الفهرس 
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Abstract
Knowledge of the frequency of precipitating factors for acute heart failure (AHF) is essential, as this can inform targets for prevention and treatment. Most data come exclusively from Western Europe and North America; nevertheless, geographic differences do exist. We aimed to investigate the prevalence of precipitating factors of AHF and their association with patient characteristics, in-hospital and long-term mortality in Egyptian patients hospitalized for heart failure. Using the ESC-HF-LT Registry which is a retrospective, multi-center, observational study of patients presenting to cardiology centers in European and Mediterranean countries, patients presenting with AHF were recruited from 20 centers all over Egypt. Investigators were asked to report possible precipitating factors from among several predefined reasons.
Results: We included 1661 patients (mean age 60 ±12 years, 69% males). The mean LVEF was 38 ±11%. Seventy seven percent of the total population had HFrEF, 9.8% had HFmrEF, and 13.3% had HFpEF. The commonly reported precipitating factors for AHF hospitalization among study population were as follows (in decreasing order of frequency): infection in 30.3% of patients, acute coronary syndrome/myocardial ischemia (ACS/MI) in 26%, anemia in 24.3%, uncontrolled hypertension in 24.2%, atrial fibrillation (AF) in 18.3%, renal dysfunction in 14.6%, and non-compliance in 6.5% of patients. HFpEF patients had significantly higher rates of AF, uncontrolled hypertension, and anemia as precipitants for acute decompensation. ACS/MI were significantly more frequent in patients with HFmrEF. WHF patients had a significantly higher rates of infection and non-compliance, whereas new-onset HF patients showed a significantly higher rates of ACS/MI and uncontrolled hypertension. One year follow up showed that patients with HFrEF had a significantly higher rate of mortality compared to patients with HFmrEF and HFpEF (28.3%, 19.5, and 19.4%, P= 0.004). Patients with WHF had a significantly higher rates of 1-year mortality when compared to those with NOHF (30.0% vs 20.3%, P <0.001). Renal dysfunction, anemia, and infection were independently associated with worse long-term survival.