098 Predictors of outcome in heart failure with preserved ejection fraction

Abstract

A heart failure with preserved ejection fraction (HFPEF) is present in half the patients with heart failure (HF); the prognosis in more recent studies has been shown to be essentially similar to that of systolic HF. The objective of our study is to define the clinical, biological and echocardiographic predictors of outcome in patients with HFPEF. We included 1200 patients, admitted in Ibn Rochd Center of Cardiology from May 2006 to February 2010. HFPEF was defined as LVEF ɛ45% and receiving a loop diuretic for breathlessness. All patients were evaluated clinically with monitoring of blood pressure (BP), 6 min walk test and electrocardiogram. Two-dimensional echocardiography and laboratory tests were performed in all patients. Of 1200 patients, 63 (5.25%) had HFPEF; the median age was 66 years (42–94) and 61.9% were men. 49.2% of the patients were hypertensive and 33% were diabetic, and 61.9% were in NYHA class II, and 23.8% were in NYHA class III. The median of 6 min walk test was 118 m . The mean LVEF was 46% (40–69). Hypertensive (44.4%) and Ischemic heart disease (17.46%) remain the two most frequent etiology. During a median follow up of 32 months, mortality was 16%. By univariable analysis, NHYA class; 6 min walk distance; atrial fibrillation; right ventricular dysfunction and systolic pulmonary artery pressure (sPAP) were associated with an adverse prognosis. In multivariable analysis, increasing age, NYHA class, and renal failure were predictors of adverse prognosis; beta-blockers treatment, increasing Hb and female sex were predictors of a better outcome. As several studies, clinical and biological variables were more powerful predictors of outcome in HFPEF than echocardiographic variables which are recommended to identify diastolic function.