Clinical and echocardiographic features in patients with different phenotypes of heart failure

Abstract

Background: Despite the advancements in heart failure (HF) management, a gap remains in distinguishing the clinical and echocardiographic profiles among the different phenotypes of HF, particularly in HF with mid-range ejection fraction (HFmrEF). The aim of the current study was to establish clinical and echocardiographic differences in patients with HF with reduced and mid-range left ventricular ejection fraction (LVEF).

Methods: The study included 80 patients with chronic HF with LVEF less than 50% who were divided into two groups: HF with reduced ejection fraction (HFrEF) (n=45) and HFmrEF (n=35). All patients underwent clinical, laboratory, and instrumental studies, including transthoracic echocardiography. Statistical analysis was performed using «STATISTICA 12.0».

Results: Patients of both groups were predominantly male (p>0.05), comparable in age prevalence of atrial fibrillation and diabetes mellitus (p>0.05). Patients with HFmrEF more often suffered from hypertension (p=0.04) and stable angina class 3 (p=0.010). Laboratory markers in both groups had no significant differences except for NT-proBNP levels (p=0.031), which were higher in patients with HFrEF. Patients with HFrEF had higher linear and volumetric parameters of both atria and ventricles (p<0.05), which demonstrated undeniable correlation between LVEF and other heart diameters and volumes.

Conclusions: Our study showed that patients with HFmrEF have significant differences from HFrEF (higher incidence of hypertension, lower NYHA class and NT-proBNP levels). This highlights that the further study of clinical and laboratory characteristics of HFmrEF should be conducted.