To analyze the clinical and pathological characteristics of heart failure with preserved ejection fraction(HFpEF)in advanced elderly patients.

Systematic anatomical data from pathology database of Beijing Hospital from April 1969 to October 2013 were retrospectively analyzed.The 154 HFpEF patients aged(85.7±7.4)years with left ventricular ejection fractions(LVEF)≥50%, and 49 patients aged(82.8±7.8)years who had heart failure with reduced LVEF ≤40%(HFrEF)were included.Clinical feature and pathological changes of heart and other organs were compared between patients with HFpEF and HFrEF, and between groups aged less 80 years versus over 80 years in HFpEF patients.

The parameters were higher in HFpEF group versus in HFrEF group as follows: the average age of patients(85.7±7.4 vs.82.8±7.8 years, P=0.017), hypertension(80.5% or 124 cases vs.26.5% or 13 cases, P<0.001), diabetes mellitus(58.4% or 90 vs.20.4% or 10 cases, P<0.001), atrial fibrillation(65.6% or 101 cases vs.12.2% or 6 cases, P<0.001)and chronic obstructive pulmonary disease(COPD)(26.6% or 41 cases vs.4.1% or 2 cases, P=0.001). As compared with HFpEF patients aged 61-85 years group, the same HFpEF patients aged 86-99 years group had significantly increased proportion of atrial fibrillation(P=0.046), of COPD(P=0.002), of senile degenerative heart valvular disease(P=0.009), of chronic myocardial ischemia(P=0.027), of mini-focal old myocardial infarction(P=0.041)and of emphysema(P=0.005).

The proportion of patients with HFpEF increases along with ageing.Atrial fibrillation and COPD are common geriatric co-morbidities in the elderly especially advanced elderly HFpEF patients.The patients are prone to complicated with atrial fibrillation and COPD, and often have chronic myocardial ischemia.Therefore, we should pay attention to the influences of the above diseases on elderly patients with HFpEF.

Heart failure; Autopsy