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Background: Evaluate the clinical profile of patients presenting with heart failure having normal or preserved ejection fraction and to determine the prevalence of comorbid illnesses in these patients.Methods: The study was carried out on patients that presented with heart failure at the Vadilal Sarabhai hospital, Ahmedabad between September 2014-2016. Heart failure patients with normal ejection fraction (>50%) were selected. Socio-demographic, vital signs, data of 2D Echocardiography and Tissue Doppler study were collected. The patients were classified as per the Echocardiographic study into four categories. Different laboratory parameters were compared in patients with respect to (a) grade of Hypertension (b), grade of anemia (c), HbA1c levels. Statistical analysis was done using the SPSS software v20. Mann-Whitney and Kruskal-Wallis tests were performed to compare the means between different study groups.Results: Out of the 70 patients, a majority (47%) belonged to the Grade 2 (pseudo-normalized) group of diastolic dysfunctions with most of them having only dyspnea and pedal edema (33%). 58.6% patients required intensive care for at least one day. Regarding co-morbidities 27 (38.6%) had hypertension, 34 (48.6%) were diabetic and 49(70%) had anemia. Patients with higher grade of dysfunction had higher HbA1c (p=0.023) and worsening anemia (p=0.003).Conclusions: Authors concluded that it is of prime importance to find, prevent and treat the comorbidities along with targeted therapies for HFpEF. Further evaluation can be done for clinical applicability of different markers including HbA1c and U.ACR for renal dysfunction in HFpEF.
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Background and Objective: Microalbuminuria is a well accepted marker for micro and macrovascular damage in patients with diabetes mellitus. There is growing evidence that microalbuminuria is an important risk indicator for development of ischemic heart disease. This study was conducted to establish a relationship between microalbuminuria and ischemic heart disease in non-diabetic subjects. Methodology: Fifty randomly selected non-diabetic patients with ischemic heart disease who fulfilled the criteria for the study were evaluated for traditional risk factors and microalbuminuria. Results: Microalbuminuria was detected in 36 (72%) patients with Ischemic Heart Disease (p<0.05). 77% patients with infarct pattern on ECG and 22% patients with ischemia pattern on ECG had microalbuminuria. Majority of patients had microalbuminuria levels between 30-100 mg/day (41% males and 64% females). 72.72% of female patients had microalbuminuria (MA) compared to 71.79% of the male patients. 71.79% of hypertensive patients had microalbuminuria compared to 72.72% of normotensive patients. 79.17% of smokers with microalbuminuria presented with myocardial infarction compared to 62.5% of non-smokers with microalbuminuria. MA level is also associated with ECG (LVH, QTc prolongation) and 2D ECHO findings. Conclusion: Our patients with ischemic heart disease had a significantly positive association with microalbuminuria. Hence, microalbuminuria can be regarded as an additional risk factor for ischemic heart disease.