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Peer-reviewedCC BYCureus

Clinical and Echocardiographic Characterization of Stage B Heart Failure in Asymptomatic Adults With Cardiovascular Risk Factors.

  • Muhammad Ayhan Amir1,2
  • Abdul Hannan3,4
  • Muhammad Farhan Shabbir5
  • Eemaz Nathaniel6
  • Azat Iarullin Ilgizovich7,8
  • Faiqa Haleem9
  • Saba Saeed10,11
  • Muhammad Usman Arshad12,13
  • Isra Mohamed Idris Abubakr14,15
  • Shatha BaniKhalaf16
16 affiliations
  1. 1Internal Medicine, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, PAK.
  2. 2Internal Medicine, University Hospitals Dorset NHS Foundation Trust, Dorset, GBR.
  3. 3Internal Medicine, University of South China, Hengyang, CHN.
  4. 4Internal Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR.
  5. 5Interventional Cardiology, Ch. Pervaiz Elahi Institute of Cardiology, Multan, Multan, PAK.
  6. 6Cardiology, Rehman Medical College, Peshawar, PAK.
  7. 7Internal Medicine, City Clinical Hospital No. 12, Kazan, RUS.
  8. 8Internal Medicine, S. M. Kirov Military Medical Academy, Saint Petersburg, RUS.
  9. 9Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK.
  10. 10General Medicine, Ziauddin University, Karachi, PAK.
  11. 11General Medicine, Manchester University NHS Foundation Trust, Manchester, GBR.
  12. 12Medicine, Foundation University Medical College, Rawalpindi, PAK.
  13. 13Medicine, University Hospitals Dorset NHS Foundation Trust, Dorset, GBR.
  14. 14Internal Medicine, Ahfad University for Women, Omdurman, SDN.
  15. 15General Practice, University Hospital Sharjah, Sharjah, ARE.
  16. 16General Practice, Jordan University of Science and Technology, Irbid, JOR.
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Abstract

Background

Stage B heart failure (pre-HF) is characterized by objective cardiac abnormalities without HF symptoms. This study assessed the prevalence and clinical and echocardiographic characteristics of those who were asymptomatic yet had cardiovascular risk factors and Stage B HF.Methods

This cross-sectional study included 900 asymptomatic adults with cardiovascular risk factors, consecutively recruited from participating hospitals from October 2025 to July 2026. We performed clinical evaluation and a standardized transthoracic echocardiogram. Stage B/pre-HF was defined as the presence of objective cardiac structural or functional abnormalities in the absence of heart failure symptoms or signs. We evaluated independent factors associated with Stage B/pre-HF using multivariable logistic regression.Results

In this hospital-based cohort, Stage B/pre-HF was determined in 261 (29.0%) participants. Hypertension, diabetes mellitus, and obesity were more prevalent in the Stage B group, occurring in 154 (59.0%), 118 (45.2%), and 109 (41.8%), respectively. Stage B/pre-HF was characterized descriptively by lower left ventricular ejection fraction and higher left ventricular mass index, left atrial volume index, E/e' ratio, and tricuspid regurgitation velocity, along with impaired diastolic function. Hypertension was the strongest independent association (OR = 5.930, 95% CI: 3.815-9.217), followed by diabetes (OR = 2.945, 95% CI: 1.913-4.532), age, sex, and BMI. The model showed good fit (Nagelkerke R² = 0.565; Hosmer-Lemeshow p = 0.449).Conclusion

Stage B/pre-HF was common among asymptomatic adults with cardiovascular risk factors and was characterized by structural and functional cardiac abnormalities. These findings support the potential value of early identification and management of modifiable cardiovascular risk factors in asymptomatic adults at risk for HF.

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Cite

BibTeXRIS
BibTeX
@article{amir2026clinical,
  title = {{Clinical and Echocardiographic Characterization of Stage B Heart Failure in Asymptomatic Adults With Cardiovascular Risk Factors.}},
  author = {Muhammad Ayhan Amir and Abdul Hannan and Muhammad Farhan Shabbir and Eemaz Nathaniel and Azat Iarullin Ilgizovich and Faiqa Haleem and Saba Saeed and Muhammad Usman Arshad and Isra Mohamed Idris Abubakr and Shatha BaniKhalaf},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116788},
  url = {https://europepmc.org/article/MED/42921564},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Clinical and Echocardiographic Characterization of Stage B Heart Failure in Asymptomatic Adults With Cardiovascular Risk Factors.
AU  - Muhammad Ayhan Amir
AU  - Abdul Hannan
AU  - Muhammad Farhan Shabbir
AU  - Eemaz Nathaniel
AU  - Azat Iarullin Ilgizovich
AU  - Faiqa Haleem
AU  - Saba Saeed
AU  - Muhammad Usman Arshad
AU  - Isra Mohamed Idris Abubakr
AU  - Shatha BaniKhalaf
PY  - 2026
DA  - 2026/09/23
JO  - Cureus
DO  - 10.7759/cureus.116788
UR  - https://europepmc.org/article/MED/42921564
AB  - Background  Stage B heart failure (pre-HF) is characterized by objective cardiac abnormalities without HF symptoms. This study assessed the prevalence and clinical and echocardiographic characteristics of those who were asymptomatic yet had cardiovascular risk factors and Stage B HF.Methods  This cross-sectional study included 900 asymptomatic adults with cardiovascular risk factors, consecutively recruited from participating hospitals from October 2025 to July 2026. We performed clinical evaluation and a standardized transthoracic echocardiogram. Stage B/pre-HF was defined as the presence of objective cardiac structural or functional abnormalities in the absence of heart failure symptoms or signs. We evaluated independent factors associated with Stage B/pre-HF using multivariable logistic regression.Results  In this hospital-based cohort, Stage B/pre-HF was determined in 261 (29.0%) participants. Hypertension, diabetes mellitus, and obesity were more prevalent in the Stage B group, occurring in 154 (59.0%), 118 (45.2%), and 109 (41.8%), respectively. Stage B/pre-HF was characterized descriptively by lower left ventricular ejection fraction and higher left ventricular mass index, left atrial volume index, E/e' ratio, and tricuspid regurgitation velocity, along with impaired diastolic function. Hypertension was the strongest independent association (OR = 5.930, 95% CI: 3.815-9.217), followed by diabetes (OR = 2.945, 95% CI: 1.913-4.532), age, sex, and BMI. The model showed good fit (Nagelkerke R² = 0.565; Hosmer-Lemeshow p = 0.449).Conclusion  Stage B/pre-HF was common among asymptomatic adults with cardiovascular risk factors and was characterized by structural and functional cardiac abnormalities. These findings support the potential value of early identification and management of modifiable cardiovascular risk factors in asymptomatic adults at risk for HF.
SN  - 2168-8184
ER  -