Abstract: TH-PO0302
Progression from Diastolic Dysfunction to Heart Failure with Preserved Ejection Fraction (HFpEF): Role of the Kidneys
Session Information
- Hypertension and CVD: Clinical - 1
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Goyal, Shivi, Rice University, Houston, Texas, United States
- Patel, Rahul, Emory University, Atlanta, Georgia, United States
- Prasad, Anand, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
Background
Diastolic dysfunction (DD) sets the stage for the development of HFpEF, the prevalence of which has been growing rapidly. CKD plays an important role in this progression; however, interactions with other risk factors like aging, obesity, diabetes, hypertension, anemia, etc., commonly present in this paradigm are unclear. We compared patients who had DD without HFpEF with patients who had HFpEF to evalute these interactions.
Methods
In a retrospective cohort design, unselected patients with DD were identified from a hospital-based echocardiography lab database. HFpEF was defined as the presence of DD along with symptoms of HF plus either BNP>85 mg/dl, or congestion on CXR or PASP>35 mmHg. Medical charts were reviewed to identify and document risk factors. Associations were examined using multiple logistic regression analysis.
Results
Table 1 shows the characteristics of the study population (n=206) by the presence of DD (n=56) or HFpEF (n=150). Overall, CKD was highly prevalent (80%). Patients with HFpEF had significantly lower Hgb, A1C, and eGFR and higher rates of CAD, CKD, use of HF medications as compared to patients with DD. There was no significant difference in age, BMI, blood pressure, presence of diabetes, AFib, obstructive sleep apnea, and iron deficiency in the two groups. In logistic regression model including significant variables, male sex (β=-1.5, OR=0.2 [95%CI, 0.04-0.9], p=0.04) and Hgb (β=-0.4, OR=0.67 [95%CI, 0.47-0.9], p=0.014) negatively and CAD (β=2.2, OR=8.9 (95%CI, 1.9-53.9, p=0.008) positively associated with HFpEF.
Conclusion
Female sex, presence of CAD, and anemia, instead of lower eGFR or CKD independently associated with HFpEF. A multidisciplinary approach addressing the modifiable risk factors is essential to prevent the development of HFpEF.