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Abstract

ABSTRACT
Introduction. Atrial fibrillation (AF) is the commonest heart rhythm disturbance. In Cameroon, its prevalence is about 7-8% in hospital based studies. AF is associated with symptoms which affect the functional status of patients. Functional class of AF patients rated by the (European Heart Rhythm Association) EHRA scale has not been studied in Cameroon. We aimed to determine the functional status of AF patients according to the EHRA classification in a hospital setting in Yaounde. Methods. It was a cross-sectional analytic study. We recruited 61 patients. Informed consent was obtained from all participants. Proportions were calculated to display the frequency of various EHRA classes and to stratify them into good and poor functional class groups. Univariate and multivariate analyses were performed to determine the factors associated with poor functional status. A result was considered statistically significant if the 95% confidence intervals did not include 1 or if the p-value was <0.05. Results. Our mean age was 71 years with 62% of our patients aged between 60-80 years. The most common risk factor of AF were hypertension (63%), and heart failure (41%). Majority (40%) had HFpEF. Beta-blockers were the most used rate control strategy (50%) and 72% patients had optimal heart rate. More than half our AF patients (54%) had poor functional class. Diastolic dysfunction was a significant predictor of poor functional status (OR=5; 95%CI: 1.04-25; P=0.03). Conclusion. Poor functional status was frequent in our population of AF patients despite most of them having good systolic function. Diastolic dysfunction has a negative impact on functional class of AF patients. Treating diastolic dysfunction may be an important long term strategy in improving functional status of AF patients.

RÉSUMÉ
Introduction. La fibrillation auriculaire (FA) est le trouble du rythme cardiaque le plus fréquent. Au Cameroun, sa prévalence est d'environ 7 à 8% en milieu hospitalier. La FA est associée à des symptômes qui affectent l'état fonctionnel des patients. L’évaluation du statut fonctionnel des patients selon la classification EHRA (European Heart Rhythm Association) n'a pas encore été étudiée au Cameroun. Notre objectif était d’évaluer l'état fonctionnel des patients atteints de FA selon la classification EHRA en milieu hospitalier à Yaoundé. Méthodologie. Il s’est agi d’une étude transversale analytique. Nous avons recruté 61 patients atteints de FA. Un consentement éclairé a été obtenu de tous les participants. Les proportions ont été calculées pour afficher la fréquence des diverses classes EHRA ; les classes fonctionnelles ont été stratifié en deux groupes : bon statut fonctionnel pour les classes I et II de ERHA et mauvais statut fonctionnel pour les classe III et IV de ERHA. Un résultat était considéré comme statistiquement significatif si les intervalles de confiance à 95% n'incluaient pas 1 et la valeur p était <0,05. Résultats. L’âge moyen était de 71 ans et 62% de nos patients étaient âgés de 60 à 80 ans. Les facteurs de risque de FA les plus courants étaient l'hypertension (63%) et l'insuffisance cardiaque (41%). La majorité (40%) avait une insuffisance cardiaque à fraction d’éjection préservée. La stratégie de contrôle de la fréquence était la plus utilisée et faisait appel majoritairement aux bétabloquants (50%) ; la fréquence cardiaque optimale chez 72% des patients. 54% de nos patients avaient un mauvais statut fonctionnel. La dysfonction diastolique était un prédicteur significatif d'un mauvais statut fonctionnel (OR = 5; IC à 95%: 1,04-25; P = 0,03).Conclusion. La majorité de notre population de patients atteints de FA présente un mauvais statut fonctionnel, bien que la plupart d'entre eux aient une bonne fonction systolique. La dysfonction diastolique a un impact négatif sur la classe fonctionnelle des patients atteints de FA.

Keywords

atrial fibrillation functional status rate control diastolic dysfunction

Article Details

How to Cite
Boombhi, J., Mokube, M., Menanga, A., Nganou, C., Mfeukeu-Kuate, L., Dzudie, A., Hamadou, B., Ebene, M., Owona, A., & Kingue, S. (2020). Functional Status by EHRA Classification of Patients with Atrial Fibrillation in the Yaounde General Hospital: a Cross-Sectionnal Study. HEALTH SCIENCES AND DISEASE, 22(1). Retrieved from https://hsd-fmsb.org/index.php/hsd/article/view/2486

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