Changes in biomarker and myocardial structural change and risk factors of heart failure with preserved versus reduced ejection fraction

Abstract

Background: The prognosis of chronic heart failure is poor, with a reported 40–50% mortality rate within the first five years after clinical symptom development. Heart failure preserved ejection fraction and heart failure reduced ejection fraction discriminate by gender, risk factors, and structural changes. Yet, there is no comprehensive study on the classification of heart failure according to LVEF and risk factors of CHF in Mongolia. That’s why this topic was chosen. Aim: To determine the type of chronic heart failure using clinical criteria, biomarkers and echocardiography and investigate the relationship with age, sex, risk factors and structural changes. Materials and Methods: This cross-sectional study included adults aged above 18 years and used. Patients with clinical symptoms of heart failure were selected according to the Framingham criteria. The classification of heart failure according to LVEF was determined using the NT pro BNP and echocardiography in selected individuals. Risk factors of heart failure were detected by questionary and physical examinations. Results: In total 96 people aged 18-86 years enrolled in this study. Of which, 36 (37.5%) were men, 60 (62.5%) were women and median age was 56.7±14.5 years. Heart failure with preserved ejection fraction prevalence increased with age and it was statistically significant (p=0.004). Obesity (p=0.02) and diabetes (p=0.04) were statistically significant risk factors for heart failure with preserved ejection fraction (HFpEF) in women, while hypertension (p=0.04, p=0.03) and atrial fibrillation (p= 0.01, p=0.02) was heart failure with preserved ejection fraction (HFpEF) equally in men and women. On the other hand ischemic heart disease was significant risk factor for heart failure with reduced ejection fraction (HFrEF) in men and women (p=0.000). HFrEF was most common in the group with eccentric hypertrophy (46%, p-0.000), whereas HFPEF incidence was highest in those with concentric hypertrophy (16%, p-0.000). Conclusions: Heart failure with reduced ejection fraction were at their highest rates at ages 50-59, while the prevalence of heart failure with preserved ejection fraction increased with age. Age, obesity, diabetes, hypertension and atrial fibrillation were identified as the foremost risk factors in the heart failure with preserved ejection fraction. Ischemic heart disease was significant risk factor for heart failure with reduced ejection fraction. HFrEF was most common in the group with eccentric hypertrophy, whereas HFPEF incidence was highest in those with concentric hypertrophy.