Epidemiology of heart failure with preserved ejection fraction: Results from the RICA Registry

• Published in: Medicina clínica (English ed.) 2021-07, Vol.157 (1), p.1-9
• Main Authors: Trullàs, Joan Carles, Pérez-Calvo, Juan Ignacio, Conde-Martel, Alicia, Llàcer Iborra, Pau, Suárez Pedreira, Iván, Ormaechea, Gabriela, Soler Rangel, Llanos, González Franco, Alvaro, Cepeda, José María, Montero-Pérez-Barquero, Manuel, Adarraga Cansino, D., Álvarez Rocha, P., Arévalo-Lorido, J.C., Carrascosa, S., Cepeda, J.M., Conde-Martel, A., García Escrivá, D., González Franco, A., León Acuña, A., Llàcer, P., Montero-Pérez-Barquero, M., Moreno Palanco, M.A., Ormaechea, G., Pérez Calvo, J.I., Rodríguez Suárez, S., Rugeles Niño, J., Soler Rangel, M.L., Suárez Pedreira, I., Trullàs, J.C., Vázquez Ronda, M.A.
• Format: Article
• Language: English
• Subjects: Epidemiology; Epidemiología; Heart failure; Heart failure diastolic; Insuficiencia cardiaca; Insuficiencia cardiaca diastólica; Stroke volume; Volumen de eyección
• ISSN: 2387-0206; 2387-0206
• DOI: 10.1016/j.medcle.2020.05.045

There is great interest in better characterizing patients with heart failure (HF) with preserved ejection fraction (HF-PEF). The objective of this study is to determine the prevalence, progression over time and to describe the clinical and epidemiological characteristics of patients with HF-PEF. From the National Registry of Heart Failure (RICA, prospective multicentre cohort study) we analysed patients consecutively admitted for HF in Internal Medicine wards over a period of 11 years (2008–2018). 4752 patients were included, 2957 (62.2%) with preserved ejection fraction. This prevalence remained constant from 2008 to 2019. Compared to patients with HF and reduced ejection fraction (HF-REF) patients with HF-PEF are older, more are female, there is a higher prevalence of hypertensive and valvular aetiology, they have a profile of different comorbidities and worse functional status. A high proportion of patients receive disease-modifying treatment for IC-REF (renin-angiotensin-aldosterone system inhibitors and beta-blockers). The overall mortality after one-year follow-up was 24% and 30% in the HF-PEF and the HF-REF, respectively. In the multivariate analysis, the risk of death was higher in patients with HF-REF compared to HF-PEF (OR 1.84; 95% CI [1.43–2.36]). The length of hospital stay was also lower in the HF-PEF patients but there were no differences in re-hospitalizations. Sixty percent of patients in the RICA registry have preserved ejection fraction. These patients have a higher comorbidity burden and a worse functional status, but lower mortality compared with HF-REF patients. La caracterización de los pacientes con insuficiencia cardiaca (IC) con fracción de eyección preservada (IC-FEp) sigue teniendo interés. El objetivo fue conocer la prevalencia, características clínicas y epidemiológicas de la IC-FEp, y sus cambios en los últimos años. Analizamos el Registro RICA, de la Sociedad Española de Medicina Interna; estudio de cohorte multicéntrico y prospectivo, de pacientes ingresados por IC, consecutivamente en servicios de Medicina Interna, durante un periodo de 11 años (2008–2018). Se incluyeron 4752 pacientes, 2957 (62,2%) con IC-FEp, proporción que se mantuvo constante durante todo el periodo. En comparación con los pacientes con IC y fracción de eyección reducida (IC-FEr), los pacientes con IC-FEp tienen: mayor edad, predominio de sexo femenino, etiología hipertensiva y valvular, distinto perfil de comorbilidades y peor capacidad funcional (men