Observational study of patients with heart failure with reduced ejection fraction (HFrEF) admitted with decompensation

Type of funding sources: None.

HFrEF is associated with significant negative patient outcomes and requires substantial health care resource.

Using the hospital registry from 1st May 2021, 100 consecutive patients were identified, who attended the heart failure clinic following their first hospitalisation with decompensated heart failure with severe LV impairment (ejection fraction <30%). Electronic records were reviewed manually. The first year is described.

Mean age 56.8 yrs. (22-83 yrs.), 72% male, 63% were Maori/Pacific and the time to first contact was 35 days (2-177 days). Risk factors included smoking (19%), diabetes (35%), mean BMI 35.9 (17- 70), AF/AFL (33%), IHD (32%) and eGFR <60 (33%).

By one year, medical therapy included beta-blocker (76% >50% target dose), RAAS inhibitor (81% >50% target dose), MRA (70%), SGLT2i (23%), diuretic (66%). The average number of outpatient contacts were 6.5 with 21% of patients having at least 1 HFrEF admission. At last review, 55% were asymptomatic with 10% receiving device therapy. Follow up imaging was performed in 83% with 78% reporting left ventricular improvement. Nine patients died, average age of 61.2 years.

Despite improving therapies, delivery by our heart failure service could be further optimised. A system co designed with our communities may provide additional advances.