Frontiers in cardiovascular medicine · 2026
Clinical and epidemiological characterization of heart failure patients in a high-altitude setting: a retrospective study at a tertiary hospital in Quito, Ecuador.
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Ullauri Vladimir, Aguirre Espinosa Marlon Patricio, Padilla Molina Tanya María, Moreira-Vera Diana, Jaramillo Prado Henry Oswaldo, Finke Barriga Ana Gabriela, Salto González John Fabricio, Flores Rodríguez Liliana Elizabeth, Cárdenas Calderón Marisol Elizabeth, Ayala Abarca Giuseppe Paul, Izquierdo-Condoy Juan S, Vasconez-Gonzalez Jorge, Ortiz-Prado Esteban
Аннотация
BACKGROUND: Heart failure (HF) is a major global health problem and a leading cause of morbidity and mortality. In Latin America, evidence remains limited, and HF characterization in high-altitude care settings is underreported. Quito (-2,800 m a.s.l.) provides a unique clinical context, although retrospective hospital-based data without standardized hypoxia phenotyping or sea-level comparators cannot support altitude-specific causal inference.
OBJECTIVE: This study aims to describe the clinical and epidemiological characteristics of patients diagnosed with HF at the Metropolitan Hospital of Quito, a tertiary care facility located at an altitude of approximately 2,800 meters, from January 2021 to December 2023.
METHODS: A retrospective observational study was conducted using anonymized medical records of 122 patients diagnosed with HF (ICD-10 codes I500, I501, I509). Data on demographic, clinical, and outcome variables were collected. Exploratory comparisons were performed by discharge survival status (alive vs. deceased) using chi-square or Fisher's exact tests for categorical variables and two-sample Student's t-tests for continuous variables (two-sided p < 0.05).
RESULTS: Most patients (88.5%) were aged over 65 years, with men comprising 55.7% of the cohort. Hypertension (59.8%), dyslipidemia (18.9%), and atrial fibrillation (44.3%) were the most prevalent comorbidities. Hypertensive heart disease was the most frequent documented etiology of HF (14.8%), although etiology was unavailable in a substantial proportion of records. In-hospital mortality was low (3.3%). Exploratory univariate analyses identified unadjusted associations between in-hospital mortality and dialysis dependency, immunologic diseases, and other vascular diseases.
CONCLUSIONS: This study provides a contemporary clinical and epidemiological profile of HF patients managed at a high-altitude tertiary hospital in Quito and identifies exploratory factors associated with in-hospital mortality in this care setting. Future multicenter studies incorporating standardized hypoxia-related measurements and appropriate comparator cohorts are needed to better understand HF phenotypes and outcomes in Andean populations.
OBJECTIVE: This study aims to describe the clinical and epidemiological characteristics of patients diagnosed with HF at the Metropolitan Hospital of Quito, a tertiary care facility located at an altitude of approximately 2,800 meters, from January 2021 to December 2023.
METHODS: A retrospective observational study was conducted using anonymized medical records of 122 patients diagnosed with HF (ICD-10 codes I500, I501, I509). Data on demographic, clinical, and outcome variables were collected. Exploratory comparisons were performed by discharge survival status (alive vs. deceased) using chi-square or Fisher's exact tests for categorical variables and two-sample Student's t-tests for continuous variables (two-sided p < 0.05).
RESULTS: Most patients (88.5%) were aged over 65 years, with men comprising 55.7% of the cohort. Hypertension (59.8%), dyslipidemia (18.9%), and atrial fibrillation (44.3%) were the most prevalent comorbidities. Hypertensive heart disease was the most frequent documented etiology of HF (14.8%), although etiology was unavailable in a substantial proportion of records. In-hospital mortality was low (3.3%). Exploratory univariate analyses identified unadjusted associations between in-hospital mortality and dialysis dependency, immunologic diseases, and other vascular diseases.
CONCLUSIONS: This study provides a contemporary clinical and epidemiological profile of HF patients managed at a high-altitude tertiary hospital in Quito and identifies exploratory factors associated with in-hospital mortality in this care setting. Future multicenter studies incorporating standardized hypoxia-related measurements and appropriate comparator cohorts are needed to better understand HF phenotypes and outcomes in Andean populations.