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.
Original language | English (US) |
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Pages (from-to) | 23-36 |
Number of pages | 14 |
Journal | European Journal of Heart Failure |
Volume | 21 |
Issue number | 1 |
DOIs | |
State | Published - 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.
Keywords
- 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