The Functional Class and Electrocardiographic Abnormalities in Heart Failure Patients in Southern Nigeria: A Retrospective Observational Study

Norbert Ndubuisi Unamba, Julius Uguru Edeogu, Miriam Ijeoma Orji


BACKGROUND:  Impairment of the functional status of heart failure (HF) patients is invariably a cause of concern, as it translates to a reduced quality of life and the loss of work man-hours occasioned by frequent hospitalizations. These periods of hospitalizations are quite frequently related to the occurrence of cardiac arrhythmias.

OBJECTIVES: To determine the prevalent electrocardiographic abnormalities and functional status of the heart failure patients, and to investigate the relationship between the presence of cardiac arrhythmias and functional class.

METHODS: Three hundred and thirty-three (333) heart failure patients were studied. Anthropometric and biochemical parameters were collected, and the functional class assessed by the New York Heart Association (NYHA) functional classification system. Electrocardiography (ECG) was performed on each patient to identify the presence of an arrhythmia.  

RESULTS:  Most of the HF patients were within the fifth and sixth decades of life. Among the heart failure patients, most of the participants were in the NYHA stage II functional class. We also found that 97.4% of the HF patients had some form of ECG abnormality at hospitalization. The commonest ECG abnormality was left atrial enlargement, while the commonest sustained arrhythmia was atrial fibrillation. Sinus tachycardia was however solely able to predict a progression to an advanced NYHA class.

Conclusions: Patients in HF were mostly in the NYHA II class, and were relatively young. A normal ECG finding is quite rare in HF. Sinus tachycardia in the context of HF may portend a more debilitating functional status.


Heart failure, functional status, electrocardiographic abnormality



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