Lejeune Sibille, Roy Clotilde, Slimani Alisson, Pasquet Agnes, Vancraeynest David, Beauloye Christophe, Vanoverschelde Jean-Louis, Gerber Bernhard L, Pouleur Anne-Catherine
Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc and Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium.
Acta Cardiol. 2021 Sep;76(7):697-706. doi: 10.1080/00015385.2020.1770460. Epub 2020 Jul 17.
Due to aging of the population and the increase of cardiovascular risk factors, heart failure and preserved ejection fraction (HFpEF) is a rising health issue. Few data exist on the phenotype of HFpEF patients in Belgium and on their prognosis.
We describe clinical characteristics and outcomes of Belgian HFpEF patients.
We prospectively enrolled 183 HFpEF patients. They underwent clinical examination, comprehensive biological analysis and echocardiography, and were followed for a combined outcome of all-cause mortality and first HF hospitalisation.
Belgian patients with HFpEF were old (78 ± 8 years), predominantly females (62%) with multiple comorbidities. Ninety-five per cent were hypertensive, 38% diabetic and 69% overweight. History of atrial fibrillation was present in 63% of population, chronic kidney disease in 60% and anaemia in 58%. Over 30 ± 9 months, 55 (31%) patients died, 87 (49%) were hospitalised and 111 (63%) reached the combined outcome. In multivariate Cox analysis, low body mass index (BMI), NYHA class III and IV, diabetes, poor renal function and loop diuretic intake were independent predictors of the combined outcome ( < .05). BMI and renal function were also independent predictors of mortality, as were low haemoglobin, high E/e' and poor right ventricular function.
Belgian patients with HFpEF are elderly patients with a high burden of comorbidities. Their prognosis is poor with high rates of hospitalisation and mortality. Although obesity is a risk factor for developing HFpEF, low BMI is the strongest independent predictor of mortality in those patients.
由于人口老龄化和心血管危险因素增加，射血分数保留的心力衰竭（HFpEF）成为一个日益严重的健康问题。关于比利时HFpEF患者的表型及其预后的数据很少。
我们描述比利时HFpEF患者的临床特征和结局。
我们前瞻性纳入了183例HFpEF患者。他们接受了临床检查、全面的生物学分析和超声心动图检查，并随访全因死亡率和首次因心力衰竭住院的联合结局。
比利时HFpEF患者年龄较大（78±8岁），以女性为主（62%）且合并多种疾病。95%患有高血压，38%患有糖尿病，69%超重。63%的患者有房颤病史，60%有慢性肾病，58%有贫血。在30±9个月的时间里，55例（31%）患者死亡，87例（49%）住院，111例（63%）达到联合结局。在多变量Cox分析中，低体重指数（BMI）、纽约心脏协会（NYHA）III级和IV级、糖尿病、肾功能不全和襻利尿剂的使用是联合结局的独立预测因素（P<0.05）。BMI和肾功能也是死亡率的独立预测因素，低血红蛋白、高E/e'和右心室功能不全同样如此。
比利时HFpEF患者为老年患者，合并症负担重。他们的预后较差，住院率和死亡率较高。尽管肥胖是发生HFpEF的危险因素，但低BMI是这些患者死亡率最强的独立预测因素。
