Subjective quality of life and emotional pain among subjects with heart failure in a West African Teaching Hospital

Objective: Heart failure (HF) is a common pathology worldwide. Associated emotional pain is an important risk factor of increased morbidity and secondary psychopathology.Methods: Subjects in stable state of HF attending the cardiology clinic of Lagos University Teaching Hospital (LUTH) were recruited into the study. World Health Organization Quality of Life-Bref (WHOQoL-Bref), Psychache Scale (PAS) instruments were administered on subjects that consented to the study.Results: One hundred and forty four (144) subjects of equal sex distribution were studied. The mean age was 31.7±10.2 years. The highest number of subjects, 57 (39.6%) rated their overall QoL as good; while 30 (20.8%) rated it as very poor. When the QoL score was dichotomized to good and poor, females subjects significantly scored lower with X2=5.69, p=0.017*.The mean score on PAS by the male subjects was 30.88±9.80; and for the females it was 29.90±9.95. For all the subjects combined, the overall mean score was 30.39±9.85, with range of 13-50. When the PAS scores were dichotomized, there was no significant gender difference. There were significant negative correlations between PAS scores and sociodemographic variables of age and educational levels; that is r=-0.212 with p=0.011*and r=-0.207 with p=0.013* respectively.Conclusion: High number of subjects in our study had emotional pain which is an important risk factor of suicide.Keywords: Quality of life, Heart failure, Emotional pain, Nigeri

Influence of systolic blood pressure on outcomes in Nigerians with peripartum cardiomyopathy

Background: The relationship between blood pressure (BP) trajectories and outcomes in patients with peripartum cardiomyopathy (PPCM) is not clear. Aim: The study aimed to assess the clinical features and outcomes (all-cause mortality and unrecovered left ventricular [LV] systolic function) of PPCM patients grouped according to their baseline systolic BP (SBP). Patients and Methods: PPCM patients presenting to 14 tertiary hospitals in Nigeria were consecutively recruited between June 2017 and March 2018 and then followed up till March 2019. SBP at first presentation was used to categorize the patients into seven groups: <90, 90-99, 100-109, 110-119, 120-129, 130-139, and ≥140 mmHg. Unrecovered LV systolic function was defined as echocardiographic LV ejection fraction (LVEF) below 55% at the last profiling. Results: Two hundred and twenty-seven patients were recruited and followed up for a median of 18 months. Of these, 4.0% had <90 mmHg, 16.3% had 90-99 mmHg, 24.7% had 100-109 mmHg, 24.7% had 110-119 mmHg, 18.5% had 120-129 mmHg, 7.5% had 130-139 mmHg, and 4.4% had ≥140 mmHg of SBP at presentation. The highest frequency of all-cause mortality was recorded among patients with SBP ≤90 mmHg (30.8%) followed by those with 90-99 mmHg (20.5%) (P = 0.076), while unrecovered LV systolic function did not differ significantly between the groups (P = 0.659). In a Cox proportional regression model for all-cause mortality, SBP <90 mmHg had a hazard ratio (HR) of 4.00 (95% confidence interval [CI] 1.49-10.78, P = 0.006), LVEF had an HR of 0.94 (95% CI 0.91-0.98, P = 0.003, B = 0.06%), and use of angiotensin-converting enzyme or angiotensin receptor and/or β-receptor blockers had an HR of 1.71 (95% CI 0.93-3.16, P = 0.085). However, SBP was not associated with LV function recovery. Conclusion: In our cohort of PPCM patients, one-fifth was hypotensive at presentation. SBP <90 mmHg at presentation was associated with a four-fold higher risk of all-cause mortality during a median follow-up of 18 months