Abstract 163: High Burden of Valvulopathy in Heart Failure: A Moving Target

Background: The lifetime risk of developing Heart Failure (HF) is 20% for Americans ≥40 years of age. In the United States, greater than 650,000 new HF cases are diagnosed annually. About 5.1 million persons in the United States have clinically manifest HF. Additionally, HF has high absolute mortality rates of approximately 50% within 5 years of diagnosis. HF carries substantial health and economic burden. It is the primary diagnosis in >1 million hospitalizations annually. Patients hospitalized for HF are at high risk for all-cause re hospitalization. The total cost of HF care in the United States exceeds $30 billion annually. Objective: The study objective was to investigate the prevalence of valvular heart disease among patients hospitalized for HF in a largely Hispanic population. Methods: This is a retrospective study with aims inclusive of: analyzing the hospitalization and 4 months, 6 months, 2 year- re-hospitalization rates of HF in University Medical Center between Oct 2010 and Oct 2013; evaluating the association between valvular heart disease and hospitalizations for HF. Inclusion criteria were: admission/re hospitalizations with HF (with reduced, preserved and borderline EF). Echocardiographic determination of at least moderate valvular disease was utilized in this study as significant. Exclusion criteria were: patients lost to follow-up, death in hospital, transfer to another acute care facility, and discharge against medical advice. Demographics were also collected. Results: Hospitalizations involving 195 patients (120 men and 75 women) were randomly analyzed. The racial spread showed 77.4% (151 of 195) Hispanics and 22.6% (44 of 195) non-Hispanics. Out of the 195 index hospitalizations, the 4 month, 6 months and 2 years rehospitalization visits were 17.4% (34 of 195), 22.5% (44 of 195) and 38.5% (75 of 195) respectively. The prevalence of significant valvular heart disease was 45.9% (90 of 195), while the prevalence of no valvular heart disease was 54.1% (105 of 195) (p < 0.05). Conclusion: Multiple, prior studies have shown that valvular heart diseases have a comparatively low association with clinical Heart Failure. This study raises a valid point that in some population groups (the Hispanic), the burden of valvular heart disease may be greater than has been published in other groups. This calls for more studies, and has lots of potential implications in Heart Failure management.