BACKGROUND: Therapeutic approach of heart failure (HF) has evolved considerably to improve the prognosis that remains dark .The purpose of our study was to analyze the evolution of the ejection fraction (FE) heart failure and to identify predictors factors of mortality and re-hospitalization. METHODS: Our study is prospective including 200 consecutive cases of HF patients with EF ≤ 40% during the period from 2012 to 2015. Clinical, para-clinical, evolultive data were collected at admission and atb3 months. The main study criteria is the occurrence of a major event: cardiac death and or rehospitalization for HF. RESULTS: The mean age of our patients was 56 + - 12. with male predominance. Ischemic etiology was the main causes (45%). All patients had pharmacological treatment of HF , 88% patients were put on ACE inhibitors, 91% on beta-blockers(BB) and 49% on spiranolactone, loop diuretics were prescribed in 95% of cases. The optimal dose was reached for the main molecules (IEC, BB and spiranolactone) only in respectively 12%, 15% and 10% patients . Myocardial revascularization was performed in 36 patients (40%). Among the 45 patients with valvulopathy surgical treatment was indicatetd for _ patients(17%). A cardiac resynchronization theray with defibrillator was implanted in 30 patients, an automatic defibrillator without resynchronization was implanted in 15 patients (7.5%). No patients from our study had a cardiac transplantation or rehabilitation.Hospital and 3-months mortality was 5% and 17.5% respectively, .Hospitalization rate was 36% and was highest in the first three months after discharge. The multi-variable analysis revealed four independent mortality factors: diabetes, EF , ischemic etiology, and TAPSE. Age, stage IV dyspnea, atrial fibrillation , and SLG <-12.were independent predictors factors of rehospitalization. CONCLUSION: is a serious disease associated with poor prognosis despite advanced therapeutics.
BACKGROUND: Therapeutic approach of heart failure (HF) has evolved considerably to improve the prognosis that remains dark .The purpose of our study was to analyze the evolution of the ejection fraction (FE) heart failure and to identify predictors factors of mortality and re-hospitalization. METHODS: Our study is prospective including 200 consecutive cases of HF patients with EF ≤ 40% during the period from 2012 to 2015. Clinical, para-clinical, evolultive data were collected at admission and atb3 months. The main study criteria is the occurrence of a major event: cardiac death and or rehospitalization for HF. RESULTS: The mean age of our patients was 56 + - 12. with male predominance. Ischemic etiology was the main causes (45%). All patients had pharmacological treatment of HF , 88% patients were put on ACE inhibitors, 91% on beta-blockers(BB) and 49% on spiranolactone, loop diuretics were prescribed in 95% of cases. The optimal dose was reached for the main molecules (IEC, BB and spiranolactone) only in respectively 12%, 15% and 10% patients . Myocardial revascularization was performed in 36 patients (40%). Among the 45 patients with valvulopathy surgical treatment was indicatetd for _ patients(17%). A cardiac resynchronization theray with defibrillator was implanted in 30 patients, an automatic defibrillator without resynchronization was implanted in 15 patients (7.5%). No patients from our study had a cardiac transplantation or rehabilitation.Hospital and 3-months mortality was 5% and 17.5% respectively, .Hospitalization rate was 36% and was highest in the first three months after discharge. The multi-variable analysis revealed four independent mortality factors: diabetes, EF , ischemic etiology, and TAPSE. Age, stage IV dyspnea, atrial fibrillation , and SLG <-12.were independent predictors factors of rehospitalization. CONCLUSION: is a serious disease associated with poor prognosis despite advanced therapeutics.