A Comparative Study Of Frality Syndrome In Patients With Heart Failure With Preserved VS Reduced Ejection Fraction

Completed

Conditions: Heart failure, unspecified,

Registration Number: CTRI/2023/06/054583

Lead Sponsor: Dr Srishti Mukhi Department of Medicine

Brief Summary: Background: Heart failure (HF) is a leading cause of cardiovascular morbidity andmortality, with a global prevalence that increases significantly with age. InIndia, HF is primarily associated with coronary heart disease, hypertension,obesity, diabetes mellitus (DM), and rheumatic heart disease. HF is categorizedinto three phenotypes based on left ventricular ejection fraction (LVEF): HFwith reduced ejection fraction (HFREF), HF with preserved ejection fraction(HFPEF), and HF with mid-range ejection fraction (HFmrEF). Frailty, a syndromecharacterized by decreased physiological reserves, commonly coexists with HF,exacerbating its clinical outcomes.

Objectives: This study aimed to estimate the prevalence of frailty syndrome inpatients with HFPEF and HFREF and to compare the prevalence between these twogroups.

Methods: A hospital-based comparative study was conducted over 18 months atGuru Gobind Singh Medical College & Hospital, Faridkot, involving 100 HFpatients aged 40-65 years. Participants were divided equally into HFPEF andHFREF groups. Frailty was assessed using the Fried Frailty Index, whichevaluates five criteria: weight loss, exhaustion, low physical activity, weakhand grip strength, and slow walking speed. The sum score of these five criteria classifies people into oneof three frailty stages (or groups): not frail (score 0), pre frail (score 1â€“2)and frail (score 3-5).Statistical analysis wasperformed using SPSS version 26, with significance set at p <0.05.

Results: The study found that 42% of patients were pre-frail, and 36% werefrail, indicating that the majority (78%) exhibited some degree of frailty.Frailty was significantly more prevalent in HFREF patients (46%) compared toHFPEF patients (26%) (p=0.037). Females in the HFREF group were more likely tobe frail than males (p=0.008). DM was significantly associated with frailty inthe HFPEF group (p=0.024), but not in the HFREF group. Factors such as BMI,hypertension, HF etiology, symptomatology, and echocardiographic findingsshowed no significant association with frailty. However, significantassociations were found between frailty and individual components of the FriedFrailty Index, such as weight loss, slow walking speed, exhaustion, weak handgrip strength, and low physical activity, but they did not differsignificantly between the two groups of heart failure. However, the compositescore of all these components contributing to the Fried Frailty Indexsignificantly differed between the two groups.

Conclusion: Frailty is highly prevalent among HF patients, particularly in thosewith HFREF. The study highlights the importance of assessing frailty usingsimple bedside parameters to guide targeted interventions, which may improveclinical outcomes. Further research is required to explore the interplaybetween frailty and HF to optimize management strategies.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 100

Inclusion Criteria

Subjects aged 40-65 years of either gender with heart failure.

Exclusion Criteria

1.Patients with chronic kidney disease (CKD), chronic liver disease (CLD), bronchial asthma and COPD.
2.Patients with stroke, dementia, neuromuscular disorders 3.Patients with malignancies.
4.Patients suffering from HIV-AIDS.
5.Patients with hypothyroidism.
6.Immunocompromised patients.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
1.FRIED FRALITY INDEX IN HEART FAILURE	BASELINE
2.COMPARISSION OF FRIED FRALITY INDEX BETWEEEN HEART FAILURE WITH PRESERVED AND REDUCED EJECTION FRACTION	BASELINE

Secondary Outcome Measures

Name	Time	Method
SEVERITY OF DISEASE	AT THE END OF 1 YEAR AND 6 MONTHS

Trial Locations

Locations (1): Guru Gobind Singh medical College
🇮🇳
Faridkot, PUNJAB, India
Guru Gobind Singh medical College
🇮🇳Faridkot, PUNJAB, India
DrSrishti Mukhi
Principal investigator
9582686388
srishtimukhi@gmail.com