Clinical and Echocardiographic Profile of Patients With Heart Failure With Reduced Ejection Fraction: A Retrospective...

Heart failure with reduced ejection fraction (HFrEF) is a major contributor to cardiovascular morbidity and mortality worldwide. This condition is associated with delayed diagnosis and high comorbidity burden since patients often present at a younger age with advanced disease. Echocardiography plays a central role in identifying structural abnormalities and prognostic markers. This study aimed to evaluate the clinical and echocardiographic profile of patients with HFrEF and assess outcome predictors in a tertiary care center.

A retrospective observational study was conducted at Madras Medical College from May 2024 to May 2025, including 75 patients diagnosed with HFrEF (left ventricular ejection fraction (LVEF) ≤40%). Clinical data on demographics, comorbidities, and New York Heart Association (NYHA) functional class were collected along with echocardiographic parameters such as left ventricular dimensions, diastolic dysfunction, valvular lesions, right ventricular function, and pulmonary artery systolic pressure (PASP). Outcomes assessed included mortality, hospital stay, and readmission.

The mean age was 58.4 ± 11.2 years, with males comprising 45 patients (60%). Hypertension (42 patients, 56%), diabetes (36 patients, 48%), and ischemic cardiomyopathy (39 patients, 52%) were predominant. Most patients presented in NYHA class III or IV (55 patients, 73%). Echocardiography revealed a mean LVEF of 31.6 ± 5.8, LV dilatation in 48 patients (64%), diastolic dysfunction in 60 patients (80%), and moderate-to-severe mitral regurgitation in 25 patients (33%). Patients with EF <25% had significantly higher mortality (five patients, 15%) and readmission (10 patients, 29%) rates. PASP >40 mmHg independently predicted readmissions, while right ventricular dysfunction and mitral regurgitation were associated with adverse outcomes on univariate analysis.

This study highlights that severe left ventricular dysfunction and elevated PASP are strong prognostic markers in HFrEF. Comprehensive echocardiographic evaluation is essential for risk stratification, and early intervention is crucial to improve outcomes in Indian patients with HFrEF.