Dissimilarities in Females Having Heart Failure with Mildly Reduced Ejection Fraction

Abstract

Background: The clinical features, epidemiology, pathogenesis & management of heart failure with mildly reduced ejection fraction (HFmrEF) differ in gender-specific dissimilarities like hormonal impact, anthropometry, pregnancy-related changes, comorbidities, specific diseases in women (incidence of HFpEFis higher in females whereas HFrEF is more common in males). This study aims to identify gender differences with meaningful clinical implications in females diagnosed with heart failure with HFmrEF. Methodology: This study was done in 130 patients with HFmrEF patients aged more than 18 years without any evidence of sepsis were included in this study. Results: Females patients were 26% (35 patients) of the study population having mean age of  64 years and belonged to upper-middle SES. Mean BMI was 25.6 (class I obesity), NYHA class II & III noted in 58% & 37% respectively. CAD was seen in 57%,mean haemoglobin & NT-proBNP were 10.8 gm% & 11145pg/ml respectively. Patients had mean EF of 44% and moderate PH  was noted in 35%. Readmission rates were 28% in 1 year (17% in males). Around 90 % were on anti-platelets, statins and beta-blocker therapy. Diuretics/MRA’s were used in <40% (compared to 31% in males), while SGLT2I & ARNI used in 30% & 16% respectively (42% & 20 % males). An improvement in left ventricular function was noted in 30% and AKI, CKD, ADHF & UTI were the major deterrents for initiating core HF therapy. Conclusion: This study addressed the under-represented female population with HFmrEF sharing similar clinical features as their gender counterparts but with a higher proportional prevalence of anaemia, PH, CKD, readmission rates, and inadequate core HF treatment.