Background: Chronic Heart Failure (CHF) diagnosis requires
symptoms/signs of HF and objective evidence of cardiac
dysfunction. Effective management, as per European Society of
Cardiology (ESC) guidelines, is critical for reducing mortality
and improving quality of life in HF patients. This study aims to
assess adherence to ESC guidelines on pharmacological and
device-based treatments of HF, including angiotensin receptor
neprilysin inhibitor (ARNI) and sodium-glucose Co-transporter 2
(SGLT2) inhibitors, in a contemporary cohort of Egyptian HF
patients. Methods: This cross-sectional, multi-center,
observational study was carried out on 500 HF patients
categorized according to ejection fraction into 3 groups: HFrEF,
HFmrEF, and HFpEF. Data were collected via structured
interviews, observations, and medical file reviews. Results: Of
500 patients, 310 had HFrEF, 115 had HFmrEF, and 75 had
HFpEF. HFpEF patients had a higher mean BMI (27.6 kg/m²).
HF histories (P < 0.001) varied, with HFrEF at 83.9%, HFmrEF
at 67.8%, and HFpEF at 89.3%. Hospitalization histories (P <
0.001) were 39.7% in HFrEF, 13.9% in HFmrEF, and 13.3% in
HFpEF. Medication use varied significantly; ACE inhibitors (P =
0.002), ARBs (P < 0.001), and ARNI (P < 0.001) were more
common in HFrEF. Significant differences were observed in
abnormal ECG findings (P < 0.001) and echocardiographic
parameters. Device-based therapy utilization was minimal across
all groups. Conclusion: Adherence to European HF guidelines is
limited in Egyptian patients, with low use of ARNI and SGLT2
inhibitors. High costs, lack of awareness, and comorbidities are
major barriers. |
