Clinical Characteristics And Prognosis Analysis Of 153 HFmrEF Patients

Objective:This study aims to collect the differences in etiological composition,demographic characteristics,clinical characteristics,laboratory examination,echocardiography data,drug therapy and prognosis of HFmrEF patients,HFp EF patients and HFr EF patients,and to explore the related factors affecting the prognosis of different types of heart failure group,so as to provide certain reference value for clinical treatment.Methods:The differences in etiological composition,clinical characteristics,biochemical laboratory examination,echocardiography data,drug therapy and prognosis situation among HFmrEF patients 、HFp EF patients and HFr EF patients were collected,analyzed,observed and compared.Results:(1)In this study enrolled a total of 654 patients have CHF,which meeting the specific diagnostic criteria,data shows they were 434 males(66.4%)and 220 females(33.6%).Their age ranged from 19 to 91 years old(68.43±12.61).According to the LVEF value of echocardiography at enrollment,202 cases were found in the HFp EF group,153 cases in the HFmrEF,and 299 cases were devided to the HFr EF.The patients with HFr EF were younger in age and most of them were male,followed by HFmrEF.HFmrEF patient’s heart rate was faster than that of the HFPEF group and slower than that of the HFr EF group.The basic diseases of HFmrEF patients included in this study were mainly coronary heart disease(75.8%),hypertension(69.3%),diabetes mellitus(40.5%),etc which were different from those of HFp EF patients and HFr EF patients.(2)For HFmrEF patients,their laboratory examination of Scr,uric acid,the glucose value since morning,high density lipoprotein(HDL-C),neutrophil/lymphocyte ratio(NLR),brain natriuretic peptide precursor amino terminal type(NT-pro BNP)level,in the middle level of HFp EF patients and HFr EF patients(P < 0.05).Spearman correlation analysis verified that the types of CHF patients in the three groups were positively correlated,Scr,uric acid,glucose,NLR,NT-pro BNP,LA and LVEDD are positively.;However HDL-C level and LVEF are negatively.(3)According to the AHEAD score,the AHEAD score of HFmrEF patients ranged from 0 to 4,and the proportion of AHEAD score of 1(39.9%)and 2(26.8%)was relatively high.The log-rank test showed that the all-cause mortality was different among HFp EF patients,HFmrEF patients and HFr EF patients according to the survival analysis,and HFr EF had the highest all-cause mortality.The same was true for the rate of readmission due to heart failure among the three groups,and the difference was statistically significant(P <0.05 for all).The 1-year cumulative survival rate of the three groups was calculated as 95.5% in the HFp EF group,94% in the HFmrEF group and 86.3% in the HFr EF group.The cumulative rate of no readmission in each group was73.1% in the HFp EF group,63.6% in the HFmrEF group and 51.2% in the HFr EF group.Conclusion:HFmrEF is a special type of heart failure different from HFp EF and HFr EF.AHEAD score,heart failure type and NT-pro BNP are related to poor prognosis of CHF patients.