The Clinical Characteristics Of The Elderly Inpatients With Heart Failure And Atrial Fibrillation

Objectives:To analysis the clinical characteristics of the elderly in-patients with heart failure（HF）and atrial fibrillation（AF）,and to compare three phenotypes of HF.Methods:The elderly inpatients（age≥60 years）with HF and AF were enrolled in our hospital from January 1,2014 to January 1,2017.HF met the criteria of the2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure（NYHA class II-IV）.According to the left ventricular ejection fraction（LVEF）,The inpatients were divided into three phenotypes,heart failure with preserved ejection fraction（HFpEF,EF≥50%）,heart failure with mid-range ejection fraction（HFmrEF,40%≤EF<50%）,and heart failure with reduced ejection fraction（HFrEF,EF<40%）.The characteristics of different type HF were compared.Results:1.The elderly inpatients with HF and AF were 696 cases in the study.Among them,there were 80 cases（11.5%）with strokes and 41 cases（5.8%）death respectively.The propotion of HFpEF,HFmrEF and HFrEF was 65.9%,12.4%and21.7%respectively.2.The average age of the elderly inpatients with HF andAF was75.5±7.6 years and men were more common seen.The most common comorbidities were hypertension（72.3%）and coronary artery disease（49%）,CHA₂DS₂-VASc score and CHADS₂ score was 4.2±1.4 and 2.9±1.1respectively.However,the use of oral anticoagulants were relatively low（39.1%）.The average length of hospital stay was 13.9 days and the average costs was13879.5 yuan.3.Compared with the HFrEF inpatients,age,women,hypertension,sy-stolic blood pressure,CHA₂DS₂-VASc score and CHADS₂ score,stroke and the average length of hospital stay were higher,but heart rate,smoking,NT-proBNP,Hb,LDL-C,BUN,UA,LVED,LVES,LAD,and PAP were lower in HFpEF ones respectively（P<0.05）.The age,systolic blood pressure were higher but comorbidity of dilated cardiomyopathy and drinking lower in patients with HFmrEF when compared to HFrEF（P<0.05）.Conclusions:1.The stroke and death incidence of the elderly inpatients with HF and AF are 11.5%and 5.8%respectively.2.The elderly inpatients with HF and AF are more common in men,the most common comorbidities with hypertension,coronary artery disease and strokes,and less relatively use of oral anticoagulants.3.HFpEF accounts for 65.9%in the elderly inpatients with HF and AF.The elderly inpatients with HFpEF and AF are more common in women,the most comorbidities with hypertension and strokes,and longer length hospital stay.The clinical characteristics of the elderly inpatients with HFmrEF and AF are between HFrEF and HFpEF.