Clinical characteristics and 1‐year outcomes in hospitalized patients with heart failure with preserved ejection fraction: results from the China Cardiovascular Association Database‐Heart Failure Center Registry

Abstract

Aim We aimed to evaluate clinical characteristics and 1‐year outcomes in hospitalized patients with heart failure with preserved ejection fraction (HFpEF) from China. Factors associated with outcomes (hospitalization for HF [HHF] and cardiovascular [CV] death) were assessed. Method and results Data were from the China Cardiovascular Association (CCA) Database‐HF Center Registry. Between January 2017 and June 2021, 41 708 hospitalized HFpEF patients with 1‐year follow‐up from 481 CCA Database‐HF Center certified secondary and tertiary hospitals across overall 31 provinces of mainland China were included in this study. Of study participants (mean age 72.2 years, 49.3% female), 18.2% had HHF in prior 1 year and 55.8% had New York Heart Association class III/IV. Median left ventricular ejection fraction was 59%. Ischaemia (26.6%), infection (14.4%) and arrhythmia (10.5%) were the three most common precipitating factors for index HHF. Nearly 67.4% had ≥3 comorbidities. Hypertension (65.2%), coronary heart disease (60.3%) and atrial fibrillation (41.2%) were the three most common comorbidities. Device and medication therapy non‐compliance with current HF guideline recommendation was observed. The 1‐year rate of clinical outcomes was 16.4%, the 1‐year rate of HHF was 13.6% and CV death was 3.1%. Factors associated with clinical outcomes included HHF in prior 1 year, serum level of sodium <135 mmol/L and N‐terminal pro‐B‐type natriuretic peptide >1800 pg/ml. Conclusion Patients with HFpEF from China were characterized by high comorbid burden and high 1‐year risk of HHF and CV death. Immediate efforts are needed to improve HFpEF management in China.

Visceral Adiposity：A Potential Marker for Mortality Risk in Heart Failure with Preserved Ejection Fraction?

“…Successful risk strati cation is a key to enhancing clinical care in HFpEF (23). A prospective study from China, which included 41708 hospitalized HFpEF patients, reported that the 1-year rate of cardiovascular death was 3.1% with the most common comorbidities of hypertension, coronary heart disease and AF (24), which is similar to our study ndings. An analysis of the ESC Heart Failure Long-Term Registry associated the increased hazard with baseline characteristics such as age, NYHA class, pulmonary congestion, aortic stenosis, AF, peripheral artery disease and chronic kidney disease (25).…”

Disturbed Cardiac Metabolism Triggers Atrial Arrhythmogenesis in Diabetes Mellitus: Energy Substrate Alternate as a Potential Therapeutic Intervention

“…Mitochondrial dysfunction in HF with preserved ejection fraction (HFpEF): In the community, HF with preserved ejection fraction (HFpEF) accounts for approximately half of the global HF cases, and the prevalence of HF is increasing in the aging population [ 51 ]. AFs were among the three most common precipitating factors for hospitalizations and the most common comorbidities in those patients with HFpEF [ 52 ]. Main risk factors for HFpEF are obesity, metabolic syndrome, and diabetes [ 53 ].…”

November 2022 at a glance: focus on epidemiology, prognosis and comorbidities

“…Patients were often burdened by multiple comorbidities, namely hypertension, atrial fibrillation and coronary artery disease (CAD). At 1‐year follow‐up, rehospitalization due to HF occurred in 13.6% of patients, while cardiovascular death in 3.1% 3 …”

“…At 1-year follow-up, rehospitalization due to HF occurred in 13.6% of patients, while cardiovascular death in 3.1%. 3 The relationship between quality of care as assessed using the European Society of Cardiology (ESC) quality indicators (QIs) and outcome was investigated among 43 704 patients with HF from the Swedish HF registry. 4,5 Out of the 16 QIs, 13 could be measured and 5 were inversely associated with all-cause mortality during follow-up.…”