Demographic and clinical profile of patients with heart failure at a tertiary care hospital

Table 1 Comparison of demographics, clinical characteristics, haematological parameters and biochemical parameters with other global registries

Parameter	King George’s Medical University (n = 407)	United States acute decompensated HF national registry (n = 105388)	Swedish HF registry (S-HFR PHC) (n = 631)	Italian registry on HF (n = 5610)
Mean age (years)	58.8	72.4	76	72
Male (%)	64.4	48	56	60.2
Female (%)	35.6	52	44	39.8
Mean heart rate (beats/minute)	91.19	NA	73	93
Mean SBP (mmHg)	122.37	144	< 100 (2.9%); 100-140 (63.8%); > 140 (33.3%)	134
Mean DBP (mmHg)	76.71	NA	NA	NA
HF phenotype distribution	HFmrEF: 25.6%; HFpEF: 16.0%; HFrEF: 58.5%	Mean EF: 34.4%	EF < 30%: 25%; EF 30%-40%: 23%; EF 40%-49%: 17%; EF ≥ 50%: 18%	HFpEF: 35%
Co-morbidities (%)	DM (overall): 28.6%; DM (isolated): 18.1%; HTN (overall): 21.5%; HTN + DM: 10.3%; HTN (isolated): 9.8%; HTN + CKD: 1.2%; CKD: 0.5%; HTN + DM + CKD: 0.2%; others: 3.2%	HTN: 73%; CAD: 57%; DM: 44%; MI: 31%; AF: 31%; renal insufficiency: 30%; VT: 8%; VF: 1%	IHD: 43.3%; AF: 43.3%; HTN: 51.5%; DM: 26.5%; valve disease: 11%; pulmonary disease: 30.3%; DCM: 4%; HCM: 0.3%	IHD: 42.3%; HTN: 57.8%; DM: 40.4%; renal dysfunction: 32.5%; AF: 37.7%
NYHA class (%)	I: 26.5; II: 69.0; III: 1.7; IV: -	I: 20; II: 44; III: 32; IV: NA	I: 8; II: 32; III: 28; IV: 4	NA
Clinical features (%)	Major: Acute pulmonary edema (0.2%), rales (0.2%); minor: DOE (10.3%), DOE + ankle edema (0.5%), nocturnal cough (0.5%), ankle edema (0.2%), DOE + pleural effusion (0.2%)	Peripheral edema: 66%; dyspnea: 89%; rales: 68%	NA	Pulmonary congestion: 78.2%; peripheral congestion: 56.1%; either/both: 88.4%; peripheral hypoperfusion: 12%; cold: 10.8%; altered sensorium: 11.5%
Mean hemoglobin (g/dL)	12.01	NA	13.5	12.5
Serum creatinine (mg/dL)	1.19	1.8; > 2: 21%; > 3: 9%	1.157	1.21; > 1.5: 28.7%
RDW (%)	16.49	NA	NA	NA
NT-proBNP (pg/mL)	mean: 3377.39; HFrEF: 3926.88; HFpEF: 2745.73; HFmrEF: 2707.94	NA	NA	51681

¹Median. Comorbidities are reported as non-mutually exclusive variables; therefore, cumulative percentages may exceed 100%.

AF: Atrial fibrillation; BMI: Body mass index; CKD: Chronic kidney disease; DCM: Dilated cardiomyopathy; DOE: Dyspnea on exertion; DM: Diabetes mellitus; HCM: Hypertrophic cardiomyopathy; HFmrEF: Heart failure with mid-range ejection fraction; HFpEF: Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; HTN: Hypertension; IHD: Ischemic heart disease; JVP: Jugular venous pressure; NA: Not available; NYHA: New York Heart Association; NT-proBNP: N-Terminal pro-B-Type natriuretic peptide; RDW: Red cell distribution width; VF: Ventricular fibrillation; ADHERE: Acute Decompensated Heart Failure National Registry; S-HFR PHC: Swedish Heart failure registry-primary health care; IN-HF: Italian Network on Heart Failure; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; CAD: Coronary artery disease; AF: Atrial fibrillation.

Table 2 Summary of electrocardiogram and Echocardiogram findings

Modality	Parameter	Findings
ECG	Heart rhythm	Sinus rhythm: 95.6%; atrial fibrillation: 4.4%
	Conduction abnormalities	Poor R-wave progression: 48.7%; LBBB: 21.1%; LAHB + RBBB: 10.2%; RBBB: 7.6%
	LBBB	Present: 2.2%; absent: 97.8%
	LVH	Present: 3.7%; absent: 96.3%
ECHO	LVDD	Mild: 40.3%; moderate: 11.5%; severe: 0.7%; absent: 47.4%
	Mitral regurgitation	Mild: 33.7%; moderate: 14.7%; severe: 11.1%; absent: 40.5%
	Tricuspid regurgitation	Mild: 27.5%; moderate: 9.1%; severe: 2.9%; absent: 60.4%
	RWMA	Present: 43%; absent: 57%
	LVEF	Mean LVEF: 38.47%
	FS	Mean: 19.32%
	LV dimensions	LVESD: 4.37 cm; LVEDD: 5.34 cm
	Left atrial size	Diameter 1: 4.49 cm; diameter 2: 4.22 cm

AF: Atrial fibrillation; ECG: Electrocardiogram; LAHB: Left anterior hemiblock; LBBB: Left bundle branch block; LVDD: Left ventricular diastolic dysfunction; LVEF: Left ventricular ejection fraction; LVF: Left ventricular function; LVH: Left ventricular hypertrophy; LVEDD: Left ventricular end-diastolic diameter; LVESD: Left ventricular end-systolic diameter; RBBB: Right bundle branch block; RWMA: Regional wall motion abnormalities; FS: Fractional shortening; ECHO: Echocardiogram; ECG: Electrocardiogram.

Table 3 Guideline-directed medical therapy prescription in the study population

Population (n = 407)	n (%)
ACEI/ARB	325 (79.85)
Ramipril	280 (68.8)
Telmisartan	33 (8.11)
Perindopril	12 (2.94)
ARNI	27 (6.63)
BB	368 (90.42)
Metoprolol	182 (44.7)
Carvedilol	186 (45.7)
MRA	335 (82.31)
Spironolactone	277 (68.05)
Eplerenone	58 (14.25)
GDMT (All 3 of ACE/ARB, BB and MRA)	260 (63.8)

ACEI: Angiotensin-converting enzyme inhibitors; ARB: Angiotensin receptor blockers; MRA: Mineralocorticoid receptor antagonists; ARNI: Angiotensin receptor-neprilysin inhibitor; BB: Beta-blockers; GDMT: Guideline-directed medical therapy.

Table 4 The distribution of doses of guideline-directed medical therapy prescribed to the study population

Drugs dose (mg/day)	mean ± SD	Median	Min	Max
Perindopril	2.77 ± 1.01	2	2	4
Ramipril	2.86 ± 1.16	2.5	1.25	7.5
Telmisartan	36.97 ± 16.67	40	20	80
Sacubitril valsartan	88.89 ± 57.74	50	50	200
Carvedilol	6.4 ± 5.7	3.12	3.12	25
Metoprolol	50 ± 15.77	50	25	100
Torsemide	18.51 ± 4.08	20	5	50
Spironolactone	49.3 ± 4.14	50	25	50
Furosemide	17.69 ± 4.39	20	10	20
Eplerenone	25 ± 0	25	25	25