{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T15:16:29Z","timestamp":1789139789415,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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 (\u22122,800\u2005m 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\n                      <jats:italic>t<\/jats:italic>\n                      -tests for continuous variables (two-sided\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1776502","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T05:35:49Z","timestamp":1776749749000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and epidemiological characterization of heart failure patients in a high-altitude setting: a retrospective study at a tertiary hospital in Quito, Ecuador"],"prefix":"10.3389","volume":"13","author":[{"given":"Vladimir","family":"Ullauri","sequence":"first","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlon Patricio","family":"Aguirre Espinosa","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya Mar\u00eda","family":"Padilla Molina","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Moreira-Vera","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Oswaldo","family":"Jaramillo Prado","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Gabriela","family":"Finke Barriga","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Fabricio","family":"Salto Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana Elizabeth","family":"Flores Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisol Elizabeth","family":"C\u00e1rdenas Calder\u00f3n","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Paul","family":"Ayala Abarca","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Metropolitano de Quito","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan S.","family":"Izquierdo-Condoy","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Americas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Vasconez-Gonzalez","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Americas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Ortiz-Prado","sequence":"additional","affiliation":[{"name":"One Health Research Group, Universidad de las Americas","place":["Quito, Ecuador"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"B1","volume-title":"Guyton and Hall Textbook of Medical Physiology","author":"John","year":"2020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"H433","DOI":"10.1152\/ajpheart.00276.2023","article-title":"Extrinsic and intrinsic modulators of inflammation-resolution signaling in heart failure","volume":"325","author":"Rao","year":"2023","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1093\/eurheartj\/ehv512","article-title":"Left ventricular heart failure and pulmonary hypertension","volume":"37","author":"Rosenkranz","year":"2016","journal-title":"Eur Heart J"},{"key":"B4","volume-title":"Heart Failure and Ejection Fraction. 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