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Heart failure whit preserved ejection fraction (HFpEF); a mexican cohort

Session Poster Session 1

Speaker Jose Antonio Magana Serrano

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : L Arizmendi (Mexico City,MX), M Rosas-Peralta (mexico city,MX), D Salinas-Morales (mexico city,MX), A Chanona (mexico city,MX), A Contreras (mexico city,MX), E Ramirez-Arias (mexico city,MX), G Castro-Martinez (Mexico City,MX), A Cigarroa-Lopez (mexico city,MX), J Magana Serrano (Mexico City,MX)

Authors:
L Arizmendi1 , M Rosas-Peralta2 , D Salinas-Morales3 , A Chanona3 , A Contreras3 , E Ramirez-Arias3 , G Castro-Martinez1 , A Cigarroa-Lopez3 , J Magana Serrano4 , 1Universidad La Salle, Facultad de Medicina - Mexico City - Mexico , 2Instituto Mexicano del Seguro Social, Programa "A todo Corazón" - mexico city - Mexico , 3cardiology hospital. National Medical Centre "Siglo XXI", IMSS, Division of Heart Failure and Cardiac Transplantation - mexico city - Mexico , 4Hospital of Cardiology at the Siglo XX National Medical Center, Division of Heart Failure and Cardiac Transplantation - Mexico City - Mexico ,

Citation:

Background Several epidemiologic studies indicate that up to 50% of patients with heart failure have a preserved ejection fraction, and this proportion has increased over time. The knowledge of its severity and associated comorbidity is determinant to develop adequate strategies for its treatment and prevention. This study was focus on the creation of a cohort and follow-up of Mexican population and to analyze its severity as well as its interaction with the comorbidity of other cardiovascular risk factors.

Methods We included patients from different sites of Mexico City than were sent to the Cardiology hospital of the National Medical Center in Mexico City for the realization of an Echocardiogram as part of their assessment by the presence of dyspnea, edema, or suspicion of hypertensive heart disease. Complete medical history, physical examination and laboratory studies including Brain Natriuretic Peptide (BNP) serum levels were performed. Diagnosis of diastolic dysfunction was based on symptoms and echocardiographic data including time of deceleration, size of left atrium, e´ septal and e´ lateral, as well as E wave, A wave and its ratio E/A. All patients had left ventricle ejection fraction > 45%.

Results We included 168 patients with HFpEF. The most common risk factor was hypertension (89.2%), followed by overweight and obesity (> 78.5%), dyslipidemia (82.1%) and diabetes (42.8%). Women were dominant, 108 (64.3%); the mean age was 63 years old. When we classify by severity of diastolic dysfunction, we found that 41.1% were grade I, 57.1% were grade II and only 1.8% were grade III. The risk factors most strongly associated with the severity of diastolic dysfunction were hypertension, obesity and dyslipidemia. We found BNP levels highly variables, but the levels were higher detected as the ejection fraction was approaching to 45%. At one year of follow up mortality was not reported. 

Conclusion HFpEF is a frequent entity in patients with cardiovascular risk factors in Mexico. The most common risk factor was hypertension. The combination of hypertension, overweight and dyslipidemia predicted the severity of diastolic dysfunction. We recommend that all Mexican patient with hypertension and overweight or obesity should be submitted as a part of its medical evaluation to an echocardiogram study in order to detect diastolic dysfunction even though the signs or symptoms are or not evident.

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