Methods and results: were examined 1536 patients (mean age 86, 3±2 years) addressed on our hospital with clinic of exertional dyspnoea and/or dyspnoea at rest. On all pts were effectuated ECG, R-thorax and Echocardiography with Colour and Tissue Doppler (VIVID), laboratory measurements.
On 968 pts (63%) dyspnoea were caused of non cardiac diseases and on 568 pts (37%) was diagnosed presence of congestive heart failure (HF). On group with HF reduced ejection fraction (<50%) took place on 488 pts (86 %) (HFrEF) and on 80 pts (14%) were documented HF with preserved (≥50%) ejection fraction (HFpEF).
All HFpEF pts (36 females and 44 males, mean age 88, 6±3 years) had elevated plasma levels of natriuretic peptides (NP) (mean level 906 ±17 pg/ml). In this group, presence of left ventricular diastolic dysfunction (E/e′ >15, Ar-A>30 ms. IVRT/T E- e′ <2) were observed on 47 pts (58%), left atrial enlargement (volume ≥34 ml/m²) with atrial fibrillation (AF) on 48 pts (60%). Pulmonary artery pressures were increased significantly (mean level 57±4 mmHg, p<0, 05) on 45 pts (56%).
Conclusion: The diagnosis of HFpEF on elderly (≥85 years old) pts is cumbersome. Diastolic LV dysfunction is very common in (58 %), but without hair specificity for HfpEF, parameter.
On old pts, diagnosis of HFpEF need to be coupled with others objective measures, such as, plasma levels of NP, LA enlargement, pulmonary hypertension and presence of AF.
