The Clinical Features Of Heart Failure With Preserved Ejection Fraction

Objective:To analyze the clinical features of heart failure with preserved ejection fraction(HFPEF).Methods:A total of306patients were collected,who admitted to Fujian provincial hospital with a diagnosis of heart failure from January1,2011to December31,2012.They were divided into two groups including174HFPEF cases (56.8%) and132HFREF cases (43.13%).Retrospectively, the general information,basic diseases, clinical manifestations,blood biochemical,Imaging studies were compared between the two groups.Results:1.Compared with HFREF group,the HFPEF patients were older [(77.30±6.74) years v s.(64.77±14.83) years,P<0.05], more female patients (44.8%VS.30.3%, P<0.05),higher body mass index[(25.12±3.94) kg/m2VS.(23.11±3.20) kg/m2],had higher incidence of hypertension (85.1%VS.60.6%,P<0.05) and atrial fibrillation (57.5%VS.22.7%,P<0.05),lower incidence of smoking history(18.4%VS.34.8%) and chronic myocardial infarction (12.6%VS.25.8%,P<0.05).Coronary heart disease (63.8%VS.57.6%)and diabetes(33.3%VS.30.3%)were also common in HFPEF,an-d they were no statistically significant differences between the two groups (P>0.05)2.There was no statistically significant differences in heart functional class by NYHA,bilateral jugular vein filling,pulmonary rales,the edema of lower limbs of two groups(P>0.05).Compared with HFREF group,the HFPEF patients had lower inciden-ce of paroxysmal nocturnal dyspnea (24.2%VS.11.6%,P≈0.04)3.Compared with HFREF group,the HFPEF patients had lower Levels of NT-proBNP,hemoglobin,creatinine,uric acid (P<0.05)。And there were no statistically significant differences in the levels of total cholesterol (TC)、triglyceride (TG)、 low density lipoprotein (LDL-C)、high density lipoprotein (HDL-C) between two groups.4.Compared with HFREF group,the HFPEF patients were less number of cases increased heart shadow in chest radiograph,and the interventricular septum[(1.12±0.24)cm VS.(1.00±0.19)cm,P<0.05]、posterior wall of left ventricle[(0.95±0.16)cmVS.(0.91±0.15)cm,P<0.05] were thicker, left ventricular diameter[(4.68±0.63)cm VS.(5.90±1.13)cm,P<0.05、left ventricular end-diastolic volume index[(42.52±11.42)ml/m2VS.(91.48±29.03)ml/m2,P<0.05] were smaller, maybe more cases of increased pulmonary artery pressure (19.5%VS.10.6%, P<0.05)Conclusion:1.More than half of the patients with heart failure have a normal ejection fraction.Compared with HFREF,the HFPEF patients are more female, aged patients, higher body mass index,hypertension, atrial fibrillation, and Coronary heart disease and diabetes were also common in HFPEF.2.The clinical symptoms and signs is similar between HFPEF and HFREF.The HFPEF patients may be have lower Levels of NT-proBNP,hemoglobin,creatinine,uric acid,Compared to HFREF.3.For the HFPEF,left ventricular thickness is relatively larger and the left ventricular cavity is relatively smaller, tend to centripetal hypertrophy,may have a higher pulmonary artery high pressure consolidation rate Compared with HFREF.