Key result
CKD, valvular disease, RV dilation, anemia, and elevated troponin are linked to higher HFpEF in-hospital mortality.
Why the study?
Describing risk factors in HFpEF is crucial for management, prompting the identification of clinical and echocardiographic characteristics associated with HFpEF and mortality during acute decompensation.
Observational (n=133)
Yes
In patients hospitalized for acute decompensated HFpEF, comorbidities such as chronic kidney disease, valvular heart disease, and specific lab abnormalities are strongly associated with in-hospital mortality.
May aid risk stratification in acute HFpEF; leaves open whether interventions targeting these factors improve survival.
Background: Congestive heart failure is responsible for repeated hospital admissions. It is classified into three types: (1) Heart Failure with reduced ejection fraction, (2) Heart failure with mid-range ejection fraction, and (3) Heart failure with preserved ejection fraction (HFpEF). It is essential to describe the risk factors of HFpEF patients' profiles as targeting them is crucial for management. Aim: Our retrospective study aims to identify the clinical and echocardiographic characteristics associated with HFpEF and its mortality among hospitalized patients with acute decompensated heart failure. Methods: 390 patients of all age groups presenting with acute heart failure decompensation at Mount Lebanon Hospital (MLH) and Middle East Institute of Health (MEIH, Bsalim) were recruited retrospectively between January 2014 and December 2016. We included 133 cases of HFpEF and collected data on each case including: baseline characteristics and comorbidities, electrocardiograms, laboratory studies, and echocardiographic parameters. Results: The 133 Lebanese patients having HFpEF were elderly (76 ± 10 years), with predominantly female gender (56%). Hypertension (87.96%) and diabetes (53.38%) were the most frequently reported comorbidities. The overall in-hospital mortality was 4.5%. Data was compared between living and deceased patients and the frequency of valvular heart disease (p=0.005) and chronic kidney disease (p=0.018) was significantly higher among deceased patients. Right ventricular (RV) dilation on echocardiography was significantly correlated with mortality. Elevated troponin, increased creatinine, hypochloremia, hyponatremia, and anemia were all lab markers associated with increased mortality (p<0.05). Conclusion: Patients with HFpEF represent 43.5% of all decompensated HF cases, with chronic kidney disease, valvular heart diseases, anemia and troponinemia, being the predominant risk factors for adverse clinical outcomes. HFpEF remains an enormous burden on cardiologists for appropriate evaluation, triage, and management.
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Khoury et al. (2021) conducted an observational in Acute Decompensated Heart Failure with Preserved Ejection Fraction (HFpEF) (n=133). Chronic kidney disease, valvular heart disease, right ventricular dilation, anemia, and elevated troponin were significantly associated with increased in-hospital mortality in patients with HFpEF.
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