Key result
Systolic heart failure was associated with more frequent hospitalizations but a similar mortality rate compared to diastolic heart failure (17.6% vs. 11.3%; P=0.3).
Cohort (n=155)
No
Absolute Event Rate: 17.6% vs 11.3%
p-value: p=0.3
In an Egyptian cohort, diastolic heart failure accounts for about one-third of CHF cases and is associated with similar mortality but fewer hospitalizations compared to systolic heart failure.
Warrants no change in heart failure subtype management; leaves open drivers of excess hospitalizations in systolic disease.
BACKGROUND: All factors predisposing for congestive heart failure (CHF), such as coronary artery disease (CAD), hypertension and diabetes are increasing in prevalence in Egypt. Despite this, no data about CHF in our country are available. AIMS: To study the relative contribution of systolic vs. diastolic heart failure in Egyptians and the prevalence of risk factors in this population, as well as their prognosis. METHODS: This was a retrospective study of patients with a diagnosis of CHF over a 3.5-year period in a general cardiology clinic. Demographic, ECG and echocardiographic data for left ventricular systolic and diastolic function were collected. The differential effect of systolic versus diastolic CHF was analyzed regarding hospitalization and mortality. RESULTS: After exclusion of valvular diseases, we found 155 patients diagnosed with heart failure, 102 patients (66%) had systolic heart failure, and 53 (34%) had diastolic heart failure. Mean age was 60+/-10 and 63+/-11 years, respectively (P=0.13). Systolic CHF patients had significantly more CAD, while those with diastolic failure were mostly hypertensives (P<0.01) for both. There was no significant difference in the incidence of diabetes mellitus, cerebrovascular accidents or atrial fibrillation between the two groups. Patients with systolic failure required more hospitalization, P<0.05, and had a mortality rate of 17.6% vs. 11.3% for patients with diastolic heart failure (P=0.3). CONCLUSION: Diastolic heart failure is present in one-third of cases of CHF in Egyptians. Hypertension is very common in this group. These patients require less hospitalization but have a similar mortality rate.
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Bassem Ibrahim (2003) conducted a cohort in Congestive heart failure (n=155). Systolic heart failure vs. Diastolic heart failure was evaluated on Mortality (p=0.3). Systolic heart failure was associated with more frequent hospitalizations but a similar mortality rate compared to diastolic heart failure (17.6% vs. 11.3%; P=0.3).
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