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Clinical Profile and Treatment Management of Heart Failure with Preserved Systolic Function in Rural Setting of India

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DOI: 10.4236/ijcm.2014.55030    2,767 Downloads   3,762 Views   Citations

ABSTRACT

Background: In recent decades, the hospital admission due to heart failure with normal ejection fraction (HFnEF) or diastolic heart failure has increased particularly in elderly patients. However, sufficient data regarding prevalence, etiologies and treatment of diastolic heart failure are not available for Indian population. So, we carried out an observational study to determine clinical profile and medical therapy for patients experiencing diastolic heart failure. Methods: This was prospective observational study carried out in rural area of India for the period of 12 months. All the patients diagnosed with heart failure with normal ejection fraction were included in the study. If the patient was having severe anemia (hemoglobin < 8.00 g/dl), hemodynamically significant valvular disease, prosthetic valve replacement, and ventricular pacemaker, they were excluded. Results: A total of 53 patients diagnosed with HFnEF were included in the study. There were 24 male patients. Hypertension, CAD and diabetes mellitus were present in 33, 24 and 16 patients respectively. 18 patients developed severe diastolic dysfunction and more common in female as compared to male (37.9% vs. 33.3%). Most frequently observed clinical feature was tachycardia (96% cases) followed by pedal edema (86%). The patients were treated according to underlying cause. Conclusions: Diastolic heart failure is more common in elderly patients. In Indian population, diastolic heart failure has been associated with hypertension, diabetes mellitus and coronary artery diseases in most of the cases.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Devasia, T. , Nandibandi, S. , Bhat, R. , Kareem, H. and Thakkar, A. (2014) Clinical Profile and Treatment Management of Heart Failure with Preserved Systolic Function in Rural Setting of India. International Journal of Clinical Medicine, 5, 171-176. doi: 10.4236/ijcm.2014.55030.

References

[1] Cowie, M., Mosterd, A., Wood, D., Deckers, J., Poole-Wilson, P., Sutton, G. and Grobbee, D. (1997) The Epidemiology of Heart Failure. European Heart Journal, 18, 208-225.
http://dx.doi.org/10.1093/oxfordjournals.eurheartj.a015223
[2] Mosterd, A.H., De Bruyne, M., Deckers, J., Linker, D., Hofman, A. and Grobbee, D. (1999) Prevalence of Heart Failure and Left Ventricular Dysfunction in the General Population; The Rotterdam Study. European Heart Journal, 20, 447-455. http://dx.doi.org/10.1053/euhj.1998.1239
[3] Ho, K.K., Pinsky, J.L., Kannel, W.B. and Levy, D. (1993) The Epidemiology of Heart Failure: The Framingham Study. Journal of the American College of Cardiology, 22, 6A-13A. http://dx.doi.org/10.1016/0735-1097(93)90455-A
[4] Levy, E. (2000) Le coût économique de l’Insuffisance Cardiaque. Archives des Maladies du Coeur et des Vaisseaux-Pratique, 86, 9.
[5] Maestre, V.G., Gallego, J., García, M., García de Burgos, F. and Martín-Hidalgo, A. (2009) Prediction Clinical Profile to Distinguish between Systolic and Diastolic Heart Failure in Hospitalized Patients. European Journal of Internal Medicine, 20, 313-318. http://dx.doi.org/10.1016/j.ejim.2008.09.001
[6] Dubourg, O., Gueret, P., Beauchet, A., Nisse-Durgeat, S. and Ducardonnet, A. (2008) Focale: Study of Systolic and Diastolic Heart Failure in a French Elderly Population. International Journal of Cardiology, 124, 188-192.
http://dx.doi.org/10.1016/j.ijcard.2007.01.050
[7] Aurigemma, G.P. and Gaasch, W.H. (2004) Diastolic Heart Failure. New England Journal of Medicine, 351, 1097-1105. http://dx.doi.org/10.1056/NEJMcp022709
[8] Reddy, S., Bahl, A. and Talwar, K. (2010) Congestive Heart Failure in Indians: How Do We Improve Diagnosis & Management? The Indian Journal of Medical Research, 132, 549.
[9] Yturralde, R.F. and Gaasch, W.H. (2005) Diagnostic Criteria for Diastolic Heart Failure. Progress in Cardiovascular Diseases, 47, 314-319. http://dx.doi.org/10.1016/j.pcad.2005.02.007
[10] Hess, O.M., Murakami, T. and Krayenbuhl, H.P. (1987) Influence of Verapamil on Diastolic Left Ventricular Function in Myocardial Hypertrophy of Different Origin. Zeitschrift für Kardiologie, 76, 82-86.
[11] Masoudi, F.A., Havranek, E.P., Smith, G., Fish, R.H., Steiner, J.F., Ordin, D.L. and Krumholz, H.M. (2003) Gender, Age, and Heart Failure with Preserved Left Ventricular Systolic Function. Journal of the American College of Cardiology, 41, 217-223. http://dx.doi.org/10.1016/S0735-1097(02)02696-7
[12] Yancy, C.W., Lopatin, M., Stevenson, L.W., De Marco, T. and Fonarow, G.C. (2006) Clinical Presentation, Management, and In-Hospital Outcomes of Patients Admitted with Acute Decompensated Heart Failure with Preserved Systolic Function: A Report from the Acute Decompensated Heart Failure National Registry (ADHERE) Database. Journal of the American College of Cardiology, 47, 76-84. http://dx.doi.org/10.1016/j.jacc.2005.09.022
[13] Chen, H.H., Lainchbury, J.G., Senni, M., Bailey, K.R. and Redfield, M.M. (2002) Diastolic Heart Failure in the Community: Clinical Profile, Natural History, Therapy, and Impact of Proposed Diagnostic Criteria. Journal of Cardiac Failure, 8, 279-287. http://dx.doi.org/10.1054/jcaf.2002.128871
[14] Acikel, S., Akdemir, R., Kilic, H., Yesilay, A.B., Dogan, M. and Cagirci, G. (2010) Diastolic Heart Failure in Elderly: The Prognostic Factors and Interventions Regarding Heart Failure with Preserved Ejection Fraction. International Journal of Cardiology, 138, 311-313. http://dx.doi.org/10.1016/j.ijcard.2008.06.068
[15] Pernenkil, M., Vinson, M., Janice, M., Shah, M., Atul, S., Beckham, R., Wittenberg, R., Rich, M. and Michael, W. (1997) Course and Prognosis in Patients ≥ 70 Years of Age with Congestive Heart Failure and Normal versus Abnormal Left Ventricular Ejection Fraction. The American Journal of Cardiology, 79, 216-219.
http://dx.doi.org/10.1016/S0002-9149(96)00719-9
[16] McAlister, F.A., Teo, K.K., Taher, M., Montague, T.J., Humen, D., Cheung, L., Kiaii, M., Yim, R. and Armstrong, P.W. (1999) Insights into the Contemporary Epidemiology and Outpatient Management of Congestive Heart Failure. American Heart Journal, 138, 87-94. http://dx.doi.org/10.1016/S0002-8703(99)70251-6
[17] Klapholz, M., Maurer, M., Lowe, A.M., Messineo, F., Meisner, J.S., Mitchell, J., Kalman, J., Phillips, R.A., Steingart, R. and Brown, E.J. (2004) Hospitalization for Heart Failure in the Presence of a Normal Left Ventricular Ejection Fraction Results of the New York Heart Failure Registry. Journal of the American College of Cardiology, 43, 1432-1438. http://dx.doi.org/10.1016/j.jacc.2003.11.040
[18] Cohen-Solal, A. (2002) Diastolic Heart Failure: Myth or Reality? European Journal of Heart Failure, 4, 395-400.
http://dx.doi.org/10.1016/S1388-9842(02)00033-8

  
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