Perfil clínico e epidemiológico dos pacientes submetidos ao ecocardiograma diagnosticados com insuficiência cardíaca com fração de ejeção reduzida no Hospital da Aeronáutica de Belém no período de janeiro de 2021 a agosto de 2022

Abstract

Heart failure (HF) is a complex clinical syndrome that renders the heart incapable of pumping blood to meet the metabolic demands of the body, either by insufficient output or through high filling pressures. Therefore, understanding the clinical and epidemiological profile of HF patients is essential for implementing algorithms recommended by various guidelines in the treatment of patients at the Hospital da Aeronáutica de Belém (HABE). To analyze and document the clinical-epidemiological profile of patients with reduced and mildly reduced ejection fraction heart failure (HF) treated at the Hospital da Aeronaútica de Belém (HABE). This is a cross-sectional observational study, with a descriptive and analytical approach, using documentary analysis of 47 medical records of patients diagnosed with HF and reduced or mildly reduced ejection fraction. A specific protocol was used for data collection. The Biostat 5.3 program was used for quantitative statistical analysis. 59.6% of the patients were male, and 80.9% were between 60 and 95 years old. Systemic arterial hypertension was found in 59.6% of the patients, followed by diabetes mellitus in 36.2% and coronary artery disease in 29.8%. Ischemic etiology was the most frequent, accounting for 46.8% of the cases. The most common New York Heart Association functional classes were NYHA II, with 23.4% of the patients being asymptomatic from a cardiovascular perspective. Echocardiograms revealed that 59.6% had reduced ejection fraction HF, while 40.4% had mildly reduced ejection fraction HF. In terms of therapy, the standard triple therapy was utilized. The majority of the study's patients with reduced and mildly reduced ejection fraction heart failure were male (59.6%), aged between 60 and 95 years (80.9%), and married (42.6%). Regarding comorbidities, a high presence of diseases strongly associated with HF was found, such as systemic arterial hypertension (59.6%), diabetes mellitus (36.2%), and coronary artery disease (29.8%). Therefore, given the high prevalence of manageable and preventable chronic diseases, it is advisable to provide a multidisciplinary approach involving geriatrics, endocrinology, and nutrition. However, it is important to note that there was a lack of anthropometric records during data collection, which could contribute to better clinical monitoring. Regarding the functional class, a predominance of NYHA II was observed, although this data also suffered from inadequate record-keeping in the medical records. In terms of medication use, there was a high utilization of medications recommended in the triple therapy of the 3rd Brazilian Guideline for Heart Failure. However, there was still a low usage of medications recommended in the most recent guidelines from the American Heart Association/American College of Cardiology (AHA/ACC) and the European Society of Cardiology (ESC). Furthermore, the analysis comparing the most frequently used medications between the two phenotypes, as well as their doses and dosages, was hindered due to the lack of adequate recording.