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Updated: Jan 14, 2026
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Comorbidity patterns and mortality in HFpEF: A retrospective longitudinal cohort study
Mohammed Yousufuddin1, Zeliang Ma1, Ebrahim Barkoudah2
1Department of Hospital Internal Medicine, Mayo Clinic Health System, Austin, MN, USA.
Summary
Comorbidities in heart failure with preserved ejection fraction (HFpEF) increase mortality risk, particularly within three years of onset. Early detection and SGLT2i therapy can mitigate these risks, improving outcomes for HFpEF patients.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Comorbid conditions (CCs) are prevalent in heart failure with preserved ejection fraction (HFpEF) and linked to poor prognosis.
- The impact of comorbidity duration on long-term mortality following HFpEF hospitalization is not well understood.
Purpose of the Study:
- To investigate the association between the duration of pre-admission comorbidities and long-term mortality in patients hospitalized for HFpEF.
- To assess how comorbidity duration influences mortality risk across different patient subgroups and treatment strategies.
Main Methods:
- Retrospective analysis of 9256 adult patients hospitalized for HFpEF between 2010 and 2022.
- Comorbidities were categorized by duration (new, early, intermediate, long-term). Mortality risk was analyzed using Cox regression, stratified by GWTG score and SGLT2i prescription.
Main Results:
- Over 2.7 years median follow-up, 64.1% of patients died. Most comorbidities increased mortality risk (HRs 1.06-1.25), with highest risks for neurological disease, CKD, stroke, and anemia.
- Mortality risk increased significantly within 3 years of comorbidity onset and then stabilized.
- SGLT2i therapy reduced mortality risk for most comorbidities, but residual risk persisted for stroke, CKD, chronic lung, and neurological disease.
Conclusions:
- Comorbidities significantly elevate mortality risk in HFpEF patients, with the highest impact observed within the first three years.
- Prognostic effects of comorbidities were consistent across different GWTG scores.
- SGLT2 inhibitor therapy demonstrates potential in attenuating comorbidity-associated mortality risks, emphasizing the need for timely intervention and optimized treatment.
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