Prognosis in heart failure with preserved ejection fraction

Heart Failure with preserved Ejection Fraction (HFpEF), like other heart failure syndromes, is heterogeneous in etiology and pathophysiology, rather than a single disease. HFpEF may account for about half of all patients with heart failure. Patients have symptoms and signs of HF with normal or near normal left ventricular EF (LV EF>50 %). The classical risk factors for developing HFpEF include advanced age and co-morbidities, notably hypertension, atrial fibrillation, and the metabolic syndrome. When complicated by increasing congestion requiring hospital admission, the prognosis is poor; 30% or more of such patients will die within 1 year (nearly two-thirds die from cardiovascular causes). Patients with chronic stable symptoms have a better prognosis. Patients with HFpEF represent an important group of patients presenting in clinical practice with HF. Overall, it appears that patients with HFpEF are at lower risk of death than patients with HFrEF, although mortality remains high in both groups. Application of the same therapeutic hypotheses that have been successfully utilized among patients with HFrEF have not been demonstrated to result in improved survival

Prediction of functional capacity during six-minute walk among patients with chronic heart failure

Formulae for predicting functional capacity during 6-minue walk are lacking and the accuracy of the existing formulae has been challenged in deferent populations. The purpose of this study was to develop an equation that would be useful in predicting functional capacity in form of maximum oxygen consumption) (V0 ) in Chronic Heart Failure Patients (CHF) during exercise. Sixty-five subjects were recruited for the study. The procedure required the subjects to walk on a self paced speed on a 20 meter marked level ground for 6 minutes. The distance covered in 6 minutes was measured and the speed calculated. The result showed that the distance covered was highly correlated with the VO2 (0.65; p 0.01). The regression analysis revealed that a linear equation model developed was a good predictor ofV0 for the group. The study concluded that in situation where sophisticated equipments are lacking; this equation might be useful during exercise supervision for patients withCHF. [VO2 (ml kg-1 min-1)