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Niger Med J. 2019 May-Jun;60(3):113-116. doi: 10.4103/nmj.NMJ_63_19.

Association between Common Etiologies and Precipitants of Acute Decompensated Heart Failure.

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Department of Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.



Acute decompensated heart failure (ADHF) comprises the etiology of heart failure and the precipitant of acute decompensation. Early identification of the precipitant of ADHF is important in management, but an association between the precipitant and etiology of ADHF has not been established.


The objective of this study is to determine whether the precipitant of acute decompensation is associated with the etiology of heart failure.


This was a prospective observational study conducted over 2 years. Patients with ADHF secondary to common etiologies such as hypertension and rheumatic heart diseases (RHD) were enrolled in the study. The demographics, precipitants, and relevant variables on echocardiography and electrocardiography were documented. The frequencies of the etiology and precipitants of heart failure were derived. The Chi-square test was used to determine an association between categorical variables, and independent t-test was used to compare the means of continuous variables. A value of P < 0.05 was considered statistically significant.


There were a total of 190 participants. Hypertensive and RHD were 96 (50.5%) and 94 (49.5%), respectively. One hundred and three (54.2%) were females and males were 87 (45.8%). The precipitants were pneumonia 104 (54.7%), arrhythmias 47 (24.7%), urinary tract infection 36 (19.5%), and infective endocarditis 3 (1.6%). The association between these etiologies and precipitants of ADHF yielded a value of P = 0.597.


There is no association between the precipitant and etiology of ADHF. Therefore, the precipitant of ADHF should be actively sought for in every case for optimal management and better outcomes.


Acute decompensated heart failure; etiology; precipitant

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