Abstract 13978: Biologic versus Imaging Markers Predicting Readmission and Death in Heart Failure With Preserved Ejection Fraction

Abstract

Introduction: Increased B-type Natriuretic Peptide (NT-proBNP) levels have been associated with adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF). Global longitudinal strain (GLS) and wall stress (WS) are frequently reported to be abnormal in these patients as well, but studies examining how structural changes in those with HFpEF affect morbidity and mortality have been scarce. Hypothesis: NT-proBNP is a stronger predictor of death and heart failure readmissions in HFpEF patients when compared to GLS and WS. Methods: We conducted a retrospective study of 237 patients admitted with acute decompensated heart failure, all with EF > 50. Average age was 78 + 11, 69% of patients were female, and average BMI was 29 + 13. GLS was measured using speckled tracing echocardiography and WS was calculated from systolic blood pressure, end-systolic left ventricular (LV) dimension, and end-systolic posterior wall thickness. Results: During a follow-up period of 2 years, 55 patients died and 55 were readmitted with the diagnosis of acute decompensated heart failure. Mean NT-proBNP among all patients was 9982 + 16268, mean GLS -17.84 + 4.52, and mean WS was 52.27 + 25.23. 129 patients had an abnormal or borderline GLS of >-18, whereas nearly all patients (230) had an abnormal WS of <109. (See table for results.) Conclusion: GLS and WS are reduced in a significant proportion of HFpEF patients. However, our data suggests that compared to echocardiographic indices of LV systolic function, biomarkers have a stronger short-term prognostic value.