The outcome of heart failure in women: a study from a tertiary heart function clinic

Area of Science:

• Cardiology
• Women's Health
• Cardiovascular Disease

Background:

• Women experience unique cardiovascular disease risk factors and mortality rates.
• Heart failure (HF) prevalence in women is influenced by factors like age, pregnancy, and menopause.
• Further understanding of HF in women regarding etiology, management, and outcomes is crucial.

Purpose of the Study:

• To analyze the characteristics, causes, and outcomes of heart failure in women.
• To evaluate the prevalence of comorbidities and adverse pregnancy events in women with HF.
• To assess the utilization of advanced HF therapies and referral patterns in women.

Main Methods:

• Retrospective study of 561 women diagnosed with HF at a tertiary cardiac center's heart function clinic.
• Analysis of patient demographics, HF diagnosis, comorbidities (diabetes, hypertension, obesity), and pregnancy history.
• Review of treatment patterns, left ventricular recovery, and patient outcomes including chronic HF, heart transplant, and mortality.

Main Results:

• The majority of women (84%) presented with HF with reduced ejection fraction (HFrEF), most commonly due to dilated cardiomyopathy (54.2%).
• High prevalence of comorbidities including diabetes (48.5%), hypertension (47.6%), and obesity (59% with BMI ≥ 30).
• Significant rates of adverse pregnancy events (miscarriages 38.6%) and a substantial proportion of women living with chronic HF (42.8%), with low heart transplant rates (3.75%).

Conclusions:

• Women are underrepresented in specialized heart function clinics, indicating low referral rates.
• Obesity is highly prevalent, and most women experience chronic HF, yet advanced therapy consideration remains low.
• There is a critical need to improve access to specialized care and advanced HF therapies for women.