Spoorti Vulavala, Anitha Aswathanarayana, Raghavendra Prasad B. N, Prabhakar Kamarthi
Heart failure is a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. The primary manifestation of heart failure is dyspnoea and fatigue which leads to exercise intolerance and fluid overload which can result in pulmonary congestion and peripheral oedema. Signs and symptoms of heart failure have been classified as being due to left ventricular failure (LVF) or right ventricular failure (RVF). Although most patient initially have LVF, both ventricles eventually fail and contribute to heart failure. The aim of the current study is to evaluate the clinical profile and differentiate systolic and diastolic heart failure. We wanted to study the clinical profile of heart failure patients and identify systolic and diastolic heart failure among those patients using echocardiography. METHODS Total 120 patients aged more than 18 years and who gave informed consent, satisfying Framingham criteria for heart failure were included. Relevant history was collected, and thorough clinical examination was done. Non-invasive modalities like 2D echocardiography was used to assess diastolic dysfunction. Appropriate investigations were rendered, and statistical analysis done using SPSS software version 22.0. Chi-square test of Fischer’s exact test (for 2 x 2 tables only) was used as a test of significance for qualitative data. RESULTS The parameters showed that majority of heart failure patients are males between age group of 51-75 years. Hypertension was the most common comorbidity in these patients. 50.8% of heart failure patients had reduced EF and 40.8% were with preserved EF. 63.26% of the preserved EF patients were females. Presence of anaemia is statistically significant (p<0.001). Statistically significant association was present between coronary artery disease (P<0.001) and reduced EF in our study. Hypertension (67.3%) was most common in patients with preserved EF. No significant association was found with symptoms and signs in heart failure with preserved and heart failure with reduced EF. CONCLUSIONS This study of clinical profiles reaffirms the value of clinical assessment in daily practice which includes chronic HF. Clinical profiles are easy to define, predict prognosis, and appear to do so better than traditional markers of disease severity. These profiles may be useful to guide therapy as the treatment modality differs between patients of reduced and preserved EF.
