HFpEF in Asia: Distinct Phenotypes, Shared Mechanisms, and Emerging Insights

Area of Science:

• Cardiology
• Public Health
• Genomics

Background:

• Heart failure with preserved ejection fraction (HFpEF) is a growing global health concern.
• Asian populations exhibit distinct epidemiological and biological profiles in HFpEF compared to Western cohorts.
• Understanding these differences is critical for effective management and treatment.

Purpose of the Study:

• To delineate the unique epidemiologic, clinical, and biological characteristics of HFpEF in Asian patients.
• To identify region-specific patterns within Asian HFpEF cohorts.
• To highlight the need for Asian-specific diagnostic frameworks and precision medicine approaches.

Main Methods:

• Comparative analysis of epidemiological data from Asian and Western HFpEF cohorts.
• Review of biological and clinical factors contributing to HFpEF pathogenesis in Asian populations.
• Examination of regional variations in HFpEF presentation across Northeast, South, and Southeast Asia.

Main Results:

• Asian HFpEF patients are often younger and less obese (by BMI) but have higher rates of diabetes, chronic kidney disease, anemia, and hypertension.
• Distinct regional patterns emerge: Northeast Asians show an older, leaner, atrial fibrillation phenotype, while South/Southeast Asians present with earlier onset and greater metabolic-renal issues.
• Mechanisms include visceral adiposity, inflammation, and accelerated cardiac aging, often at lower BMI thresholds.

Conclusions:

• HFpEF in Asian patients is a distinct syndrome requiring specific diagnostic and therapeutic considerations.
• Current diagnostic tools may need validation for Asian populations.
• Further multiomics and phenotyping studies are essential for advancing precision medicine in global HFpEF care.