Characteristics and Temporal Trends in the Mortality of Different Heart Failure Phenotypes in Primary Care

• Published in: Arquivos brasileiros de cardiologia Vol. 117; no. 2; pp. 300 - 306
• Main Authors: Jorge, Antonio José Lagoeiro, Barbetta, Leticia Mara Dos Santos, Correia, Eduardo Thadeu de Oliveira, Martins, Wolney de Andrade, Leite, Adson Renato, Saad, Maria Auxiliadora Nogueira, Santos, Márcia Maria Sales Dos, Correia, Dayse Mary, Rosa, Maria Luiza Garcia, Chermont, Sérgio, Santos, Cárita Cunha Dos, Mesquita, Evandro Tinoco
• Format: Journal Article
• Language: English; Portuguese
• Published: 01.01.2021
• ISSN: 1678-4170
• DOI: 10.36660/abc.20190912

BACKGROUNDThe classification of heart failure (HF) by phenotypes has a great relevance in clinical practice. OBJECTIVEThe study aimed to analyze the prevalence, clinical characteristics, and outcomes between HF phenotypes in the primary care setting. METHODSThis is an analysis of a cohort study including 560 individuals, aged ≥ 45 years, who were randomly selected in a primary care program. All participants underwent clinical evaluations, b-type natriuretic peptide (BNP) measurements, electrocardiogram, and echocardiography in a single day. HF with left ventricular ejection fraction (LVEF) < 40% was classified as HF with reduced ejection fraction (HFrEF), LVEF 40% to 49% as HF with mid-range ejection fraction (HFmrEF) and LVEF ≥ 50% as HF with preserved ejection fraction (HFpEF). After 5 years, the patients were reassessed as to the occurrence of the composite outcome of death from any cause or hospitalization for cardiovascular disease. RESULTSOf the 560 patients included, 51 patients had HF (9.1%), 11 of whom had HFrEF (21.6%), 10 had HFmrEF (19.6%) and 30 had HFpEF (58.8%). HFmrEF was similar to HFpEF in BNP levels (p < 0.001), left ventricular mass index (p = 0.037), and left atrial volume index (p < 0.001). The HFmrEF phenotype was similar to HFrEF regarding coronary artery disease (p = 0.009). After 5 years, patients with HFmrEF had a better prognosis when compared to patients with HFpEF and HFrEF (p < 0.001). CONCLUSIONThe prevalence of ICFEI was similar to that observed in previous studies. ICFEI presented characteristics similar to ICFEP in this study. Our data show that ICFEi had a better prognosis compared to the other two phenotypes.