Clinical characteristics of patients with preserved ejection fraction and reduced heart failure

Abstract

Objective To compare the clinical characteristics of heart failure patients with preserved ejection fraction (HFPEF) and reduced ejection fraction (HFREF). Methods A total of 171 patients with heart failure from September 2015 to November 2017 in the Second Hospital of Shanxi Medical University were retrospectively analyzed.According to left ventricular ejection fraction (EF), the patients were divided into two groups: HEPEF [EF≥45%, 84 cases, mean age (64.8±2.2)years old, 33 males and 51 females] and HFREF (EF<45%, 87 cases, mean age (74.6±1.5)years old, including 61 males and 26 females). The clinical data of the two groups including general information, underlying etiology, biochemical indicators, echocardiography results, medication in detail were recorded. Results Among the 171 patients, there were 69 patients with coronary heart disease, 44 patients with dilated cardiomyopathy, 21 patients with hypertensive heart disease, 10 patients with pulmonary heart disease, 15 patients with rheumatic heart disease, 7 patients with degenerative valvular disease, 2 patients with congenital heart disease, 2 cases of heart failure caused by atrial fibrillation, 1 case of viral myocarditis.The patients in the HFPEF group were older[(74.6±1.5)years old vs.(64.8±2.2) years old, t=3.598, P=0.015], more women(60.7% vs.29.9%, χ2=16.410, P=0.000), lower body weight[(62.7±13.4)kg vs.(68.6±14.9)kg, t=-2.395, P=0.018], less likely to have renal insufficiency(36.7% vs.53.6%, χ2=4.670, P=0.041), and more likely to have hypertension(54.8% vs.37.9%, χ2=4.871, P=0.032) and atrial fibrillation(47.6% vs.13.8%, χ2=23.107, P=0.000). The HFPEF group had higher admission systolic blood pressure than the HFREF group[(131.2±22.2)mmHg vs.(124.1±24.9)mmHg, t=2.058, P=0.041]. The BNP value[(874.2±912.3) pg/mL vs.(835.2±1 490.4)pg/mL, t=-5.011, P=0.000], hemoglobin value[(125.5±24.3)g/L vs.(134.7±23.9)g/L, t=-2.460, P=0.015] in the HFPEF group were lower than those in the HFREF group.The ESR in the HFPEF group was faster than that in HFREF group[(28.0±25.6)mm/h vs.(16.9±14.9)mm/h, t=2.486, P=0.017]. The HFPEF group had smaller left ventricular size than the HFREF group[(50.9±6.4)mm vs.(67.3±8.5)mm, t=-11.303, P=0.000]. RAS blockers (52.4% vs.86.2%, χ2=23.107, P=0.000), spironolactone (72.6% vs.88.5%, χ2=6.926, P=0.011), β-blockers (57.1% vs.75.9%, χ2=6.739, P=0.015), statin (38.1% vs.54%, χ2=4.362, P=0.046) were used more in the HFREF group, while calcium channel blockers(38.1% vs.13.8%, χ2=13.208, P=0.000) and warfarin (16.7% vs.5.7%, χ2=5.159, P=0.129) were used more in the HFPEF group. Conclusion Different clinical characteristics were found in patients with HFPEF and HFREF..Different types of heart failure need different treatment and prevention programs. Key words: Heart failure; HFPEF; HFREF; Clinical characteristics