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

• 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
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2024.101408

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.