Abohammar Samah, ElSaidy Mona Adel, Fathalla Diaa, Aldosarri Mubarak
Tanta University Hospital, Cardiology Department, Egypt.
King Saud Medical City, Cardiology Department, Riyadh, Saudi Arabia.
Egypt Heart J. 2017 Mar;69(1):21-28. doi: 10.1016/j.ehj.2016.08.002. Epub 2016 Sep 3.
Heart failure and preserved ejection fraction (HFpEF) is defined as heart failure symptoms and signs with a normal or near-normal ejection fraction (EF) with evidence of diastolic dysfunction. The few Middle Eastern studies that have been conducted were designed to compare patients with heart failure reduced ejection fraction (HFrEF) and HFpEF.The aim of this study was to study Saudi patients with HFpEF who presented with acute heart failure, and define their clinical characteristics and the signs and symptoms of heart failure, echocardiographic findings and medications at admission and at hospital discharge.
This is a prospective observational study in which patients were included following an acute heart failure presentation with N-terminal pro-BNP (NT-proBNP) > 300 ng/L and left ventricular ejection fraction (LVEF) > 50%. They were admitted to the coronary care unit of king Saud medical city from the period of March 2015 to September 2015.
114 patients were enrolled in the study and assessed at acute admission. Of these, 4% died on day one of admission.The mean ± SD age of 109 included patients was 59 ± 8 years and 55% were women. Hypertension (64%), dyslipidemia (76%), atrial tachyarrhythmia (38%), prior heart failure (33%) and anemia (35%), median NT-proBNP was 2490 ± 125 ng/l at admission. Mean (LVEF) was 61 ± 3, mean LV mass index was 118 ± 11, mean /' was 12.2 ± 2, and left atrial volume index was 47 ± 7 mL/m. Mean global left ventricular strain was -13.5 ± 1.5. At discharge the majority of patients were still symptomatic with high NT-proBNP 542 ± 266.
Patients with HFpEF were old with slight female dominance, a high rate of hypertension, diabetes, dyslipidemia and much comorbidity. LVEF was preserved despite depressed left ventricular longitudinal and diastolic functions with high filling pressure. At discharge the patients were still symptomatic calling for further research to reach the best strategy for proper management.
射血分数保留的心力衰竭（HFpEF）定义为伴有舒张功能障碍证据的、具有正常或接近正常射血分数（EF）的心力衰竭症状和体征。少数中东地区开展的研究旨在比较射血分数降低的心力衰竭（HFrEF）患者和HFpEF患者。本研究的目的是研究因急性心力衰竭就诊的沙特HFpEF患者，明确其临床特征、心力衰竭的症状和体征、入院时及出院时的超声心动图表现和用药情况。
这是一项前瞻性观察性研究，纳入急性心力衰竭就诊且N末端脑钠肽前体（NT-proBNP）>300 ng/L、左心室射血分数（LVEF）>50%的患者。他们于2015年3月至2015年9月期间入住沙特国王医疗城冠心病监护病房。
114例患者纳入研究并在急性入院时进行评估。其中，4%在入院第1天死亡。109例纳入患者的平均年龄±标准差为59±８岁，55%为女性。高血压（64%）、血脂异常（76%）、房性快速心律失常（38%）、既往心力衰竭（33%）和贫血（35%），入院时NT-proBNP中位数为2490±125 ng/L。平均（LVEF）为61±3，平均左心室质量指数为118±11，平均E/A为12.2±2，左心房容积指数为47±7 mL/m²。平均左心室整体应变率为-13.5±1.5。出院时，大多数患者仍有症状，NT-proBNP较高，为542±266。
HFpEF患者年龄较大，女性略占多数，高血压、糖尿病、血脂异常发生率高且合并症多。尽管左心室纵向和舒张功能降低且充盈压高，但LVEF仍保留。出院时患者仍有症状，需要进一步研究以找到最佳的合理管理策略。
