Analíse das características clínicas e do prognóstico de pacientes internados com insuficiência cardíaca com fração de ejeção preservada

Abstract

Analysis of clinical characteristics and prognosis of hospitalized patients with heart failure with preserved ejection fraction Introduction: Heart failure is a condition responsible for important rates of mortality and hospitalization around the world. This condition is divided into heart failure with either preserved or reduced ejection fraction. These two groups seem to have different pathophysiology, prognosis and treatment plans. Therefore, studies have been performed assessing patients with heart failure with preserved ejection fraction, aiming for a better understanding of this condition and an improvement on the patient management. Objectives: Evaluate the clinical features and the prognosis of patients with heart failure with preserved ejection fraction. Methodology: The present study consists on a retrospective cohort study performed evaluating 518 hospitalized patients with acute heart failure. The ejection fraction was assessed through echocardiography, after which patients were divided into one group with preserved ejection fraction (173 patients) and a second group with reduced ejection fraction (345 patients). Results: Among patients with preserved ejection fraction, the mean age was 61.45 ± 18.56 and 62.4% of the patients were female. The prevalence of diabetes mellitus, hypertension, atrial fibrillation and chronic kidney disease were 17.4%, 73.8% 42.6% and 20.6%, respectively. The average systolic and diastolic blood pressure were 130.07 ± 26.62 mmHg and 78.81 ± 17.34 mmHg. The mean serum levels of sodium, potassium and creatinine were, respectively, 138.69 ± 4.75, 4.30 ± 0.60 and 1.16 ± 0.61 mg/dl. During the hospitalization, 4.6% of the patients with preserved ejection fraction died and the mean period of hospitalization was 18.54 ± 17.04 days. Discussion: Patients presenting heart failure with preserved ejection fraction showed a considerable preference for the female gender and displayed high levels of systolic blood pressure, as well as diabetes, hypertension, atrial fibrillation and chronic kidney disease, especially when compared to the general population. Once hospitalized, patients presented high standard deviations of the period of hospitalization, in addition to significant mortality rates. Conclusions: It appears that patients with heart failure with preserved ejection fraction present a consistent clinical profile and disease progression. However, more studies are necessary, especially involving the Brazilian population, in order to better define the characteristics of this disease.