The role of echocardiography in the management of patients with congestive heart failure. "Tanzanian experience"

OBJECTIVES: To evaluate the usefulness of echocardiography in managing patients with congestive heart failure (CHF) and identify risks of mortality and heart failure re-admissions during follow up. DESIGN: A descriptive prospective hospital based study. SETTING: Muhimbili National Hospital and Hindul Mandal Hospital in Dares Salaam, Tanzania. SUBJECTS: 360 patients (198 male and 162 female) admitted due to congestive heart failure had echocardiography done. MAIN OUTCOME MEASURES: Identifying and characterizing echocardiographic features specific for evaluating patients with congestive heart failure. The patients were followed up for at leas one year. RESULTS: 122 patients had normal left ventricular ejection fraction (LVEF) and 238 patients had reduced left ventricular fraction. Patients with normal LVEF tended to be older and female and were more likely to have a history of hypertension whereas patients with reduced LVEF had a longer history of heart failure due to dilated cardiomyopathy or valvular heart disease. Seventy nine patients (21.9%) died. Patients with depressed ejection fraction had a higher death rate during follow up as compared with preserved ejection fraction. CONCLUSION: We had demonstrated that echocardiography is a useful non-invasive tool for assessing patients with CHF due to systolic or diastolic dysfunction.