Key result
Acute heart failure in Saudi HFpEF patients carries 4% day-one mortality and persistent discharge symptoms.
Why the study?
Few Middle Eastern studies have characterized patients with HFpEF presenting with acute heart failure, focusing on clinical features and management at admission and discharge.
Observational (n=114)
No
Patients with acute HFpEF in Saudi Arabia present with significant comorbidities and depressed longitudinal and diastolic function, and often remain symptomatic at discharge.
May signal need for closer post-discharge monitoring in HFpEF; leaves open optimal discharge criteria in regional observational cohorts.
Heart failure and preserved ejection fraction (HFpEF) is defined as heart failure symptoms and signs with a normal or near-normal ejection fraction (EF) with evidence of diastolic dysfunction. The few Middle Eastern studies that have been conducted were designed to compare patients with heart failure reduced ejection fraction (HFrEF) and HFpEF. The aim of this study was to study Saudi patients with HFpEF who presented with acute heart failure, and define their clinical characteristics and the signs and symptoms of heart failure, echocardiographic findings and medications at admission and at hospital discharge. Methods This is a prospective observational study in which patients were included following an acute heart failure presentation with N-terminal pro-BNP (NT-proBNP) > 300 ng/L and left ventricular ejection fraction (LVEF) > 50%. They were admitted to the coronary care unit of king Saud medical city from the period of March 2015 to September 2015. Results 114 patients were enrolled in the study and assessed at acute admission. Of these, 4% died on day one of admission. The mean ± SD age of 109 included patients was 59 ± 8 years and 55% were women. Hypertension (64%), dyslipidemia (76%), atrial tachyarrhythmia (38%), prior heart failure (33%) and anemia (35%), median NT-proBNP was 2490 ± 125 ng/l at admission. Mean (LVEF) was 61 ± 3, mean LV mass index was 118 ± 11, mean E / e ′ was 12.2 ± 2, and left atrial volume index was 47 ± 7 mL/m 2 . Mean global left ventricular strain was −13.5 ± 1.5. At discharge the majority of patients were still symptomatic with high NT-proBNP 542 ± 266. Conclusions Patients with HFpEF were old with slight female dominance, a high rate of hypertension, diabetes, dyslipidemia and much comorbidity. LVEF was preserved despite depressed left ventricular longitudinal and diastolic functions with high filling pressure. At discharge the patients were still symptomatic calling for further research to reach the best strategy for proper management.
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Abohammar et al. (2016) conducted an observational in Heart failure and preserved ejection fraction (HFpEF) (n=114). Heart failure with preserved ejection fraction (HFpEF) was evaluated on Clinical characteristics, echocardiographic findings, and symptoms at admission and discharge. Among 114 Saudi patients with HFpEF presenting with acute heart failure, 4% died on day one, and survivors exhibited high comorbidity rates and remained symptomatic at discharge.
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