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

Background: Women have unique risk factors for heart disease and a higher risk of cardiovascular mortality. Heart failure (HF) prevalence in women is affected by age, pregnancy, and menopause. More understanding of HF etiology, management, and outcome in women is needed.

Method: a retrospective study of women diagnosed with HF following at a heart function clinic (HFC) in a tertiary cardiac center.

Results: A total of 1988 HF patients were screened. Women accounted for 561 (28.2%). The mean age at first HF presentation was 47.7 ± 17.9 years. The most common diagnosis was HF with reduced ejection fraction (HFrEF ≤ 40%) 473 (84%). The most frequent cause of HF was dilated cardiomyopathy (DCM) in 304 patients (54.2%). Prevalence of diabetes (DM) was 272 (48.5%), hypertension (HTN) 267 (47.6%), and body mass index (BMI) ≥ 30 was 332 (59%). Adverse pregnancy events included miscarriages 151 (38.6%), preeclampsia 15 (3.8%), and spontaneous coronary dissection 3 (0.8%). Left ventricle recovery to EF ≥ 50% occurred in 116 (20.7%) patients, while death occurred in 32 (5.7%) patients during follow-up. Women living with chronic HF were 240 (42.8%). The use of beta-blockers occurred in (96%), renin-angiotensin enzyme inhibitors (86.6%), mineralocorticoids (55.4%), and sodium-glucose cotransporter 2 inhibitors (31.6%). Women who had a heart transplant were 19 (3.75%).

Conclusion: Referral to specialized heart function clinics remains low for women. There is high burden of obesity among women and the majority of women have chronic HF but advanced HF therapy consideration is low in women.