In a Ghanaian referral center, heart failure affects a relatively young population (mean age 42.3 years) and is primarily driven by hypertension, rheumatic heart disease, and cardiomyopathy, contrasting with ischemic-predominant etiologies in Western populations.
572 consecutive patients with heart failure referred to the National Cardiothoracic Centre, Accra, Ghana, over a 4-year period were evaluated for the aetiology of heart failure using two-dimensional Doppler echocardiography with colour flow. The mean age of the subjects with heart failure was 42.3 +/- 0.9 years. The male to female ratio was 1.2:1.0. Combined heart failure was seen in 50.5% of subjects. Peak incidence of heart failure occurred in the 5th decade. The main causes of heart failure were hypertension (21.3%; n = 122), rheumatic heart disease (20.1%; n = 115) and cardiomyopathy (16.8%; n = 96). Congenital heart disease and coronary artery disease accounted for 9.8 and 10% of cases, respectively. The commonest rheumatic valvular lesion was mitral regurgitation (78%). Dilated cardiomyopathy was the commonest form of idiopathic cardiomyopathy (67.7%; n = 65). Endomyocardial fibrosis and hypertrophic cardiomyopathy accounted for 22.9% (n = 22) and 9.4% (n = 9), respectively, of cardiomyopathies.
Amoah et al. (Sat,) studied this question.