Clinical characteristics and correlates of patients with heart failure with mid-range ejection fraction in southwest Nigeria

A new class of Heart Failure (HF) phenotypes, HF with midrange Ejection Fraction (HFmrEF), was recently introduced, but its clinical characteristics and therapeutic distinctiveness are not yet well understood. This study aimed to describe the clinical characteristics, echocardiographic features, and other correlates of HFmrEF in southwest Nigeria. Two hundred and sixty-nine consecutive HF subjects who had echocardiography done in the cardiology clinics of two teaching hospitals were recruited for this study. Clinical parameters such as age, body mass index, waist-hip ratio, and gender were determined. The presence of comorbidities, such as hypertension and diabetes, was also assessed. Statistical analysis was done, and p <0.05 was taken as statistically significant. HFmrEF subjects constituted 27.5% of total cohort, while subjects with HF with preserved Ejection Fraction (HFpEF) and HF with reduced Ejection Fraction (HFrEF) were 29.0% and 43.5% respectively. HFmrEF was more likely to be associated with high systolic blood pressure and obesity. The clinical characteristics of HFmrEF were intermediate between those of the other two HF phenotypes. Prevalence of comorbidities, such as anaemia, iron deficiency, pulmonary hypertension, and left ventricular hypertrophy were also intermediate between HFpEF and HFrEF. Atrial fibrillation was commonest among HFmrEF subjects. There was no significant age or gender variation between the three phenotypes. Patients with HFmrEF have clinical and demographic distinctiveness that are often intermediate between HFpEF and HFrEF phenotypes. Further studies of this HF phenotype will help in understanding its therapeutic identity and its prognosis among Africans.