Heart failure (HF) is a clinical syndrome caused by structural and/or functional impairment of the heart, characterized by objective evidence of congestion or insufficient tissue perfusion, associated with elevated natriuretic peptides (1,2,3). It has an increasing incidence and prevalence, related to increased life expectancy and the expansion of cardiovascular risk factors in the global population, generating high direct and indirect costs in health systems as a result of progressive hospitalizations due to decompensation of the disease. (1,2,3)

In this regard, it is essential to describe the main clinical, demographic, and socioeconomic characteristics of patients with HF, the available diagnostic tools, and the treatments used, in order to improve the management of this condition in our daily practice. Knowing our patients with HF is imperative from a healthcare perspective.

The registry SEPE-HF (Santa Cruz epidemiology and research on heart failure) has attempted to describe epidemiological aspects and the medical management of patients hospitalized for HF in different hospitals in the city of Santa Cruz de la Sierra (Bolivia), one of the most important cities in the country and therefore with a large volume of patients under follow-up. (4)

Firstly, it should be noted that most of the characteristics described in relation to risk factors, clinical management, and mortality are similar to other registries in the region, highlighting the increasing prevalence of HF with preserved ejection fraction and the high burden of diabetes mellitus and atrial fibrillation. (5)

In this cohort, Chagas cardiomyopathy is one of the main etiologies in patients with HF over 50 years of age, surpassing ischemic and valvular causes. This is clearly related to its geographical distribution, the chronicity of the disease, and the high rate of infestation in the population in previous years. These patients are frequently hospitalized for congestion or arrhythmic complications and have a poorer prognosis, highlighting the need for studies to evaluate the behavior of HF in patients with Chagas disease. (3)

It should also be noted that echocardiograms were performed on only 75% of hospitalized patients, which could be related to the unavailability of this resource in some centers. We must therefore continue to deepen our understanding of the difficulties faced by health systems in our region and how to create possible solutions.

With regard to the therapeutic approach, this registry highlights the opportunity that hospitalizations represent to optimize the entire spectrum of outpatient treatment, including specific drugs for HF, hygienic-dietary measures, and vaccination, in order to prevent further decompensations. (1,2,3)

Heart failure registries, such as ARGEN-IC and SEPE-HF, are a real stimulus for new population studies to understand how this disease behaves in our region. (4,5)