The Functional Class and Electrocardiographic Abnormalities in Heart Failure Patients in Southern Nigeria: A Retrospective Observational Study

Authors

  • Norbert Ndubuisi Unamba DEPARTMENT OF INTERNAL MEDICINE, UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL
  • Julius Uguru Edeogu DEPARTMENT OF INTERNAL MEDICINE, UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL
  • Miriam Ijeoma Orji MADONNA UNIVERSITY TEACHING HOSPITAL, ELELE

DOI:

https://doi.org/10.60787/tnhj.v20i2.475

Keywords:

Heart failure, functional status, electrocardiographic abnormality

Abstract

Background: Impairment of the functional status of heart failure (HF) patients is invariably a cause of concern, as it translates to a reduced quality of life and the loss of work man-hours occasioned by frequent hospitalizations. These periods of hospitalizations are quite frequently related to the occurrence of cardiac arrhythmias.

Objectives: To determine the prevalent electrocardiographic abnormalities and functional status of the heart failure patients, and to investigate the relationship between the presence of cardiac arrhythmias and functional class.

Methods: Three hundred and thirty-three (333) heart failure patients were studied. Anthropometric and biochemical parameters were collected, and the functional class assessed by the New York Heart Association (NYHA) functional classification system. Electrocardiography (ECG) was performed on each patient to identify the presence of an arrhythmia.  

Results: Most of the HF patients were within the fifth and sixth decades of life. Among the heart failure patients, most of the participants were in the NYHA stage II functional class. We also found that 97.4% of the HF patients had some form of ECG abnormality at hospitalization. The commonest ECG abnormality was left atrial enlargement, while the commonest sustained arrhythmia was atrial fibrillation. Sinus tachycardia was however solely able to predict a progression to an advanced NYHA class.

Conclusions: Patients in HF were mostly in the NYHA II class, and were relatively young. A normal ECG finding is quite rare in HF. Sinus tachycardia in the context of HF may portend a more debilitating functional status.

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Author Biographies

Norbert Ndubuisi Unamba, DEPARTMENT OF INTERNAL MEDICINE, UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL

cardiology specialist

Julius Uguru Edeogu, DEPARTMENT OF INTERNAL MEDICINE, UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL

DEPARTMENT OF INTERNAL MEDICINE, SENIOR REGISTRAR/CARDIOLOGIST

Miriam Ijeoma Orji, MADONNA UNIVERSITY TEACHING HOSPITAL, ELELE

DEPARTMENT OF INTERNAL MEDICINE, REGISTRAR

References

World Health Organization. Cardiovascular diseases (CVDs). 2015.

http://www.who.int/mediacentre/factsheets/fs317/e./. Accessed 4 June 2020.

Joseph P, Leong D, Martin M, et.al. Reducing the burden of cardiovascular disease. Clinical Research 2017; 121(6): 677-694.

Gary SF, Tang WH, Walsh RA. Pathophysiology of Heart Failure. In: Valentin Fuster RA, Harrington RA, editors. Hurst's The Heart. 13th ed. 2011. p. 719-38.

Savarese G, Lund LH. Global public health burden of heart failure. Card Fail Rev. 2017; 3(1): 7-11.

Benjamin EJ, Muntner P, Alonso A, et.al. Heart disease and stroke statistics – 2019 update: A report from the American Heart Association. Circulation 2019; 139: e56-e528.

Ziaeian B, Fonarow GC. The prevention of hospital readmissions in heart failure. Prog Cardiovasc Dis. 2016; 58(4): 379–385.

Dharmarajan K, Rich MW. Epidemiology, pathophysiology, and prognosis of heart failure in older adults. Heart Fail. Clin. 2017; 3(4): 381-387.

Ogah OS, Stewart S. Falase AO, et.al. Contemporary profile of acute heart failure in Southern Nigeria: Data from the Abeokuta Heart Failure Clinical Registry. JACC Heart Fail. 2014; 2(3): 250-259.

Opadijo OG, Omotosho AB. Diagnosis of congestive heart failure (CHF): any role for electrocardiogram? Sahel Med J 2000; 3(2): 74-77.

Alikor CA, Nwafor EC. Availability and utilization of electrocardiogram as cardiac diagnostic tool in private hospitals in Port Harcourt. Nig J Cardiol 2018; 15:94-97.

Castel MA, Magnani S, Mont L, et al. Survival in New York Heart Association class IV heart failure patients treated with cardiac resynchronization therapy compared with patients on optimal pharmacological treatment. Europace. 2010; 12: 1136-1140.

Criteria Committee of the New York Heart Association. Diseases of the heart and blood vessels. In: Harvey RM, et al, eds. Nomenclature and criteria for Diagnosis of Diseases of the Heart and Great Vessels. 7th ed. Boston, MA: Little, Brown & Co.; 1973: 286.

Ahmed A, Aronow WS, Fleg JL.Higher New York Heart Association classes and increased mortality and hospitalization in heart failure patients with preserved left ventricular function. Am Heart J 2006; 151(2): 444-450.

Pocock J, Wang D, Pfeffer MA, et al. Predictors of mortality and morbidity in patients with chronic heart failure. Eur Heart J. 2006; 27: 65-75.

Mckee PA, Castelli WP, McNamara PM, et al. The natural history of congestive heart failure: the Framingham study. N Engl J Med. 1971; 285: 1441-1446.

Hancock EW, Deal BJ, Mirvis DM, et.al. AHA/ACC/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Electrocardiogram changes associated with cardiac chamber hypertrophy. Circulation. 2009; 119: e251-e261.

Karaye KM, Sani MU. Electrocardiographic abnormalities in patients with heart failure. Cardiovasc J Afr 2008; 19: 22-25.

Owusu IK, Adu-Boakye Y, Appiah LT. Electrocardiographic abnormalities in heart failure patients at a teaching hospital in Kumasi, Ghana. J Cardiovasc Dis Diagn 2014,2:2. DOI: 10.4172/2329-9517, 1000142.

Wang Q, Wang J, Wang P, et al. Glycemic control is associated with atrial structural remodelling in patients with type 2 diabetes. BMC Cardiovascular Disorders 2019; 278: 1-9. https://doi.org/10.1186/s12872-019-1249-2

Moller JE, Hillis GS, Oh JK et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation 2003; 107: 2207-2212.

Shin H-Y, Jeong I-H, Kang C-K, et al. Relation between left atrial enlargement and stroke subtypes in acute ischemic stroke patients. J Cerebrovasc Endovasc Neurosurg 2013; 15(3): 131-136.

Akpa MR, Iheji O. Short-term rehospitalisation or death and determinants after admission for acute heart failure in a cohort of African patients in Port Harcourt, southern Nigeria. Cardiovasc J Afr 2018; 29: 46-50.

Ojji DB, Alfa J, Ajayi SO, et al. Pattern of heart failure in Abuja, Nigeria: an echocardiographic study. Cardiovasc J Afr 2009; 20: 349-352.

Khan S, Ali SA. Exploratory study into awareness of heart disease and health care seeking behaviour among Emirati women (UAE) – Cross-sectional descriptive study. BMC Women’s Health 2017; 17:88.

Raphael C, Briscoe C, Davies J, et al. Limitations of the New York Heart Association functional classification system and self-reported walking distances in chronic heart failure. Heart 2007; 93(4): 476-482.

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Published

2020-10-08

How to Cite

Unamba, N. N., Edeogu, J. U., & Orji, M. I. (2020). The Functional Class and Electrocardiographic Abnormalities in Heart Failure Patients in Southern Nigeria: A Retrospective Observational Study. The Nigerian Health Journal, 20(2), 44–53. https://doi.org/10.60787/tnhj.v20i2.475
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