title: Clinical and echocardiographic characteristics and outcomes in congestive heart failure at the Hospital of The State University of Haiti.
abstract: This study aimed to evaluate the clinical and epidemiologic profile of congestive heart failure at the principal free-care hospital in Haiti. Cardiovascular disease represents the most prevalent cause of admissions to the medical service of the University Hospital of the State of Haiti. No previous study has examined the demographics of congestive heart failure in urban Haiti.
  
  
  
  Two hundred forty-seven patients presented to the inpatient service between May 2011 and May 2013. Evaluation included history and physical, CBC, renal/metabolic profile, serum glucose, anti-HIV antibody, ECG, chest radiograph and echocardiogram. Treatment included angiotensin converting enzyme inhibitors, furosemide and spironolactone, carvedilol, digoxin and anticoagulation.
  
  
  
  Women (62.4%) outnumbered men; patients were relatively young (mean age 50.1) and from the lowest socio-economic levels of the population. Nearly all (98.8%) presented with NYHA III-IV status, with correspondingly high mortality (23.3%). Echocardiography showed 73% dilated cardiomyopathy; 83% showed moderate to severe LV systolic dysfunction (mean EF 36.5 +/- 15%) and 17% preserved LV systolic function. The three principal etiologies were dilated cardiomyopathy (29%) hypertensive cardiomyopathy (27%) and peripartum cardiomyopathy (20%). Ischemic cardiomyopathy was rare (3.4%). At 27 months follow-up, 76.7% of the patients were alive and well. Among those who died, mean survival time was 113 days. Readmission carried a poor prognosis.
  
  
  
  This congestive heart failure study from Haiti shows an unusually high proportion of young women, primarily due to peripartum cardiomyopathy. Ischemic cardiomyopathy is rare, as in Africa. Further study is warranted to address the particular problem of the high frequency of peripartum cardiomyopathy in this population.
authors: Cardiology Unit, Department of Medicine, Hospital of the University of the State of Haiti, Port-au-Prince, Haiti; Faculty of Medicine and Pharmacy of the University of the State of Haiti, Port-au-Prince, Haiti.
authors: Rodolphe
authors: R
authors: Malebranche
authors: Cardiology Unit, Department of Medicine, Hospital of the University of the State of Haiti, Port-au-Prince, Haiti.
authors: Christian
authors: C
authors: Tabou Moyo
authors: Cardiology Unit, Department of Medicine, Hospital of the University of the State of Haiti, Port-au-Prince, Haiti.
authors: Paul-Henry
authors: PH
authors: Morisset
authors: University of Notre-Dame of Haiti, Port-au-Prince, Haiti.
authors: Nernst-Atwood
authors: NA
authors: Raphael
authors: Division of Cardiology, Mount Sinai - Beth Israel Hospital, New York, NY. Electronic address: wilentz@gmail.com.
authors: James Robert
authors: JR
authors: Wilentz
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D000077261:Carvedilol; D015331:Cohort Studies; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006205:Haiti; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006760:Hospitalization; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D011412:Propanolamines / Q000627:therapeutic use; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D017678:Sex Distribution; D013148:Spironolactone / Q000627:therapeutic use; D013318:Stroke Volume; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D002227:Carbazoles; D002316:Cardiotonic Agents; D004232:Diuretics; D011412:Propanolamines; D000077261:Carvedilol; D013148:Spironolactone; D004077:Digoxin; D005665:Furosemide