Characteristics of patients hospitalized for a

first episode of acute heart failure

Achref HAMDANI, Zaineb AJRA, Fahmi BAYAR, Lamia RASHIKOU, Refaat GHENI, Riadh BEN HAMIDA, Taha OUNISSI, Zied IBN ELHADJ.
Department of Cariology, Mohamed Taher MAAMOURI University Hospital, Nabeul. Tunisia

INTRODUCTION: A first episode of acute heart failure (AHF) frequently

reveal the underlying heart disease. The aim of this study was to determine
the characteristics of patients hospitalized for de novo AHF and its main
etiologies.

MATERIALS AND METHODS: We conducted a prospective and descriptive

study which included 100 patients hospitalized for a first episode of AHF in
the department of cardiology of Mohamed Taher MAAMOURI University
Hospital at Nabeul, Tunisia, between 1 January 2023 and 31 October 2023.

RESULTS: Our population included 62 men and 38 women, with average

age of 61±13.7 years. Hypertension was found in 61% of cases, followed by
smoking (54%), dyslipidemia (50%), diabetes (40%) and obesity (18%).
Dyspnea was the main reason for hospitalization in 68% of cases, followed
by lower limb edema (LLE) (24%). Pulmonary crackles were found in 74% of
cases. Polypnea and tachycardia were found in 64% and 58% of cases
respectively, followed by orthopnea (48%) and LLE (38%). The
electrocardiogram revealed repolarization disorders in 42% of cases, atrial
fibrillation in 25%, ventricular excitability disorders in 24%, left ventricular
hypertrophy in 18% and complete atrio-ventricular block in 4%.
Transthoracic echocardiography found a mean Left Ventricular Ejection
Fraction (LVEF) of 36.9 ± 15.4% and classified the HF as preserved LVEF in
30%, mildly reduced LVEF in 31% and as reduced LVEF in 39%. Coronary
angiography was performed in 78% of patients, and was pathological in 42
(53.8%). The majority of patients (55%) had isolated left-sided heart failure.
Etiologies were dominated by ischemic heart disease (55%), followed by
primary dilated cardiomyopathy (15%) and hypertensive heart disease
(14%). Poor therapeutic compliance and dietary transgression were the
main factors triggering AHF (26%), followed by arrythmias (20%) and silent
myocardial ischemia (16%).

CONCLUSION: De novo AHF can be life-threatening in the very short term

and have an impact on the patient's prognosis in the medium to long term.
It requires immediate and long-term management and a search for the
underlying etiology dominated by ischemic heart disease.

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