Investigation of clinical and echocardiographic characteristics of heart failure patients with mid-range ejection fraction followed in OUR clinic

Aim: The aim of this study is to investigate the demographic, clinical and echocardiographic characteristics of patients with mid-range ejection fraction heart failure (MrEF-HF) diagnosed and followed in our clinic, by comparing them with the characteristics of HF patients with reduced and preserved EF. Methods: The study included 54 chronic, euvolemic HF patients over 18 years of age, newly diagnosed according to the diagnostic algorithms of the current HF guidelines or previously diagnosed and followed up. The study population consisted of patients admitted to the cardiology outpatient clinic or hospitalized with the diagnosis of acute HF and made euvolemic before discharge. Patients were divided into three groups according to left ventricular (LV) EF; HF with reduced EF (REF-HF) (40% and below), HF with MrEF-HF (41-49%), and HF with preserved EF (PEF-HF) (50% and above). The demographic characteristics, clinical characteristics, and structural and functional parameters which obtained by 2-dimensional echocardiography of patients were recorded. The characteristics of the MrEF-HF group were evaluated with statistical analysis and compared with REF-HF and PEF-HF groups. Results: Each group consisted of 18 patients. Among the echocardiographic parameters, mitral E wave velocity deceleration time, left atrial longitudinal dimension, LV ejection time, LV end-systolic and end-diastolic dimensions and LV end-systolic and end-diastolic volumes were statistically different in the MrEF-HF group from the REF-HF group and found similar with PEF-HF group. The uses of mineralocorticoid receptor antagonists, furosemide and beta blockers of MrEF-HF group were statistically different from the REF-HF group and similar to the PEF-HF group. Echocardiographic parameters such as interventricular septal thickness, right ventricular Tei index and LV Tei index were found to be statistically different between REF-HF and PEF-HF groups; these parameters of MrEF-HF group were numerically between the other two groups and statistically similar to the other two groups. While age, which is one of the demographic data, was found statistically different between REF-HF and PEF-HF groups; age in the MrEF-HF group was numerically between the other two groups and statistically similar to the other two groups. No significant differences were found between the groups in all other demographic, clinical and laboratory findings. Conclusion: Our results showed that the echocardiographic findings of patients with MrEF-HF were substantially similar to those of patients with PEF-HF and also MrEF-HF may be a region of transition or overlap between REF-HF and PEF-HF.