Jasper Tromp1,2,3, Tiew-Hwa Teng1, Wan Ting Tay1, Chung Lieh Hung4, Calambur Narasimhan5, Wataru Shimizu6, Sang Weon Park7, Houng Bang Liew8, Tachapong Ngarmukos9, Eugene B Reyes10, Bambang B Siswanto11, Cheuk-Man Yu12, Shu Zhang13, Jonathan Yap1, Michael MacDonald14, Lieng Hsi Ling15,16, Kirsten Leineweber17, A Mark Richards15,18,19, Michael R Zile20, Inder S Anand21, Carolyn S P Lam1,3,18. 1. National Heart Centre Singapore, Singapore, Singapore. 2. Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands. 3. Duke-NUS Medical School, Singapore, Singapore. 4. Mackay Memorial Hospital, Taipei, Taiwan. 5. Care Hospital, Hyderabad, India. 6. Nippon Medical School's Department of Cardiovascular Medicine, Tokyo, Japan. 7. Korea University Hospital, Seoul, Korea. 8. Jeffrey Cheah School Of Medicine And Health Sciences, Monash University Malaysia & Department of Cardiology, Queen Elizabeth Hospital 2, Malaysia. 9. Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 10. Manila Doctors Hospital, Manila, Philippines. 11. National Cardiovascular Center Universitas Indonesia, Jakarta, Indonesia. 12. Heart Centre, Hong Kong Baptist Hospital, Hong Kong, SAR, The People's Republic of China. 13. Fuwai Hospital, Beijing, The People's Republic of China. 14. Changi General Hospital, Singapore, Singapore. 15. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road Singapore, Singapore 119228. 16. Cardiac Department, National University Health System, Singapore. 17. Bayer AG, Wuppertal, Germany. 18. National University Heart Centre, Singapore, Singapore. 19. Christchurch Heart Institute, University of Otago, 2 Riccarton Avenue, Christchurch 8011, New Zealand. 20. Medical University of South Carolina, and the Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA. 21. Veterans Affairs Medical Center, Minneapolis, MN, USA.
Abstract
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a global public health problem. Unfortunately, little is known about HFpEF across Asia. METHODS AND RESULTS: We prospectively studied clinical characteristics, echocardiographic parameters and outcomes in 1204 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions, grouped as Northeast Asia (Hong Kong, Taiwan, China, Japan, Korea, n = 543), South Asia (India, n = 252), and Southeast Asia (Malaysia, Thailand, Singapore, Indonesia, Philippines, n = 409). Mean age was 68 ±12 years (37% were < 65 years) and 50% were women. Seventy per cent of patients had ≥2 co-morbidities, most commonly hypertension (71%), followed by anaemia (57%), chronic kidney disease (50%), diabetes (45%), coronary artery disease (29%), atrial fibrillation (29%) and obesity (26%). Southeast Asian patients had the highest prevalence of all co-morbidities except atrial fibrillation, South Asians had the lowest prevalence of all co-morbidities except anaemia and obesity, and Northeast Asians had more atrial fibrillation. Left ventricular hypertrophy and concentric remodelling were most prominent among Southeast and South Asians, respectively (P < 0.001). Overall, 12.1% of patients died or were hospitalized for heart failure within 1 year. Southeast Asians were at higher risk for adverse outcomes, independent of co-morbidity burden and cardiac geometry. CONCLUSION: These first prospective multinational data from Asia show that HFpEF affects relatively young patients with a high burden of co-morbidities. Regional differences in types of co-morbidities, cardiac remodelling and outcomes of HFpEF across Asia have important implications for public health measures and global HFpEF trial design.
BACKGROUND:Heart failure with preserved ejection fraction (HFpEF) is a global public health problem. Unfortunately, little is known about HFpEF across Asia. METHODS AND RESULTS: We prospectively studied clinical characteristics, echocardiographic parameters and outcomes in 1204 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions, grouped as Northeast Asia (Hong Kong, Taiwan, China, Japan, Korea, n = 543), South Asia (India, n = 252), and Southeast Asia (Malaysia, Thailand, Singapore, Indonesia, Philippines, n = 409). Mean age was 68 ±12 years (37% were < 65 years) and 50% were women. Seventy per cent of patients had ≥2 co-morbidities, most commonly hypertension (71%), followed by anaemia (57%), chronic kidney disease (50%), diabetes (45%), coronary artery disease (29%), atrial fibrillation (29%) and obesity (26%). Southeast Asian patients had the highest prevalence of all co-morbidities except atrial fibrillation, South Asians had the lowest prevalence of all co-morbidities except anaemia and obesity, and Northeast Asians had more atrial fibrillation. Left ventricular hypertrophy and concentric remodelling were most prominent among Southeast and South Asians, respectively (P < 0.001). Overall, 12.1% of patients died or were hospitalized for heart failure within 1 year. Southeast Asians were at higher risk for adverse outcomes, independent of co-morbidity burden and cardiac geometry. CONCLUSION: These first prospective multinational data from Asia show that HFpEF affects relatively young patients with a high burden of co-morbidities. Regional differences in types of co-morbidities, cardiac remodelling and outcomes of HFpEF across Asia have important implications for public health measures and global HFpEF trial design.
Authors: Agnieszka Kapłon-Cieślicka; Karolina Kupczyńska; Piotr Dobrowolski; Błażej Michalski; Miłosz J Jaguszewski; Waldemar Banasiak; Paweł Burchardt; Łukasz Chrzanowski; Szymon Darocha; Justyna Domienik-Karłowicz; Jarosław Drożdż; Marcin Fijałkowski; Krzysztof J Filipiak; Marcin Gruchała; Ewa A Jankowska; Piotr Jankowski; Jarosław D Kasprzak; Wojciech Kosmala; Piotr Lipiec; Przemysław Mitkowski; Katarzyna Mizia-Stec; Piotr Szymański; Agnieszka Tycińska; Wojciech Wańha; Maciej Wybraniec; Adam Witkowski; Piotr Ponikowski; On Behalf Of "Club 30" Of The Polish Cardiac Society Journal: Cardiol J Date: 2020-09-28 Impact factor: 2.737
Authors: Antonella Gallo; Noemi Macerola; Angela Maria Favuzzi; Maria Anna Nicolazzi; Antonio Gasbarrini; Massimo Montalto Journal: Med Princ Pract Date: 2022-01-28 Impact factor: 2.132