摘要：Figures See all figures Authors P.L. Massoure , N.C. Roche , G. Lamblin , F. Topin , C. Dehan , É. Kaiser , L. Fourcade Service de cardiologie, hôpital d’instruction des armées Laveran, boulevard A. Laveran, 13384 Marseille cedex 13, France, Service de médecine, hôpital Bouffard, Djibouti, Hôpital d’instruction des armées Laveran, boulevard A. Laveran, 13384 Marseille cedex 13, France, Bataillon des marins pompiers de Marseille, Marseille, France, Service de biologie clinique, hôpital Bouffard, Djibouti, Service de réanimation, hôpital Bouffard, Djibouti Key words: heart failure, coronary disease, high blood pressure, dilated cardiomyopathy, khat, Djibouti DOI : 10.1684/mst.2013.0188 Page(s) : 211-6 Published in: 2013 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). Conclusion. 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.
