PMID- 36406095
OWN - NLM
STAT- MEDLINE
DCOM- 20221122
LR  - 20221230
IS  - 1995-7270 (Electronic)
IS  - 1995-7262 (Print)
IS  - 1995-7262 (Linking)
VI  - 34
IP  - 3
DP  - 2022 Sep
TI  - An audit of Heart failure management among ambulatory adult patients at Queen 
      Elizabeth Central Hospital (QECH), Malawi.
PG  - 170-175
LID - 10.4314/mmj.v34i3.5 [doi]
AB  - BACKGROUND: There are limited data on the clinical characteristics and use of 
      guideline directed medical therapy among patients with heart failure in Malawi. 
      We conducted a study to assess patient characteristics and clinical management 
      given to heart failure patients at Queen Elizabeth Central hospital in Malawi. 
      METHODS: In a cross sectional study, patients with a diagnosis of heart failure 
      who were followed up in the adult chest clinic at QECH were recruited to 
      ascertain their characteristics and the therapy they were receiving. 
      Echocardiograms and electrocardiograms were performed to identify abnormalities. 
      RESULTS: A total of 79 patients were recruited and 62% (49 out of 79) were 
      female. The median age was 60 years (IQR 40.5-70.5). Most patients were 
      hypertensive with NYHA (New York Heart Association) class I and II symptoms. Left 
      ventricular(LV) systolic dysfunction was found in 55% (36 out of 65), with 68% 
      (39 out of 65) having features of left ventricular remodeling. Most patients were 
      on at least a single neurohormonal drug with 77% (61 out of 79) on ACEI 
      (angiotensin converting enzyme inhibitor), 52% (42 out of 79) on a beta blocker 
      and 34%(27 out of 79) on aldosterone antagonists. The recommended doses of 
      medications were achieved in 14% (9 out 61), 24% (10 out 42), 22% (6 out of 27) 
      on ACEI, beta blockers and aldosterone antagonists respectively. CONCLUSIONS: 
      Hypertension is the commonest comorbidity in patients with heart failure, who are 
      mostly females with NYHA class I or II symptoms. Most had LV remodeling changes 
      and are on at least one neurohormonal antagonist but most remain sub optimally 
      treated.
CI  - (c) 2022 Kamuzu University of Health Sciences and the Medical Association of 
      Malawi.
FAU - Mwabutwa, Emmanuel S
AU  - Mwabutwa ES
AD  - Department of Medicine, School of Medicine, Kamuzu University of Health Sciences, 
      Blantyre, Malawi.
FAU - Kateta, Steve
AU  - Kateta S
AD  - Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
FAU - Kinley, Louis
AU  - Kinley L
AD  - Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
FAU - Ulemu, Tadala
AU  - Ulemu T
AD  - Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
FAU - Goodson, Patrick
AU  - Goodson P
AD  - Department of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
FAU - Muula, Adamson S
AU  - Muula AS
AD  - Department of Community and Environmental Health, School of Global and Public 
      Health, Kamuzu University of Health Sciences (KUHeS), Blantyre, Malawi.
FAU - Kumwenda, Johnstone
AU  - Kumwenda J
AD  - Department of Medicine, School of Medicine, Kamuzu University of Health Sciences, 
      Blantyre, Malawi.
LA  - eng
GR  - U24 HL136791/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - Malawi
TA  - Malawi Med J
JT  - Malawi medical journal : the journal of Medical Association of Malawi
JID - 9500170
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 0 (Adrenergic beta-Antagonists)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - Mineralocorticoid Receptor Antagonists/therapeutic use
MH  - Cross-Sectional Studies
MH  - Malawi/epidemiology
MH  - *Heart Failure/drug therapy/epidemiology
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Hospitals
MH  - *Hypertension/drug therapy
PMC - PMC9641614
OTO - NOTNLM
OT  - Guideline directed medical therapy
OT  - Heart Failure
EDAT- 2022/11/22 06:00
MHDA- 2022/11/23 06:00
PMCR- 2022/09/01
CRDT- 2022/11/21 04:10
PHST- 2022/11/21 04:10 [entrez]
PHST- 2022/11/22 06:00 [pubmed]
PHST- 2022/11/23 06:00 [medline]
PHST- 2022/09/01 00:00 [pmc-release]
AID - 10.4314/mmj.v34i3.5 [doi]
PST - ppublish
SO  - Malawi Med J. 2022 Sep;34(3):170-175. doi: 10.4314/mmj.v34i3.5.