Baseline characteristics of patients with heart failure and preserved ejection fraction at admission with acute heart failure in Saudi Arabia

Abstract

Heart failure and preserved ejection fraction (HFpEF) is defined as heart failure symptoms and signs with a normal or near-normal ejection fraction (EF) with evidence of diastolic dysfunction. The few Middle Eastern studies that have been conducted were designed to compare patients with heart failure reduced ejection fraction (HFrEF) and HFpEF.The aim of this study was to study Saudi patients with HFpEF who presented with acute heart failure, and define their clinical characteristics and the signs and symptoms of heart failure, echocardiographic findings and medications at admission and at hospital discharge.MethodsThis is a prospective observational study in which patients were included following an acute heart failure presentation with N-terminal pro-BNP (NT-proBNP) > 300 ng/L and left ventricular ejection fraction (LVEF) > 50%. They were admitted to the coronary care unit of king Saud medical city from the period of March 2015 to September 2015.Results114 patients were enrolled in the study and assessed at acute admission. Of these, 4% died on day one of admission.The mean ± SD age of 109 included patients was 59 ± 8 years and 55% were women. Hypertension (64%), dyslipidemia (76%), atrial tachyarrhythmia (38%), prior heart failure (33%) and anemia (35%), median NT-proBNP was 2490 ± 125 ng/l at admission. Mean (LVEF) was 61 ± 3, mean LV mass index was 118 ± 11, mean E/e′ was 12.2 ± 2, and left atrial volume index was 47 ± 7 mL/m2. Mean global left ventricular strain was −13.5 ± 1.5. At discharge the majority of patients were still symptomatic with high NT-proBNP 542 ± 266.ConclusionsPatients with HFpEF were old with slight female dominance, a high rate of hypertension, diabetes, dyslipidemia and much comorbidity. LVEF was preserved despite depressed left ventricular longitudinal and diastolic functions with high filling pressure. At discharge the patients were still symptomatic calling for further research to reach the best strategy for proper management.

Comorbidities and Negative Prognostic Factors in Lebanese Patients Presenting with Acute Decompensated Heart Failure with Preserved Ejection Fraction: A Multicenter Retrospective Study

“…CKD leads to derangements in vascular physiology which in turn yield a bad cardiovascular outcome through abnormal coagulation and fibrinolytic systems, dysfunction of the endothelium, loss of balance between endothelin and nitrogen oxide, electrolyte disturbances that can lead to arrhythmia, and over activation of the sympathetic nervous system and reninangiotensin-aldosterone systems [17]. Furthermore, VHD was noted in 21% of cases and was associated with mortality among the study patients, which is concordant with results from other studies showing a prevalence of 8 % [35], and 13 % [36].…”

Prevalence and Baseline Characteristics of Patients with Heart Failure and Preserved Ejection Fraction at Outpatients Sitting in Saudi Arabia

“…The present study revealed that anemia was common among HF-PEF patients and it was similar to one of the local study (35% in CCU hospitalized patient with HF-PEF) [15] and international study, where 43% of HF-PEF had anemia [23]. Previous studies have also shown that anemia was more common in HF-REF [20,22,24].…”

“…Study Year EF cuttoff for HF-PEF Prevalence Agarwal et al [10] 2001 >50% 19.9% Elshaer et al [11] Elderly inpatients in 2009 >50% 61.8% Khalid et al [12] Inpatients in 2011 >40% 52.2% Alqahtani et al [13] In and out patients in 2012 >55% 25.8% Sulaiman et al [14] Inpatients in 2015 40% 31% Abohammar et al [15] CCU patients >55% 25.8% Present study Outpatients >45% 51%…”

Outcomes of patients with anemia and renal dysfunction in hospitalized heart failure with preserved ejection fraction (from the CN-HF registry)

“…The prevalence of anemia in HFpEF patients varies greatly from 15.0% to 79.0% in different reports of different region, different study population, different LVEF and different diagnostic criteria of anemia [2,[12], [13], [14], [15], [16], [17], [18], [19], [20]] (Table 4). The prevalence of anemia in this study was roughly consistent with previous studies.…”