B96-07 Prognostic Value of Cardiometabolic, Cardiorespiratory, and Echocardiographic Profiles in Adults With Heart Failure: Insights From a Cohort Study in Nigeria

Rationale Heart failure (HF) is a leading cause of morbidity and mortality, affecting 1-2% of adults worldwide. There is a disproportionate burden and dynamic phenotype of HF in the low and middle-income countries particularly in sub-Saharan Arica. Emerging evidence highlights the influence of cardiometabolic and cardiopulmonary profiles (comorbidities) on the aetiopathogenesis, presentation, management and outcomes of HF. However, there is a dearth of local data. This study seeks to contribute evidence on the burden and prognostic value of these systemic profiles in persons with HF within the region. Methods This cohort study involved 200 consenting adults with stable HF at Jos University Teaching Hospital, Nigeria. Each participant had relevant medical history taken, physical examination and investigations. Cardiometabolic profile was assessed historically and by a metabolic panel test with cardiometabolic index, metabolic syndrome and Charlson comorbidity index assessed. Cardiorespiratory profile was assessed historically and by administering Berlin’s and STOP-Bang questionnaires to assess obstructive sleep apnea, a pulmonary function test and a six-minute walk test distance assessment. Electrocardiography and echocardiography was done for all participants. Prognosis was assessed by looking at health-related quality of life, heart failure hospitalizations and mortality over 12 months across the spectrum of HF. Data was analysed using Epi-info version 7.2.5. Results A significant burden and variation in cardiometabolic and cardiorespiratory profiles (comorbidities) are observed across the spectrum of heart failure phenotypes and are associated with outcomes (see Table). HFpEF is associated with a higher burden of cardiometabolic (cardiometabolic index P = 0.002, CCI P = 0.001, MS P = 0.007) and obstructive cardiopulmonary abnormalities compared with other phenotypes (pulmonary function P = 0.037, OSA P = 0.006) along with high hospitalization and mortality rates (P = 0.031, P = 0.698). Conversely, HFrEF is associated with a high burden of cardiometabolic, and cardiopulmonary abnormalities along with poorer quality of life (P = 0.042), 6MWT distance (P = 0.011), hospitalization (P = 0.031) and mortality rates (P = 0.698) compared with other phenotypes. HFmrEF and HFimpEF are associated with a relatively lower burden of cardiometabolic and cardiorespiratory perturbations and more favorable outcomes compared with the extremes of HFpEF and HFrEF (See Table). The differences between HFmrEF and HFimpEF were not statistically significant. Conclusion The traditional perspective of HF is evolving to a new comprehension of inter-relationships between organs and systems. Emerging evidence highlights the role of cardiometabolic and cardiopulmonary profiles on the evolution, management and outcomes of HF. Adequate profiling and management of these factors in HF patients will improve quality of life and clinical outcomes in these patients.