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Prevalence of echocardiographic findings compatible with Preserved Ejection Fraction Heart Failure in a real-world practice
Session:
Sessão de Posters 40 - Insuficiência cardíaca - da Preservada ao Transplante
Speaker:
António Baptista Carvalho
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
António Baptista Carvalho; José Ferreira Santos; Duarte Espregueira Mendes; Rita Gomes; Rita Rodrigues; Rita Santos; Isabel Melo; João Santos; Telma Martins; Joana Patinha; João Colaço; Lígia Mendes
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Diagnosing heart failure with preserved ejection fraction (HFpEF) poses challenges. The current criteria, outlined in the ‘HFA–PEFF diagnostic algorithm’, rely on parameters obtained through transthoracic echocardiography. However, some of these criteria are commonly encountered in clinical practice.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objective: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">To determine the prevalence of echocardiographic findings aligning with Heart Failure with Preserved Ejection Fraction, as per the ‘HFA–PEFF diagnostic algorithm’, among patients with suspected hypertension.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We retrospectively evaluated consecutive patients referred for ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography over a one-year period at a single center. Patients with LVEF <50% +</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">and severe valvular disease were excluded. Echocardiographic assessments and ABPM followed best practices. We assessed the prevalence of functional and morphological criteria defined in the ‘HFA–PEFF diagnostic algorithm’. The identified findings compatible with HFpEF were compared among different age groups (<50 years, 50-69 years, and ≥70 years) and hypertension status.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Our analysis involved 1888 patients (average age 60 ± 13 years, 49% female). Of these, 20.4% exhibited normal blood pressure on ABPM, 47.9% had controlled hypertension, and 31.7% had uncontrolled hypertension. Only 1.6% had a previous HFpEF diagnosis. On average, patients showed 2.19 ± 1,67 echocardiographic findings aligning with the 'HFA–PEFF diagnostic algorithm' criteria (corresponding to an average 2.36 points). Overall, 43.7% of patients had at least one major functional criterion (most commonly, e’ lateral < 10 cm/s, observed in 38.4%), while 61.2% had at least one major morphological criterion (most frequently, LAVI > 34ml/m2, seen in 61.1%). Additionally, 30.9% exhibited both major functional and morphological criteria (4 points). Only 11.8% of patients showed no minor or major criteria for HFpEF (0 points). Stratifying by age and blood pressure control revealed a significant increase in prevalence of findings compatible with the 'HFA–PEFF diagnostic algorithm' criteria (refer to figure).</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Echocardiographic findings consistent with HFpEF are highly prevalent and widespread in real-world clinical practice, increasing with advancing age and in patients with hypertension. Integrating these echocardiographic criteria with natriuretic peptides in appropriate clinical setting, could yield a high prevalence of HFpEF.</span></span></p> <div> <div> </div> </div>
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