FREQUENCY AND CLINICAL PROFILE OF HEART FAILURE WITH PRESERVED EJECTION FRACTION USING CLINICAL CRITERIA AND ECHOCARDIOGRAPHY

Abstract

Background: Heart failure with preserved ejection fraction (HFpEF) presents a significant global burden. The frequency and clinical as well as echocardiographic characteristics of HFpEF are still under characterised. Objective: To determine the frequency, clinical and echocardiographic profile of HFpEF among patients presenting with heart failure. Methods: This was a cross-sectional study which included 149 adult patients with clinical heart failure at a tertiary care cardiology center from date to date. All patients included in the study were equally divided into HFpEF (LVEF ≥50%) and non-HFpEF (LVEF <50%) groups. Demographic, clinical, echocardiographic and biochemical parameters were compared with stratified analysis by age. Results: HFpEF was present in 45.6% (n=68/149) of patients. HFpEF patients were significantly older (70.28±5.68 vs. 64.04±8.92 years; p<0.001). These patients had higher BMI (31.92±6.40 vs. 27.72±4.36 kg/m²; p<0.001) and higher blood pressure readings (138.09±16.94 vs. 124.63±18.16 mmHg; p<0.001). Hypertension (83.6% vs. 66.7%; p=0.019), dyslipidemia (60.9% vs. 40.8%; p=0.018) and obesity (59.7% vs. 28.4%; p<0.001) were more common in HFpEF group. Coronary artery disease was found to be more prevalent in non-HFpEF (50.6%). HFpEF patients had significantly higher left atrial volume index (42.05±9.86 vs. 35.87±9.43 mL/m²; p<0.001) but their NT-proBNP levels were lower than non HFpEF group(median: 1556.5 vs. 3910.0 pg/mL; p<0.001). In older patients the association between obesity and HFpEF was significant (p<0.001). Conclusion: HFpEF constituted nearly half of heart failure cases with older age, more metabolic comorbidities, and significant left atrial issues. There is a need for phenotype specific diagnostic and therapeutic approaches in South Asian populations.