title: [Heart failure patterns in Djibouti: epidemiologic transition].
abstract: BACKGROUND
  The features of heart failure (HF) in Djibouti have not been well described. We sought to document the current patterns of HF here.
  
  
  METHODS
  We prospectively included Djiboutian adults hospitalized for HF in the French Military Hospital (Djibouti) from August 2008 through December 2010.
  
  
  RESULTS
  Of 1688 adults hospitalized in the medical department, 45 (2.7%) had symptomatic HF: 38 (84%) men, mean age 55.8 years (range 27-75). Twenty-five (56%) patients were initially hospitalized for acute pulmonary edema. The underlying diseases included coronary artery disease (CAD) (62%), hypertensive heart disease (18%), rheumatic valvular disease (13%), and primary dilated cardiomyopathy (7%). Their cardiovascular risk factors included tobacco use (53%), hypertension (69%), diabetes (47%), and hypercholesterolemia (51%). Patients in the CAD group were older, and had diabetes more often (p<0.01). All khat chewers (53%) were males and smokers. Mean left ventricular ejection fraction (LVEF) was 39 ± 14%. During follow-up (14.4 ± 9 months), 8 (18%) patients died, 9 (20%) were again hospitalized for HF, and 3 (7%) had ischemic strokes. One month after discharge, the New York Heart Association (NYHA) class was II for 40%, III for 44%, and IV for 16%. Higher NYHA classes and dilated cardiomyopathy were both associated with poorer outcomes (p<0.03).
  
  
  CONCLUSIONS
  In hospitalized Djiboutians, most HF patterns are similar to those in industrialized countries. CAD is more prevalent than previously reported in African patients with HF.
authors.affiliation: Service de cardiologie, hôpital d'instruction des armées Laveran, boulevard A. Laveran, 13384 Marseille cedex 13, France. plmassoure@aol.com
authors.forename: P L
authors.initials: PL
authors.lastname: Massoure
authors.forename: N C
authors.initials: NC
authors.lastname: Roche
authors.forename: G
authors.initials: G
authors.lastname: Lamblin
authors.forename: F
authors.initials: F
authors.lastname: Topin
authors.forename: C
authors.initials: C
authors.lastname: Dehan
authors.forename: E
authors.initials: E
authors.lastname: Kaiser
authors.forename: L
authors.initials: L
authors.lastname: Fourcade
mesh_terms: D000328:Adult; D000368:Aged; D015730:Djibouti; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Djibouti; coronary disease; dilated cardiomyopathy; heart failure; high blood pressure; khat