Heart failure with reduced ejection fraction (HFrEF) is an important clinical syndrome. Evidence from several observational studies suggests sex-related differences in the incidence and prognosis of HFrEF, particularly in the setting of coronary artery disease. Women appear more prone to develop heart failure.

Objective of the study is to report clinical, electrical, echocardiographic, etiological and therapeutic aspects of HFrEF in women versus men.

Transversal retrospective study conducted between May 2006 and June 2019 including all patients beyond the age of 14 with HFrEF followed-up in therapeutic unit of heart failure of our department. Data were collected on Excel and analyzed using SPSS 2.0. We studied clinical, electrical, echocardiographic and etiological aspects of CHF among women compared to men.

1237 women among 3412 HFrEF patients were included, women mean age was 64,96±12,96 years vs. 64,89±12,79 years in men (P=0,068). 37,8% of women were diabetic vs. 26,1% of men (P<0,001), 49,6% were hypertensive vs. 32,7% (P<0,001), 4% were smokers vs. 42,5% (P<0,001). 9,2% had a history of stroke vs. 10,6% (P=0,205), 25,8% had a history of myocardial infarction vs. 32,6% (P<0,001), 5,3% were at end-stage chronic kidney disease vs. 5,5% (P=0,822). HFrEF in women compared to men was due to ischemic heart disease in 50,6% vs. 63,2% (P<0,001). Dyspnea in women compared to men was classified mostly class II NYHA in 59,7% vs. 57,3%. 12,8% of women had atrial fibrillation vs. 12,5% in men (P=0,860). Mean LVEF was 37,43±15,85% vs. 35,65±10,07% in men P<0,001. No impact of gender on hospitalization for HF was observed (P=0,867)

Myocardial infarction was significantly more prevalent in women. Several studies indicate an increased long-term risk of HFrEF following myocardial infarction in women. This may be explained by a greater prevalence of risk factors for coronary atherosclerosis as well as by female gender.