Clinical Profile and Treatment Management of Heart Failure with Preserved Systolic Function in Rural Setting of India

Background: In recent decades, the hospital admission due to heart failure with normal ejection fraction (HFnEF) or diastolic heart failure has increased particularly in elderly patients. However, sufficient data regarding prevalence, etiologies and treatment of diastolic heart failure are not available for Indian population. So, we carried out an observational study to determine clinical profile and medical therapy for patients experiencing diastolic heart failure. Methods: This was prospective observational study carried out in rural area of India for the period of 12 months. All the patients diagnosed with heart failure with normal ejection fraction were included in the study. If the patient was having severe anemia (hemoglobin < 8.00 g/dl), hemodynamically significant valvular disease, prosthetic valve replacement, and ventricular pacemaker, they were excluded. Results: A total of 53 patients diagnosed with HFnEF were included in the study. There were 24 male patients. Hypertension, CAD and diabetes mellitus were present in 33, 24 and 16 patients respectively. 18 patients developed severe diastolic dysfunction and more common in female as compared to male (37.9% vs. 33.3%). Most frequently observed clinical feature was tachycardia (96% cases) followed by pedal edema (86%). The patients were treated according to underlying cause. Conclusions: Diastolic heart failure is more common in elderly patients. In Indian population, diastolic heart failure has been associated with hypertension, diabetes mellitus and coronary artery diseases in most of the cases.