Publication:

Clinical and echocardiographic features in patients with different phenotypes of heart failure

Background Despite the advancements in heart failure (HF) management, a gap remains in distinguishing the clinical and echocardiographic profiles among the different phenotypes of HF, particularly in HF with mid-range ejection fraction (HFmrEF). The aim of the current study was to establish clinical and echocardiographic differences in patients with HF with reduced and mid-range left ventricular ejection fraction (LVEF).

Methods The study included 80 patients with chronic HF with LVEF less than 50% who were divided into two groups: HF with reduced ejection fraction (HFrEF) (n=45) and HFmrEF (n=35). All patients underwent clinical, laboratory, and instrumental studies, including transthoracic echocardiography. Statistical analysis was performed using «STATISTICA 12.0».

Results Patients of both groups were predominantly male (p>0.05), comparable in age prevalence of atrial fibrillation and diabetes mellitus (p>0.05). Patients with HFmrEF more often suffered from hypertension (p=0.04) and stable angina class 3 (p=0.010). Laboratory markers in both groups had no significant differences except for NT-proBNP levels (p=0.031), which were higher in patients with HFrEF. Patients with HFrEF had higher linear and volumetric parameters of both atria and ventricles (p<0.05), which demonstrated undeniable correlation between LVEF and other heart diameters and volumes.

Conclusions Our study showed that patients with HFmrEF have significant differences from HFrEF (higher incidence of hypertension, lower NYHA class and NT-proBNP levels). This highlights that the further study of clinical and laboratory characteristics of HFmrEF should be conducted.