093 Look on the hold of heart failure management in Morocco, about 294 patient

Objectivethe objective was to identify the epidemiological, clinical and the outcome of heart failure (HF) in a Moroccan hospital.MethodA retrospective study using a serie of 294 patients hospitalized in our service from January 2005 to December 2008.ResultsThe HF occupies 14% of hospitalizations. The mean length of stay was 14±3.1 days. The mean age was 58±11.5 years. Men were mostly represented with a ratio H / F=3.5. The main cardiovascular risk factor was smoking (55%) followed by hypertension (40%) and diabetes (35%). Dyspnea was the main symptom reported in 91% of the cases. The clinical presentation was that of left (65%), right (22%) and global(23%) HF. Among electric signs, we found Atrial fibrillation (30%), a Q-wave (58%) and left ventricular hypertrophy (28%). the chest x-ray showed a cardiomegaly (89%) and signs of pulmonary overload (86%). Biology showed electrolyte abnormalities in half of the cases, renal failure (35%) and anemia (28%). In echocardiography, the mean left ventricular ejection fraction (LVEF) was 34.5±5.4%. LVEF was > 45% for 26% of patients. 134 patients underwent a coronary angiography which objectified coronary damage in 84% of the cases. The main causes were ischemic heart disease (42%), valvular heart disease(24%) and hypertension (13%). most used drugs were angiotensin converting enzym inhibitors and diuretics. 21% of patients underwent a mitral valve replacement with mechanical prosthesis. Among patients with coronary artery disease, 33% were revascularized by coronary bypass (21%) and coronary angioplasty (12%). Cardiac resynchronization was performed for 19 patients using implantable automatic defibrillator for 3 of them.Hospital mortality was 10%.ConclusionThe main features of this population is the relatively young age, male predominance, ischemic heart disease as a leading cause and low rate of HF with preserved systolic function