Characteristics of heart failure with a preserved ejection fraction in black South African patients

Characteristics of heart failure with a preserved ejection fraction in black South African patients

Heart failure with a preserved ejection fraction (HFpEF) is common in the elderly (≥75 years) and associated with arterial stiffness. The mean age of HFpEF presentation is lower (40–55 years) in sub-Saharan Africa. No clinical study has been conducted on HFpEF in identifying and characterising this...

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Bibliographic Details
Published in:International journal of cardiology. Heart & vasculature Vol. 52; p. 101408
Main Authors: van Hoogland-van Heerden, M, Böhmer, LH, Heyneke, O, Lechaba, T, Scott, L, Norton, G, Woodiwiss, A, Mntla, P, Majane, OHI
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01-06-2024
Elsevier
Subjects:
Biomarkers
Cardiovascular disease
Haemodynamics
Heart failure with a preserved ejection fraction
Hypertension
Original Paper
Risk factors
LVM
MAPc
SBPc
LVMI
LWPWd
LVEF
Cardiovascular disease
DM
HR
LV
HFpEF
HT
LVEDd
FS
HFrEF
Risk factors
BP
DBPc
SD
NT-proBNP
ESC
APOGH
HbA1c
BMI
Hypertension
Heart failure with a preserved ejection fraction
PPc
LA/Ao
ROC
LA/LV
IQR
HFmrEF
PWV
RWT
LAE
PPp
TOPCAT
LA
Biomarkers
Haemodynamics
LVESd
IVSd
HF
LVH
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Summary:Heart failure with a preserved ejection fraction (HFpEF) is common in the elderly (≥75 years) and associated with arterial stiffness. The mean age of HFpEF presentation is lower (40–55 years) in sub-Saharan Africa. No clinical study has been conducted on HFpEF in identifying and characterising this phenotype at a younger age, moreover in a South African black population where the risk of HFpEF is two times higher than in other ethnic groups. This study investigated the characteristics of HFpEF in a black South African population, the biochemical markers that predict HFpEF and cardiac structural changes in this HF phenotype. Sixty-six participants with HFpEF and 213 controls were enrolled. All participants gave informed consent and completed a standardised questionnaire. Echocardiographic, anthropometric, central haemodynamic measurements, pulse wave velocity (PWV) and biomarker analysis were done. The mean age of HFpEF participants was 54.88 ± 13.51 years. Most of the participants (76 %) were between 20 and 64 years, while only 24 % were older. HFpEF participants were hypertensive, and more obese with increased incidence of alcohol consumption. PWV was increased in HFpEF (9.97 ± 2.78 m/s) when compared to participants without HFpEF (6.11 ± 2.18 m/s), p < 0.0001. There were no significant associations between central haemodynamic parameters, N-terminal pro B-type natriuretic peptide (NT-proBNP) (p = 0.9746), and galectin-3 (p = 0.2166). NT-proBNP, but not galectin-3, was associated with left ventricular hypertrophy (p = 0.0002) and left atrial diameter (p = 0.0005). HFpEF in South Africa is predominant in obese young to middle-age individuals with arterial stiffness and who consume alcohol regularly. NT-proBNP could be used to diagnose HFpEF, however, should be interpreted with caution in populations with a high prevalence of obesity.
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This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
ISSN:2352-9067
2352-9067
DOI:10.1016/j.ijcha.2024.101408