Characterisation of the patients with suspected heart failure: experience from the SHEAF registry

Figure 1. Final diagnosis in heart failure clinics for the whole population. (A) Histogram of the number of patients in each category of diagnosis. From a total of 6144 patients seen in the HF clinic, 29% of patients did not have HF. (B) In patients with NT-proBNP > 2000pg/ml, HFrEF was the main presenting diagnosis (50%) which was followed by HFpEF (31%).HF, heart failure; HFpEF, HF with preserved ejection fraction; HF-PH, HF with pulmonary hypertension; HFrEF, HF with reduced ejection fraction; HF-RVSD, HF with right ventricular systolic dysfunction; HF-VHD, HF with valvular heart disease; NT-proBNP, N-terminal pro-brain-type natriuretic peptide.

Figure 2. Stacked histogram demonstrating the percentage of patients with a specific HF diagnosis in each category of NYHA and CKD stage. (A) Patients with HFpEF were predominantly in NYHA functional class I/II, versus patients with HFrEF, who were predominantly in NYHA functional class IV. (B) HF patients with a diagnosis of HFpEF were more likely to have worse CKD stage than any other type of HF diagnosis. CKD, chronic kidney disease; HFpEF, heart failure with preserved ejection fraction; HF-PH, heart failure with pulmonary hypertension; HFrEF, heart failure with reduced ejection fraction; NYHA, New York Heart Association; RVSD, right ventricular systolic dysfunction; VHD, valvular heart disease

Figure 3. Incidence of all-cause mortality in each sub-phenotype of heart failure per 100 patient-years. Statistical significant changes to other groups are highlighted with letters representing the specific group. The lines represent the 95% confidence interval. HF, heart failure; HFpEF, HF with preserved ejection fraction; HF-PH, HF with pulmonary hypertension; HFrEF, HF with reduced ejection fraction; HF-RVSD, HF with right ventricular systolic dysfunction; HF-VHD, HF with valvular heart disease.

Figure 4. Kaplan-Meier survival curves. (A and B) Survival comparison of patients with versus without HF and with HFpEF versus HFrEF, over a follow-up period of up to 6 years. (C and D) Propensity matched survival comparison of patients with versus without HF and with HFpEF versus HFrEF, over a follow-up period of up to 6 years. HF, heart failure; HFpEF, HF with preserved ejection fraction; HFrEF, HF with reduced ejection fraction.

Figure 5. Kaplan-Meier survival curves. (A and B) Survival comparison of patients with NTproBNP 400-1999pg/ml versus ≥NTproBNP 400-1999pg/ml, and in different NYHA functional status, over a follow-up period of up to 6 years. (C and D) Propensity matched survival comparison of patients with NTproBNP 400-1999pg/ml versus ≥NTproBNP 400-1999pg/ml, and in different NYHA functional status, over a follow-up period of up to 6 years. NT-proBNP, N-terminal pro-brain-type natriuretic peptide; NYHA, New York Heart Association.

Figure 6. Kaplan-Meier curves comparing HFpEF and HFrEF survival. These curves have been adjusted for covariates using the Cox’s proportional-hazards regression. CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; MI; myocardial infarction; NT-proBNP, N-terminal pro-brain-type natriuretic peptide; VHD, valvular heart disease.