Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test

Tuoyo O Mene-Afejuku,1,2 Michael O Balogun,2 Anthony O Akintomide,2 Rasaaq A Adebayo2 1Department of Medicine, Metropolitan Hospital Center, New York, NY, USA; 2Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria Background: Hy...

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Main Authors: Mene-Afejuku TO, Balogun MO, Akintomide AO, Adebayo RA
Format: Article
Language:English
Published: Dove Medical Press 2017-02-01
Series:Vascular Health and Risk Management
Subjects:
Online Access:https://www.dovepress.com/prognostic-indices-among-hypertensive-heart-failure-patients-in-nigeri-peer-reviewed-article-VHRM
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spelling doaj-a4952c0cad2242d0af6a97a4406558f62020-11-24T21:06:51ZengDove Medical PressVascular Health and Risk Management1178-20482017-02-01Volume 13717931582Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk testMene-Afejuku TOBalogun MOAkintomide AOAdebayo RATuoyo O Mene-Afejuku,1,2 Michael O Balogun,2 Anthony O Akintomide,2 Rasaaq A Adebayo2 1Department of Medicine, Metropolitan Hospital Center, New York, NY, USA; 2Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria Background: Hypertensive heart failure (HHF) is associated with a poor prognosis. There is paucity of data in Nigeria on prognosis among HHF patients elucidating the role of 24-hour Holter electrocardiogram (ECG) in concert with other risk factors.Objective: The aim of this study was to determine the prognostic utility of 24-hour Holter ECG, the 6-minute walk test (6-MWT), echocardiography, clinical and laboratory parameters among HHF patients.Methods: A total of 113 HHF patients were recruited and followed up for 6 months. Thirteen of these patients were lost to follow-up, and as a result only 100 HHF patients were analyzed. All the patients underwent baseline laboratory tests, echocardiography, 24-hour Holter ECG and the 6-MWT. HHF patients were analyzed as “mortality vs alive” and as “events vs no-events” based on the outcome at the end of 6 months. Events was defined as HHF patients who were rehospitalized for heart failure (HF), had prolonged hospital stay or died. No-events group was defined as HHF patients who did not meet the criteria for the events group.Results: HHF patients in the mortality group (n = 7) had significantly higher serum urea (5.71 ± 2.07 mmol/L vs 3.93 ± 1.45 mmol/L, p = 0.003) than that in those alive. After logistic regression, high serum urea conferred increased mortality risk (p = 0.035). Significant premature ventricular complexes (PVCs) on 24-hour Holter ECG following logistic regression were also significantly higher (p = 0.015) in the mortality group than in the “alive” group (n = 93) at the end of the 6-month follow-up period. The 6-minute walk distance (6-MWD) was least among the HHF patients who died (167.26 m ± 85.24 m). However, following logistic regression, the 6-MWT was not significant (p = 0.777) for predicting adverse outcomes among HHF patients. Patients in the events group (n = 41) had significantly higher New York Heart Association (NYHA) class (p = 0.001), Holter-detected ventricular tachycardia (VT; p = 0.009), Holter-detected atrial fibrillation (AF; p = 0.028) and PVCs (p = 0.017) following logistic regression than those in the no-events group (n = 59).Conclusion: High NYHA class, elevated serum urea, Holter ECG-detected AF and ventricular arrhythmias are predictive of a poor outcome among HHF patients. The 6-MWT was not a useful prognostic index in this study. Keywords: hypertensive heart failure, ventricular tachycardia, Holter electrocardiography, prognosishttps://www.dovepress.com/prognostic-indices-among-hypertensive-heart-failure-patients-in-nigeri-peer-reviewed-article-VHRMhypertensive heart failureventricular tachycardiaHolter electrocardiographyprognosis.
collection DOAJ
language English
format Article
sources DOAJ
author Mene-Afejuku TO
Balogun MO
Akintomide AO
Adebayo RA
spellingShingle Mene-Afejuku TO
Balogun MO
Akintomide AO
Adebayo RA
Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
Vascular Health and Risk Management
hypertensive heart failure
ventricular tachycardia
Holter electrocardiography
prognosis.
author_facet Mene-Afejuku TO
Balogun MO
Akintomide AO
Adebayo RA
author_sort Mene-Afejuku TO
title Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
title_short Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
title_full Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
title_fullStr Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
title_full_unstemmed Prognostic indices among hypertensive heart failure patients in Nigeria: the roles of 24-hour Holter electrocardiography and 6-minute walk test
title_sort prognostic indices among hypertensive heart failure patients in nigeria: the roles of 24-hour holter electrocardiography and 6-minute walk test
publisher Dove Medical Press
series Vascular Health and Risk Management
issn 1178-2048
publishDate 2017-02-01
description Tuoyo O Mene-Afejuku,1,2 Michael O Balogun,2 Anthony O Akintomide,2 Rasaaq A Adebayo2 1Department of Medicine, Metropolitan Hospital Center, New York, NY, USA; 2Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria Background: Hypertensive heart failure (HHF) is associated with a poor prognosis. There is paucity of data in Nigeria on prognosis among HHF patients elucidating the role of 24-hour Holter electrocardiogram (ECG) in concert with other risk factors.Objective: The aim of this study was to determine the prognostic utility of 24-hour Holter ECG, the 6-minute walk test (6-MWT), echocardiography, clinical and laboratory parameters among HHF patients.Methods: A total of 113 HHF patients were recruited and followed up for 6 months. Thirteen of these patients were lost to follow-up, and as a result only 100 HHF patients were analyzed. All the patients underwent baseline laboratory tests, echocardiography, 24-hour Holter ECG and the 6-MWT. HHF patients were analyzed as “mortality vs alive” and as “events vs no-events” based on the outcome at the end of 6 months. Events was defined as HHF patients who were rehospitalized for heart failure (HF), had prolonged hospital stay or died. No-events group was defined as HHF patients who did not meet the criteria for the events group.Results: HHF patients in the mortality group (n = 7) had significantly higher serum urea (5.71 ± 2.07 mmol/L vs 3.93 ± 1.45 mmol/L, p = 0.003) than that in those alive. After logistic regression, high serum urea conferred increased mortality risk (p = 0.035). Significant premature ventricular complexes (PVCs) on 24-hour Holter ECG following logistic regression were also significantly higher (p = 0.015) in the mortality group than in the “alive” group (n = 93) at the end of the 6-month follow-up period. The 6-minute walk distance (6-MWD) was least among the HHF patients who died (167.26 m ± 85.24 m). However, following logistic regression, the 6-MWT was not significant (p = 0.777) for predicting adverse outcomes among HHF patients. Patients in the events group (n = 41) had significantly higher New York Heart Association (NYHA) class (p = 0.001), Holter-detected ventricular tachycardia (VT; p = 0.009), Holter-detected atrial fibrillation (AF; p = 0.028) and PVCs (p = 0.017) following logistic regression than those in the no-events group (n = 59).Conclusion: High NYHA class, elevated serum urea, Holter ECG-detected AF and ventricular arrhythmias are predictive of a poor outcome among HHF patients. The 6-MWT was not a useful prognostic index in this study. Keywords: hypertensive heart failure, ventricular tachycardia, Holter electrocardiography, prognosis
topic hypertensive heart failure
ventricular tachycardia
Holter electrocardiography
prognosis.
url https://www.dovepress.com/prognostic-indices-among-hypertensive-heart-failure-patients-in-nigeri-peer-reviewed-article-VHRM
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