الفهرس 
DEFINITION OFOnly 14 pages are availabe for public view
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Abstract
Heart failure (HF) is the only cardiovascular disease increasing in incidence. Despite the relatively recent advances in pharmacologic and non pharmacological treatments for HF, such as angiotensin converting enzyme inhibitors(ACEi), β-adrenoceptor antagonists, aldosterone antagonists, and angiotensin receptor blockers, implantable cardioverter defibrillators( ICD), cardiac resynchronization therapy (CRT-P and CRT-D).
HF remains among the leading causes of hospital admissions in elderly populations. As the population ages and therapies for acute coronary syndromes improve, the incidence and prevalence of HF are expected to rise.
The purpose of this study was to define the characteristics, treatment and outcome in hospitalized patients with systolic heart failure(SHF)in Gaza hospitals.
A prospective study of inpatients with symptomatic SHF admitted to Cardiology Services including all Government Hospitals (Shifa, Naser and European Gaza Hospital) in Gaza Strip between May and September 2010.
120 patients with symptomatic systolic heart failure were enrolled in this study, mean age at presentation was 40 -80 years, 54.2% were male patients and 45.8% were female patients.
Patients were registered in this study had co morbid conditions such as ischemic heart disease ,diabetes mellitus , chronic renal insufficiency, hypertensive disorder , smoking , chronic obstructive pulmonary disease, and anemia .
On collecting 3 months follow up data, a total of 43 patients either were readmitted because of decompensated heart failure or died. 37 patients were readmitted due to symptomatic heart failure and 6 patients died .
Older patients, diabetic patients, atrial fibrillation patients, anemic patients, elevated urea and creatinine level were associated with recurrent hospitalization or death.
The group of patients with rehospitalization or death were associated with large left ventricle end diastolic diameter and left ventricle end systolic diameter , dilated left atrium, increased left ventricle systolic and diastolic volume and lower EF. They were registered to use more diuretics, and lower use of beta blockers, ACE inhibitors, Angiotensin receptors blockers (ARBs), and aldactone. They had significantly, New York Heart Association (NYHA ) III,IV, Lower limb edema and Orthopnea .
In this study 40.9% of total patients used beta blockers, 72.5% of patients used ACE inhibitors, an only 36.7% used aldactone , which revealed that there was under usage of these drugs which are known to improve morbidity and mortality. Also, among the group of rehospitalized or dead patients; 35.8% of patients had left bundle branch block (LBBB ) and there was under usage of CRT-P or ICD which are known to improve quality of life, morbidity and mortality.