Research Newsletter Archive

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Heart failure with preserved ejection fraction (HFpEF) is increasingly being recognized as a leading cause of heart failure-related hospitalization and death, with its impact projected to exceed that of heart failure with reduced ejection fraction (HFrEF) over the coming years in part due to an aging population. The treatment has been challenging by a dearth of proven therapies and its overlap with other clinical syndromes, as well as a historical lack of diagnostic criteria. Existing research on heart failure among Hispanics have shown a rather high prevalence of cardiac dysfunction on echocardiography with only a minority of such cases resulting in overt clinical heart failure, as well as a younger median age of hospitalization for HFpEF compared to their non-Hispanic white counterparts.

This project undertaken by Dr Kim and his team is a sub-study of the Cameron County Hispanic Cohort (CCHC) study, a result of collaboration between the McGovern School of Medicine at UT Health Sciences Center in Houston and the UT School of Public Health in Brownsville. The study involves a multi-generational, and ethnically homogenous population. Prior studies have noted a high prevalence of cardiometabolic disease compared to the US population at large, placing this cohort at increased lifetime risk for the development of HFpEF. The aim was to assess the prevalence of and identify risk factors for the development of HFpEF in this minority population.

The study included over 1200 patients who underwent routine echocardiography over a decade, excluding those with reduced left ventricular ejection fraction (<50%) as well as co-morbid cardiovascular disease. Using the H2FPEF score, both echocardiographic parameters and clinical data were utilized to quantify the prevalence of sub-clinical HFpEF among the participants. Subjects were then stratified based on score into categories of low and intermediate-high risk, as well as by age. Several key findings were identified. Approximately half the patients in the study cohort were found to be at increased risk for HFpEF based on the H2FPEF score. Among young patients (<60 years old), the metabolic syndrome (as determined by the standard criteria for hypertension, dyslipidemia, waist circumference, and hyperglycemia) was found to be a significant risk factor for the development of HFpEF in this population, even after adjusting for co-variates such as body mass index. Based on these findings, Dr Kim et al concluded that the previously clinically validated H2FPEF score is a simple and useful tool to help identify those in this ethnic group at risk for HFpEF.

Since Hispanics represent a rapidly growing ethnic group in the United States, with most recent US Census data projecting representation of over 20% of the US population by the year 2030, this is a very important study to help identify high-risk groups for early initiation of preventive and life-saving therapies before transition to symptomatic HF.

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