Cardiology Letters 2017, 26(6):323-335
EPIT-HF survey of chronic heart failure with reduced, mid-range and preserved ejection fraction in Slovakia. Part 1: Focus on epidemiology
- 1 Oddelenia neinvazívnej kardiológie, Nemocnica sv. Cyrila a Metoda Univerzitná nemocnica Bratislava
- 2 Fakulty hospodárskej informatiky, Ekonomická univerzita, Bratislava, Slovenská republika
Background: There is only a limited range of data on clinical characteristics of all three phenotypes of chronic heart failure (HF) and on their comparisons. Epidemiologic data on chronic heart failure with mid-range ejection fraction (HFmrEF) in Slovakia has not been published until yet.
Aims: In a prospective survey to determine and compare epidemiological characteristics of three phenotypes of chronic HF - heart failure with reduced ejection fraction (HFrEF), HFmrEF and heart failure with preserved ejection fraction (HFpEF).
Method: The survey was performed by 161 physicians, including 115 cardiologists (71.4%) and 46 internists (28.6%). Consecutive outpatients with a diagnosis of chronic HF aged at least 18 years were included. There were no exclusion criteria. The HF phenotypes were determined according to left ventricular ejection fraction (LVEF): HFrEF - LVEF < 40%, HFmrEF - LVEF 40-49 %, HFpEF - LVEF ≥ 50%. A total of 2 677 patients with available echocardiography were enrolled. Subsets of HFrEF, HFmrEF and HFpEF consisted of 1 169 (43.7%), 720 (26.9%) and 788 (29.4%) patients, respectively.
Results: We found significant differences between three phenotypes of HF in terms of demography, etiology, symptomatology, clinical signs and mechanical and electrical remodeling. The most striking differences in these characteristics were observed between HFrEF and HFpEF. Patients with HFrEF were most symptomatic, with the highest prevalence of congestive symptoms, NYHA class III/IV and with significantly highest prevalence of HF signs. The least symptomatic, with the lowest rate of congestive symptoms and HF signs, were patients with HFpEF. Demography, symptomatology and clinical signs in HFmrEF were intermediate between HFrEF and HFpEF. Less significant differences between the HF phenotypes were found for co-morbidities and diagnostics.
Conclusion: The phenotypes of HFrEF, HFmrEF and HFpEF are epidemiologically significantly different. HFmrEF is an intermediate type of HF without universal similarity to HFrEF or HFpEF. The EPIT-HF survey presents the first epidemiological characteristics of all three phenotypes of HF in Slovakia. Tab. 6, Ref. 15, online full text (Free, PDF) www.sks.sk
Keywords: chronic heart failure; heart failure with reduced ejec-
Published: June 1, 2017 Show citation
