Clinical Features And Prognostic Factors Of Heart Failure With Preserved Ejection Fraction

Objective:To compare the clinical features and prognostic factors of heart failure with preserved ejection fraction(HFpEF)in our hospital.Methods: 523 patients with heart failure(HF)were divided into heart failure with reduced ejection fraction(HFrEF),heart failure with mid-range ejection fraction(HFmrEF),and HFpEF,according to the left ventricular ejection fraction.Their clinical characteristics and differences in prognostic indicators were compared.A total of 274 patients hospitalized with confirmed HFpEF,228 were≥65 years old and 46 were <65 years old.The clinical features of the two groups were compared and analyze the risk factors of heart failure hospitalization in patients with ≥65 years old HFpEF.Results: Patients with HFpEF had higher age,BMI,cholesterol,albumin,more female patients,and lower heart rate,troponin-I,BNP,bilirubin,uric acid,edema,and shorter hospital stay than patients with HFrEF(all p<0.05),also all-cause mortality during hospitalization,and all-cause mortality at 30 days after admission were lower than patients with HFr EF(all p<0.05).Compared with patients with HFmrEF,HFpEF was older and more women,with higher triglyceride,high-density lipoprotein,heart rate,troponin-I,BNP,bilirubin,uric acid,white blood cells,and lower urea nitrogen,also hospital stay is shorter(all p<0.05).Increasing of age,urea nitrogen,heart rate,and prolonged hospital stay were independent risk factors for all-cause mortality in patients with HFpEF.≥65-year-old patients with HFpEF were more likely to be female and had hypertension and a history of coronary heart disease(all p<0.05);<65-year-old HFpEF patients were more likely to be male,obese,and had a history of smoking,diabetes,renal insufficiency,and hyperlipidemia(all p<0.05).Logistic multivariate regression analysis showed that hyperuricemia and homocysteine were more effective in the ≥65-year-old HFpEF group.The risk of all-cause mortality was higher in hospitals with HFpEF than in patients 65 years of age or older in the HFpEF group,and the risk of all-cause mortality at 1-year follow-up was lower(all p<0.05).Older age and history of atrial fibrillation are independent risk factors for HF hospitalization of HFpEF aged ≥ 65 years after hospital discharge for one year after.Conclusion: The short-term and long-term prognosis of patients with HFpEF is poor.Compared with HFrEF and HFmrEF,HFpEF is different on the clinical features,all-cause mortality risk factors.There were many differences in the clinical epidemiology of HFpEF patients in different age groups,and different preventive and therapeutic measures might be needed.