, Eda Özlek 1
, Serkan Kahraman 2
, Mehmet Tekinalp 3
, Hicaz Zencirkiran Agus 2
, Oğuzhan Çelik 1
, Cem Çil 1
, Volkan Doğan 1
, Özcan Başaran 1
, Bedri Caner Kaya 4
, Ibrahim Rencüzoğulları 5
, Altuğ Ösken 6
, Lütfü Bekar 7
, Ozan Çakır 8
, Yunus Çelik 9
, Kadir Uğur Mert 10
, Kadriye Memiç Sancar 2
, Samet Sevinç 2
, Gurbet Özge Mert 11
, Murat Biteker 1
2Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
3Department of Cardiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş-Turkey
4Department of Cardiology, Mehmet Akif İnan Training and Research Hospital; Şanlıurfa-Turkey
5Department of Cardiology, Faculty of Medicine, Kafkas University; Kars-Turkey
6Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital; İstanbul-Turkey
7Department of Cardiology, Hitit University Çorum Erol Olçok Training and Research Hospital; Çorum-Turkey
8Department of Cardiology, Faculty of Medicine, Bülent Ecevit Universiy; Zonguldak-Turkey
9Department of Cardiology, Kırıkkale Yüksek İhtisas Hospital; Kırıkkale-Turkey
10Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University; Eskişehir-Turkey
11Department of Cardiology, Yunus Emre State Hospital; Eskişehir-Turkey
Abstract
Objective: This study aimed to examine gender-based differences in epidemiology, clinical characteristics, and management of consecutive patients with heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF).
Methods: The APOLLON trial (A comPrehensive, ObservationaL registry of heart faiLure with mid-range and preserved ejection fractiON) is a multicenter, cross-sectional, and observational study. Consecutive patients with HFmrEF or HFpEF who were admitted to the cardiology clinics were included (NCT03026114). Herein, we performed a post-hoc analysis of data from the APOLLON trial.
Results: The study population included 1065 (mean age of 67.1±10.6 years, 54% women) patients from 11 sites in Turkey. Compared with men, women were older (68 years vs. 67 years, p<0.001), had higher body mass index (29 kg/m2 vs. 27 kg/m2, p<0.001), and had higher heart rate (80 bpm vs. 77.5 bpm, p<0.001). Women were more likely to have HFpEF (82% vs. 70.9%, p<0.001), and they differ from men having a higher prevalence of hypertension (78.7% vs. 73.2%, p=0.035) and atrial fibrillation (40.7% vs. 29.9%, p<0.001) but lower prevalence of coronary artery disease (29.5% vs. 54.9%, p<0.001). Women had higher N-terminal pro-B-type natriuretic peptide (691 pg/mL vs. 541 pg/mL, p=0.004), lower hemoglobin (12.7 g/dL vs. 13.8 g/dL, p<0.001), and serum ferritin (51 ng/mL vs. 64 ng/mL, p=0.001) levels, and they had worse diastolic function (E/e'=10 vs. 9, p<0.001). The main cause of heart failure (HF) in women was atrial fibrillation, while it was ischemic heart disease in men.
Conclusion: Clinical characteristics, laboratory findings, and etiological factors are significantly different in female and male patients with HFmrEF and HFpEF. This study offers a broad perspective for increased awareness about this patient profile in Turkey.