TITLE:
Parasympathetic Dysfunction in Black African Patients with Heart Failure: A Cross-Sectional Study in Sub-Saharan Africa
AUTHORS:
Ba Hamadou, Sylvie Ndongo Amougou, Ismaila Daouda, Chris Nadège Nganou-Gnindjio, Liliane Mfeukeu-Kuate, Jérôme Boombhi, Ahmadou Musa Jingi, Alain Menanga, Samuel Kingue
KEYWORDS:
Heart Failure, Parasympathetic Dysfunction, Heart Rate Variability, Deep Breathing Test
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.4,
April
20,
2020
ABSTRACT: Background: Heart Failure (HF) is a major public health problem worldwide. Neurohormonal changes associated with HF are current therapeutic targets. The parasympathetic system in HF has not been well studied especially in black Africans. Aim: This study aimed to report on the prevalence and determinants of parasympathetic dysfunction in patients with heart failure in sub-Saharan Africa. Methods: We conducted a cross-sectional study between December 2017 and April 2018 in the outpatient and inpatient departments in two teaching hospitals in Yaounde-Cameroon. Cases were patients with HF matched with controls without HF according to age, sex, and risk factors (hypertension, diabetes, and obesity). We assessed the parasympathetic function via the Deep Breathing Test using an electrocardiograph. Results: We recruited 35 patients in each group. The mean age was 57 ± 11.68 years. Vagal dysfunction was seen in 51.4% of cases and 11.4% of controls (aOR: 10.1 [95% CI: 2.7 - 38.3], p = 0.001). This risk increased with the severity of HF-aOR: 11.8, [95% CI: 1.8 - 77.9], p = 0.01 for dyspnea stage III-IV, and aOR: 9.27, [95% CI: 1.3 - 65.3], p = 0.025) for HF with reduced Ejection fraction. This risk was not associated with the classic cardiovascular risk factors. Conclusion: Parasympathetic dysfunction as assessed with the Deep Breathing Test was seen in over half of the patients with HF and this was associated with the severity and type of HF.