: We found that 45.5% of our patients had HFpEF whereas 37.5% had HFrEF. Patients with HFpEF were older and had a significantly higher incidence of hypertension and obesity. HFrEF was significantly more associated with congestive symptoms than HFpEF. The S3 gallop was significantly more present in patients with HFrEF. Patients with HFpEF had significantly higher rate of atrial fibrillation. Furosemide, spironolactone and digoxin were significantly used more frequently in patients with HFrEF. Conclusion: HFpEF is the most frequent form of heart failure in the hospital setting in Yaoundé, Cameroon. Patients with HFpEF were significantly older and more affected by hypertension and obesity than those with HFrEF. Cardiac ultrasound is indispensable to differentiate between the two entities for better management.