Clinical profile, management and outcomes of heart failure with preserved ejection fraction in Argentina: Final results from the ArFey-Preser Registry

Abstract

Introduction: Heart failure (HF) with preserved ejection fraction (HFpEF) is underrepresented in Argentine registries. The objectives of this report were to analyze clinical profile, evaluation, and treatment of HFpEF in Argentina. Material and methods: ArFey-Preser was a multicenter, observational registry that included ambulatory or pre-hospital discharge patients, with LV ejection fraction ≥50%, signs-symptoms of HF, and evidence of structural heart disease. Endpoints were mortality and HF hospitalization at one year and total mortality at the end of the study. Results: Between December/22-May/24, 638 patients were included, 72.4±11.3 years, 62.1% women, LVEF 60.5±6.4%. The most prevalent comorbidities were: arterial hypertension 90%, chronic kidney disease 54.2%, obesity 50.3%,  diabetes 44.5%, atrial fibrillation/flutter 40.4%, anemia 36.7%, and coronary artery disease 26%. The functional class was 3-4 in 34.2% and previous hospitalizations due to HF in 58.6%. Evaluation included: echocardiogram 100%, natriuretic peptides 57%, ischemia search 39.3%, coronary angiography 58.8%, additional methods 6.9%. Baseline medication included sodium-glucose transport protein 2 inhibitors (SGLT2i) 42.3%, mineralocorticoid receptor antagonists (MRA) 42.3%, diuretics 78.2%, renin-angiotensin system inhibitors (RASi) 82.4% and beta-blockers (BB) 79.6%; with 12month  increment in iSGLT2 of 17,2% and reduction in BB of  -8,6% and RASi of -8,1 (all p<0,001). Annual mortality was 7.3% and hospitalization for HF 11.5%; while 24-month survival was 90.3%. Conclusions: HFpEF in Argentina is characterized by a predominance of women, elderly, multimorbidity and frequent events. The screening for coronary heart disease was high, with low use of additional methods. The underuse of MRA and SGLT2i indicates a gap with current recommendations.