Research on the incidence patterns of heart failure with preserved ejection fraction:Clinical changes over the past 20 years
Objective This study retrospectively analyzed the incidence,clinical characteristics,and evolution of traditional Chinese medicine(TCM)syndrome patterns in patients with heart failure with preserved ejection fraction(HFpEF)over the past 20 years.Methods Patients discharged from the cardi-ovascular department of Xiyuan Hospital,China Academy of Chinese Medical Sciences,during the peak period of cardiovascular diseases(October to December)in 2003,2013,and 2023 were selected.The method of chi-square tests,univariate ANOVA,and Brown-Forsythe ANOVA were used to compare the basic characteristics,comorbidities,medication usage,echocardiographic parameters,and distribution of TCM syndromes among HFpEF patients in these three years.Results(1)The absolute number of HFpEF patients and their proportion within the heart failure population have shown an increasing trend over time.(2)There has been a significant increase in the age of HFpEF patients over time;the left atrial diameter(LAD)and left ventricular posterior wall thickness(LVPW)have also shown significant increase.Over the past 20 years,the comorbidity burden among patients with HFpEF had increased.The primary underlying diseases had consistently been hypertension,coronary artery disease,atrial fibrillation,and diabetes.Additionally,the number and proportion of patients with metabolic diseases such as hyperlipidemia and hyperuricemia had also risen.With the development of new drugs and the promotion of guidelines,there has been a growing trend in the long-term oral use of ACE inhibitors/ARBs/ARNIs and beta-blockers,while the use of cardiotonic drugs has declined.(3)The pattern distribution of TCM syndromes indicated that qi deficiency,blood stasis,and fluid retention were the main syndromes in HFpEF patients.Conclusion Over time,the incidence and severity of HFpEF have increased,associated with an aging population,a higher prevalence of comorbidities,and,in particular,an increase trend in metabolic diseases.The key TCM pathomechanisms in HFpEF,characterized by qi deficiency,blood stasis,and fluid retention,have not changed over time.
heart failure with preserved ejection fractionpatterns of onsetclinical characteristicscomorbiditiesmedication usetraditional Chinese medicine syndrome patternspopulation agingmetabolic diseases
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