Racial Differences of Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Health Disparities

Background:

• Understanding race-related differences in heart failure with preserved ejection fraction (HFpEF) is crucial for effective treatment.
• Existing research has not fully elucidated these potential disparities.

Purpose of the Study:

• To investigate and compare cardiac structure and function across different racial groups in patients diagnosed with HFpEF.
• To identify potential race-specific pathophysiological mechanisms and inform individualized treatment approaches.

Main Methods:

• A comprehensive transthoracic echocardiography was performed on 1,518 patients with HFpEF (360 Asian, 787 White, 171 Black) across three institutions.
• Analysis included clinical characteristics, anthropometrics (BMI, obesity), and detailed echocardiographic parameters of left ventricular (LV) and atrial structure and function.

Main Results:

• Significant differences were observed in age, sex distribution, BMI, and obesity prevalence among racial groups.
• Black patients exhibited greater LV thickening, concentricity, and LV stiffening, while Asian patients showed greater LV and left atrial dilation and higher arterial stiffness.
• Distinct patterns in right ventricular dilatation and left atrial volumes were also noted across racial cohorts.

Conclusions:

• Patients with HFpEF of Asian, Black, and White race demonstrate significant variations in clinical, anthropometric, and cardiac indices.
• These race-related differences highlight the importance of considering individual patient profiles for tailoring treatment strategies in HFpEF.