Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria

<p>Abstract</p> <p>Background</p> <p>The study aimed to determine the frequency and characteristics of heart failure with normal EF in a native African population with heart failure.</p> <p>Methods</p> <p>It was a hospital cohort study. Subjects were 177 consecutive individuals with heart failure and ninety apparently normal control subjects. All the subjects underwent transthoracic echocardiography. The group with heart failure was further subdivided into heart failure with normal EF (EF ≥ 50) (HFNEF) and heart failure with low EF(EF <50)(HFLEF).</p> <p>Results</p> <p>The subjects with heart failure have a mean age of 52.3 ± 16.64 years vs 52.1 ± 11.84 years in the control subjects; p = 0.914. Other baseline characteristics except blood pressure parameters and height were comparable between the group with heart failure and the control subjects. The frequency of HFNEF was 39.5%. Compared with the HFLEF group, the HFNEF group have a smaller left ventricular diameter (in diastole and systole): (5.2 ± 1.22 cm vs 6.2 ± 1.39 cm; p < 0.0001 and 3.6 ± 1.24 cm vs 5.4 ± 1.35 cm;p < 0.0001) respectively, a higher relative wall thickness and deceleration time of the early mitral inflow velocity: (0.4 ± 0.12 vs 0.3 ± 0.14 p < 0.0001 and 149.6 ± 72.35 vs 110.9 ± 63.40 p = 0.001) respectively.</p> <p>The two groups with heart failure differed significantly from the control subjects in virtually all echocardiographic measurements except aortic root diameter, LV posterior wall thickness(HFLEF), and late mitral inflow velocity(HFNEF). HFNEF accounted for 70(39.5%) of cases of heart failure in this study.</p> <p>Hypertension is the underlying cardiovascular disease in 134(75.7%) of the combined heart failure population, 58 (82.9%) of the subjects with HFNEF group and 76(71%) of the HFLEF group. Females accounted for 44 (62.9%) of the subjects with HFNEF against 42(39.3%) in the HFLEF group (p = 0.002).</p> <p>Conclusion</p> <p>The frequency of heart failure with normal EF in this native African cohort with heart failure is comparable with the frequency in other populations. These groups of patients are more likely female, hypertensive with concentric pattern of left ventricular hypertrophy.</p

Clinical Characteristics of Urticaria among Nigerians at a Dermatology Clinic.

Background: Urticaria is a vascular reaction of the upper dermis marked by transient appearance of wheals and severe itching. Angioedema involves the deeper dermis and subcutaneous tissues. Urticaria affects up to 20% of the population. It is categorized as acute if symptoms occur and resolve within 6 weeks. Diagnosis is usually clinical with a thorough history taken to reveal possible triggers. Investigations are carried out to identify any systemic disease.Objective: This study was carried out to document the predisposing factors and clinical presentations of patients with urticaria in our environment.Methods: Data was obtained from clinic records of all patients seen from January 2007 to December 2009 and urticaria protocol filled routinely at the dermatology clinic of the Lagos University Teaching Hospital.Results: Ninety six patients (1.79%) out of the 5360 patients seen during the 2 year period were diagnosed as having urticaria. There were 37 (45.1%) males and 45 (54.9%) females with a ratio of 1:1.2. Majority of patients 59 (71.95%) had chronic urticaria. Various trigger factors were demonstrated in 62 patients (74.4%) while none were noted in 21 patients (25.6%). The most common triggers were drugs and food. Sulfa containing drugs and NSAIDs were commonly implicated drugs. Physical factors were not commonly implicated.Conclusion: Although triggers of urticaria may be myriad, attempts at identifying triggers and causes of urticaria (with subsequent avoidance) through the patient's history are still the most important management approach. Further studies are needed to clarify the known triggers and other risk factors peculiar to our environment.Keywords: Urticaria, Angioedema, Nigeri