A profile of heart failure with preserved ejection fraction in a teaching hospital

Abstract

Objective: Heart failure with preserved ejection fraction (HFPEF) is fast becoming an important public health issue. Nearly fifty percent of all heart failure cases are due to HFPEF. There are many associated comorbidities has been associated with this condition which may be pathophysiologically related. There is no specific treatment yet. The focus remains on symptomatic treatment of heart failure along with carefully managing the associated conditions. The present study was aimed at analyzing the comorbidities in HFPEF in a tertiary care centre. Method: Patient diagnosed with heart failure were echocardiographically analyzed. Those showing diastolic dysfunction on tissue Doppler imaging were diagnosed as HFPEF. Patients with chronic obstructive pulmonary disease, valvular heart disease, constrictive pericarditis, restrictive/ hypertrophic cardiomyopathy and sepsis related diastolic dysfunction were excluded. One hundred such patients fulfilling the inclusion and exclusion criteria were enrolled. Plasma B type natriuretic peptide(BNP) level was assayed in all participants. Institutional Ethics Committee approval was taken beforehand. Written informed consent was taken from each patient. Result: The mean age of the patients in the study group was 63.06yrs. HFPEF was more common in females(62%). The common comorbidities observed were hypertension(82%), high body mass index (80%),anaemia (76%), hyperlipidemia (30%) diabetes mellitus(28%). The plasma BNP was elevated in all except 2 patients. The BNP level was higher in those with higher left atrial size and those showing more severe diastolic dysfunction on tissue doppler imaging. Conclusion- HFPEF can be diagnosed clinically with the help of echocardiography. Plasma BNP level assay may be done when diagnosis is in doubt. The patients with HfpEf are heterogeneous and treatment need to be individualized depending on the associated comorbidities. Further studies with larger sample size are required to define the profile of this disease.