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A A Garganeeva1, E A Kuzheleva, M A Kuzmichkina

  • 1Tomsk National Research Medical Center of the Russian Academy of Science, Cardiology Research Institute. fake@neicon.ru.

Kardiologiia
|January 10, 2019
PubMed
Summary

Heart failure (HF) patient characteristics changed between 2002 and 2016, with fewer symptomatic cases and increased HFpEF diagnoses. Guideline-directed medical therapy for heart failure with reduced ejection fraction (HFrEF) improved, but HFpEF diagnosis warrants review.

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Heart failure (HF) is a complex clinical syndrome with evolving diagnostic criteria and treatment strategies.
  • Understanding temporal trends in HF patient characteristics and management is crucial for optimizing care.
  • Previous studies highlight variations in HF epidemiology and treatment across different healthcare settings.

Purpose of the Study:

  • To compare the clinical characteristics and management of hospitalized heart failure patients in 2002 versus 2016.
  • To identify changes in the prevalence of different HF subtypes (HFpEF, HFrEF, HFmrEF) over time.
  • To assess trends in the prescription of evidence-based medications for heart failure patients.

Main Methods:

  • Retrospective analysis of medical records for patients admitted with a heart failure diagnosis.

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  • Comparison of two distinct three-month periods: January 2002 (n=210) and January 2016 (n=378).
  • Evaluation of patient symptoms, diuretic use, HF classification, and medication prescriptions.

    • Main Results:

    • Fewer patients presented with symptoms or required diuretics in 2016 (63%) compared to 2002 (98.6%).
    • The proportion of heart failure with preserved ejection fraction (HFpEF) increased significantly (58.6% to 74.1%), while heart failure with mid-range ejection fraction (HFmrEF) declined (21.9% to 11.9%).
    • Prescription rates for beta-blockers and aldosterone antagonists in heart failure with reduced ejection fraction (HFrEF) significantly increased, while ACEi/ARB prescription remained similar.

    Conclusions:

    • Improved guideline-directed medical therapy (GDMT) for HFrEF patients was observed in 2016.
    • The rise in HFpEF diagnoses, often without typical symptoms or diuretic needs, raises questions about diagnostic accuracy.
    • Further research is needed to refine HF diagnostic criteria and management strategies, particularly for HFpEF.