Prevalence and factors associated with dilated cardiomyopathy among patients presenting to Uganda Heart Institute in heart failure

Abstract

BACKGROUND: DCM still remains one of the commonest causes of heart failure in black Africans and over the past 50yrs, its prevalence in the African population has greatly increased from 10-17% in both Uganda and South Africa(Sliwa, Damasceno et al. 2005) to approximately 35% of all cardiac diseases(Sliwa, Wilkinson et al. 2008) and accounts for almost a half of hospitalizations secondary to heart failure(Maharaj 1991). This study set out to determine the prevalence, and the factors associated with DCMP among patients presenting to Uganda Heart Institute in heart failure. METHODS: This was a cross-sectional study among all eligible patients who presented to Uganda Heart Institute with heart failure. Heart failure was defined in accordance to Framingham criteria. A total of 145 patients who met the inclusion criteria were consecutively recruited, data was collected using a questionnaire on socio-demographics, clinical and laboratory parameters. Echocardiography was done to assess for the left ventricular diameter in diastole and ejection fraction for evidence of dilated cardiomyopathy. RESULTS: Out of the 145 patients who were enrolled, 92 (63.45%), were female,96 (66.21%) were residing in a rural setting and 70 (48.28%) patients were between 50-70yrs. The Prevalence of dilated cardiomyopathy among patients with heart failure presenting to Uganda Heart Institute was 44.14%. Females were less likely to be diagnosed with DCM compares to their male counterparts (AOR:0.501, p-value=0.014) and patients with dilated cardiomyopathy were twice likely to present with jugular venous distention (AOR:2.101, p-value=0.038). CONCLUSION: The prevalence of dilated cardiomyopathy among patients presenting to UHI in Heart failure is very high and it still remains the highest compared to other regions of Africa. Patients still present late when they are quite ill requiring diuresis and the female sex is twice unlikely to present with DCM.