Abstract 15323: Patients With Heart Failure With Preserved Ejection Fraction Contend With Deficits Across Multiple Domains of Health

Abstract

Introduction: The domain management approach to caring for heart failure patients outlines the importance of considering deficits from multiple health domains including: medical, mental and emotional, physical, and social. The extent to which these deficits exist in patients with HFpEF is unknown. We sought to characterize deficits across multiple domains among patients seen in an outpatient HFpEF program. Hypothesis: We hypothesized that HFpEF patients would have a high prevalence of deficits across multiple domains. Methods: We conducted a retrospective study of 134 patients with HFpEF seen between July 2018 and December 2019 in the Weill Cornell HFpEF Program, which incorporates the domain management approach through several assessments. The medical domain includes an assessment of multimorbidity (≥ 2 comorbid conditions), polypharmacy (≥ 5 medications), malnutrition (Mini Nutritional Assessment < 12), and hearing and vision impairment (self-report). The mental and emotional domain includes cognitive impairment (Mini-Cog < 3), depression (PHQ-9 ≥ 10), and anxiety (GAD-7 ≥ 10). The physical function domain includes frailty (Short Physical Performance Battery < 10), functional impairment (Katz Index < 6), and fall within the past year (self-report). The social domain includes loneliness (UCLA 3-Item Loneliness Scale ≥ 6) and living situation (self-report). Results: The median age was 75 years (IQR 69-82), 60% were women, and 64% were White. The Figure shows the prevalence for each deficit across the four domains. The most common deficits were multimorbidity (100%), polypharmacy (98%), frailty (79%), and loneliness (62%). Notably, 13% of patients had deficits in all four domains, 31% in three domains, 47% in two domains, and 9% in one domain. Conclusions: HFpEF patients have deficits spanning multiple domains. This supports the importance of considering issues such as multimorbidity, polypharmacy, frailty, and loneliness when caring for these patients.