• Jasper Tromp, Tiew-Hwa Teng, Wan Ting Tay, Chung Lieh Hung, Calambur Narasimhan, Wataru Shimizu, Sang Weon Park, Houng Bang Liew, Tachapong Ngarmukos, Eugene B Reyes, Bambang B Siswanto, Cheuk-Man Yu, Shu Zhang, Jonathan Yap, Michael MacDonald, Lieng Hsi Ling, Kirsten Leineweber, RichardsA MarkAMYong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road Singapore, Singapore 119228.National University Heart Centre, Singapore, Singapore.Christchurch Heart Institute, University of Otago, 2 Riccarton Avenue,, Michael R Zile, Inder S Anand, LamCarolyn S PCSPNational Heart Centre Singapore, Singapore, Singapore.Duke-NUS Medical School, Singapore, Singapore.National University Heart Centre, Singapore, Singapore., and ASIAN-HF Investigators.
• National Heart Centre Singapore, Singapore, Singapore.
• Eur. J. Heart Fail. 2019 Jan 1; 21 (1): 23-36.

BackgroundHeart failure with preserved ejection fraction (HFpEF) is a global public health problem. Unfortunately, little is known about HFpEF across Asia.Methods And ResultsWe prospectively studied clinical characteristics, echocardiographic parameters and outcomes in 1204 patients with HFpEF (left ventricular ejection fraction ≥50%) from 11 Asian regions, grouped as Northeast Asia (Hong Kong, Taiwan, China, Japan, Korea, n = 543), South Asia (India, n = 252), and Southeast Asia (Malaysia, Thailand, Singapore, Indonesia, Philippines, n = 409). Mean age was 68 ±12 years (37% were < 65 years) and 50% were women. Seventy per cent of patients had ≥2 co-morbidities, most commonly hypertension (71%), followed by anaemia (57%), chronic kidney disease (50%), diabetes (45%), coronary artery disease (29%), atrial fibrillation (29%) and obesity (26%). Southeast Asian patients had the highest prevalence of all co-morbidities except atrial fibrillation, South Asians had the lowest prevalence of all co-morbidities except anaemia and obesity, and Northeast Asians had more atrial fibrillation. Left ventricular hypertrophy and concentric remodelling were most prominent among Southeast and South Asians, respectively (P < 0.001). Overall, 12.1% of patients died or were hospitalized for heart failure within 1 year. Southeast Asians were at higher risk for adverse outcomes, independent of co-morbidity burden and cardiac geometry.ConclusionThese first prospective multinational data from Asia show that HFpEF affects relatively young patients with a high burden of co-morbidities. Regional differences in types of co-morbidities, cardiac remodelling and outcomes of HFpEF across Asia have important implications for public health measures and global HFpEF trial design.© 2018 The Authors. European Journal of Heart Failure & 2018 European Society of Cardiology.

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