IJCS | Volume 33, Nº1, January / February 2019

47 Table 1 - Comparison of groups in relation to demographic, clinical, therapeutic, laboratory and outcome variables Variables Total LVEF p < 40% 40 – 49% ≥ 50% Age – Mean (SD) 42.9 (13.6) 70.3 (14.4) +/++ 75.2 (12.4) 74.6 (12,9) 0.003* Age ≥ 65 years (%) 75.2 67.6 80.6 81.3 Male (%) 58.6 67.8 58.9 45.3 < 0.001* FC IV (%) 52.3 55.3 52.4 47.9 0.392 Etiology (%) < 0001* Ischemic 52.3 57.1 56.3 41.8 Hipertensive 19.5 11.3 18.0 32.9 Idiopathic 8.6 10.4 11.7 3.4 Valve 11.5 8.0 10.2 17.8 Others 8.0 13.2 3.9 4.1 (Version 21.0. Armonk, NY: IBM. Corp.) software was used to perform statistical analysis. The level of significance assumed was 5%. The research project was approved by the Ethics Committee in Research of the Catholic University of Pernambuco UNICAP/PE (CAAE: 70897517.8.0000.5206). The study was conducted in accordance with the principles of the Declaration of Helsinki. Results A sample of 599 patients was collected between January 2007 and March 2017. Out of these, 106 did not have any LVEF data available and were not included in the analysis. A total of 493 patients fulfilled the inclusion and exclusion criteria of the study. From the sample studied, most HF individuals (43%) were classified with LVEF < 40%, followed by 30% of with LVEF ≥ 50% and 26% with LVEF 40-49%. The age of the patients varied from 20 to 99 years, with a mean of 73 (SD = 14) years, 370 (75%) were 65 years old or more, with men accounting for the majority of them (59%), Functional Class (FC) IV (52%), ischemic etiology (52%), followed by hypertensive (19%) and idiopathic (9%) etiologies. The outcome in-hospital death was 14% of the sample. Nineteen percent of patients were readmitted within 30 days. Among themost frequent comorbidities found, we can highlight: systemic arterial hypertension (SAH) in 87% of patients; diabetes mellitus (DM) in 51% and coronary insufficiency (CI) in 59%. In a comparative analysis, the groups were significantly distinct with regard to SAH and CI, being more frequent in HFmrEF patients; valve disease and alcoholismweremore common inHFpEF and HFrEF, respectively. The main cause for decompensation was acute coronary syndrome - ACS (38%), followed by infection (33%) and arrhythmia (atrial fibrillation). In relation to pharmacological therapeutics during hospitalization, the use of beta-blockers was observed in 73%of patients, angiotensin converting enzyme inhibitors (ACEi) / angiotensin II receptor blockers (ARB) in 68%and aldosterone receptor antagonist spironolactone in 42%. When the three groups were comparatively analyzed (Table 1), HFpEF and HFmrEF patients were older, with a prevalence of female patients, compared to the HFrEF group,whichhadaprevalence ofmales (68%). Ischemic and idiopathic etiologies were observed in a higher percentage of HFrEF and HFmrEF patients, whereas the hypertensive and valve etiologies weremore frequent among thosewith HFpEF.ACSwas themain cause for decompensation, being more frequent inHFmrEF (46%), followedbyHFrEF (39%). Hypertension andCIweremore prevalent amongHFmrEF patients (93%and 67%, respectively), whereas valvedisease accounted for ahigherproportion inHFpEF, andalcoholism in the HFrEF and HFmrEF groups. In relation to systolic blood pressure (SBP) at admission, the values were lower in patients with HFrEF. As to heart rate (HR) and NYHA functional Cavalcanti et al. Decompensated heart failure with intermediate ejection fraction Int J Cardiovasc Sci. 2020;33(1):45-54 Original Article