Differences in clinical characteristics and outcomes in real-world HFpEF patients according to clinical definitions

Abstract Background Heart failure with preserved ejection fraction (HFpEF) is characterised by its heterogeneity, which extends to definition. How HFpEF defined has important consequences for recruitment into clinical trials and outcomes, several definitions have been used across guidelines trials. Purpose The aim of this study was characterise a cohort newly-diagnosed community patients their outcomes according in recent outcome Methods We conducted single-centre who underwent echocardiography suspected symptomatic HF elevated NT-proBNP (>125 pg/ml). Patients were classified as whether they met the diagnostic criteria using ESC 2016 Guidelines,1 H2FPEF (score ≥6) 2 CHARM-Preserved,3 I-Preserve,4 TOPCAT,5 PARAGON-HF6, HFA PEFF7 EMPEROR-Preserved.8 primary time mortality or cardiovascular hospitalisation. Results In total, there 282 evaluated (mean age 78±9 years; 63.5% female; median 1199 As expected high prevalence comorbidities (68% hypertension, 49% obesity, 36% atrial fibrillation, 21% ischaemic heart disease 17.4% diabetes). All CHARM-Preserved criteria, while most restrictive, only 69 (24.5%) (Table). HFA-PEFF identified 86 (30.5%) HFpEF. One hundred eighty three (65%) criteria. Recent trials' included wide range (PARAGON-HF 58%, EMPEROR 62%, TOPCAT 72% I-Preserved 76%). Among eight HFpEF, more AF (95.7%), obesity (73.9%) diabetes (26.1%) group compare others.(Picture1) Median follow-up 18±9 months. Over period, whole 46 suffered (16.3%), including 11 deaths 36 cardiac related hospitalisations. incidence highest meeting definition (24%). I-PRESERVE discriminatory. Clinical trial gave similar event rates but substantially (Picture 2). Conclusions There significant variation characteristics depending on used. appear reasonable compromise regarding patient selection rates. had lowest rates, those definitions, though it restrictive. Our results could be inform design future studies. Funding Acknowledgement Type funding sources: None. Demographic characteristics, outcomesKaplan-Meier Survival curve