Heart failure with preserved ejection fraction in Asia

on behalf of the ASIAN-HF Investigators

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)23-36
Number of pages14
JournalEuropean Journal of Heart Failure
Issue number1
StatePublished - Jan 2019

Bibliographical note

Funding Information:
The ASIAN-HF study is supported by grants from Boston Scientific Investigator Sponsored Research Program, National Medical Research Council of Singapore, A*STAR Biomedical Research Council ATTRaCT program, and Bayer. Conflict of interest: C.S.P.L. is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from Boston Scientific, Bayer, Thermofisher, Medtronic, and Vifor Pharma; and has consulted for Bayer, Novartis, Takeda, Merck, AstraZeneca, Janssen Research & Development, LLC, Menarini, Boehringer Ingelheim, Abbott Diagnostics, Corvia, Roche, and Amgen. The other authors have nothing to disclose.


  • Asia
  • Co-morbidities
  • Echocardiography
  • Heart failure with preserved ejection fraction
  • Public Health
  • Prevalence
  • Prospective Studies
  • Follow-Up Studies
  • Ventricular Function, Left
  • Comorbidity
  • Humans
  • Middle Aged
  • Male
  • Stroke Volume/physiology
  • Heart Failure/diagnosis
  • Asia/epidemiology
  • Female
  • Aged

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Multicenter Study
  • Journal Article


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