Emergence of ischemic cardiomyopathy as the main cause of heart failure in urban Sudanese population

Abstract

Heart failure is a rapidly growing cardiovascular (CV) problem in Sudan due to affluence and lifestyle changes producing high rates of CV risk factors and consequent coronary heart disease in addition to the historical causes of hypertension and rheumatic heart disease. This study is intended to measure the prevalence of heart failure (HF) among hospital admissions and study the recent trends in etiology, clinical features and methods of treatment. Methods: All admissions at Sudan Heart Institute between January 2000 and June 2011 were studied. Patients went through detailed history taking and physical examination. Investigations included 12 lead ECG and chest X-ray, echocardiography and cardiac catheterization was also carried out where indicated. Results: A total of 12453 cases were collected and 1073 were verified by the authors and an independent cardiologist, constituting 8.6% of CV disease admissions. Female to male ratio was 1:1.6 and age 15 to 96 years (median 58 years). 74.6 % of all patients were urban dwellers. Left ventricular (LV) systolic dysfunction accounted for 71.6% and preserved systolic function 28.4%.  Ischemic aetiology accounted for 44.6% of cases, hypertension 24.8 %, RHD 14.4% and idiopathic 12.4%. Conclusion: Ischemic cardiomyopathy emerged as the main cause of HF among urban population probably due to changes in lifestyle. Treatment and prevention of these risk may reduce the prevalence of heart failure.