Heart failure with preserved ejection fraction and systolic dysfunction in the community.
BACKGROUND
In developed countries, heart failure with preserved ejection fraction (HFpEF) is more prevalent than heart failure with reduced ejection fraction (HFrEF) in the community. However, it has not been completely established if this fact is also observed within our community.


OBJECTIVE
To determine the most prevalent form of heart failure (HFpEF or HFrEF) and whether the prevalence of HFpEF is higher in the community.


METHODS
This is a cross-sectional study conducted with patients clinically diagnosed with HF who were seen in community-based health care centers from January to December 2005. Echodopplercardiograms were performed for all patients. The form of HF was stratified according to the presence of abnormalities and the shortening fraction observed on the echodopplercardiogram.


RESULTS
The study evaluated 170 patients (61.0 +/- 13.3 years of age), most of them women and elderly. HFpEF was the more prevalent form of HF (64.2%, p<0.001), affecting mostly elderly women (62%, p = 0.07), whereas the opposite condition, HFrEF, was observed mostly in elderly men (63.6%, p = 0.07). Patients with no HF represented one-third of the cases (27.6%). HFrEF patients had more lower-limb edema, coronary disease, diabetes, chronic renal failure, higher Boston scores and hospital readmissions. Use of alcoholic beverages and smoking were also more common among HFrEF patients.


CONCLUSIONS
HFpEF is the most prevalent form of HF in the community especially among elderly women, whereas HFrEF affects mostly elderly men and is associated with greater clinical severity, main risk factors and no changes in lifestyle. Despite the signs and symptoms of HF, this condition was not confirmed for one-third of the cases.
Moutinho
Marco Aurélio Esposito
MA
Universidade Federal Fluminense, Fundação Municipal de Saúde de Niterói - Programa Médico de Família, Niterói, RJ - Brazil. maesposito@cardiol.br
Colucci
Flávio Augusto
FA
Alcoforado
Veronica
V
Tavares
Leandro Reis
LR
Rachid
Mauricio Bastos Freitas
MB
Rosa
Maria Luisa Garcia
ML
Ribeiro
Mário Luiz
ML
Abdalah
Rosemery
R
Garcia
Juliana Lago
JL
Mesquita
Evandro Tinoco
ET
D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004487:Edema / Q000000981:diagnostic imaging / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D035002:Lower Extremity / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D014463:Ultrasonography