In 2003, the incidence rate of heart failure (HF) was 482 per 100,000 persons, with incidence rates of 377 and 587 per 100,000 men and women, respectively. Compared with that in 2002, the incidence rate in 2020 was higher at 609 per 100,000 persons, with incidence rates of 619 and 599 per 100,000 men and women, respectively. [1] 

In the NHID, an estimated 1,326,886 people, or 2.58% of the total population, had HF in 2020. The estimated number of patients with heart failure increased 3.6-fold in about 18 years, from 369,211 in 2002 (a prevalence of 0.77%). [1] 

In 2002, an estimated 1,431 deaths occurred owing to heart failure, with a rate of 3.0 per 100,000 persons. In 2020, an estimated 8,020 deaths occurred owing to HF, a rate of 15.6 per 100,000 persons. An increasing trend was observed from 2002 to 2020. [1] 

The prevalence in men was 2.55%, and that in women was 2.62%. [1]  Of 475,019 total patients in 2014, 42.3% were male and 57.7% were female. [2]

In 2020, the age-specific prevalence of HF was 0.06%, 0.07%, 0.18%, 0.38%, 0.87%, 2.02%, 4.71%, 10.57%, and 18.62% for those aged 0–9, 10–19, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and ≥80 years, respectively. [1] 

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Dyspnea is graded according to the activity necessary symptom manifestation, which helps track the disease course or the response to heart failure treatment, though it is not proportional to the degree of ventricular function. The New York Heart Association (NYHA) functional Classification categorizes symptoms into four classes, from Class I to Class IV. [3] 

Dyspnea is a common symptom of heart failure and it is usually exacerbated during exercise. However, these symptoms are non-specific. When heart failure gradually becomes severe, patients develop orthopnea and paroxysmal nocturnal dyspnea. In addition, a decrease in cardiac output causes severe fatigue, and patients with arrhythmias, such as atrial fibrillation, often develop palpitations. Anorexia, indigestion, and bloating may occur in patients with RV dysfunction. [3] 

The Korea Acute Heart Failure registry, which examined 5,625 patients hospitalized for acute HF from 2011 to 2014, revealed that ischemic heart disease, cardiomyopathy, valvular heart disease, tachycardia, and hypertensive heart disease accounted for 37.6%, 20.6%, 14.3%, 10%, and 4%, respectively. In Korea, ischemic heart disease is the most common cause of HF. [3] 

In patients with suspected HF, the following initial tests are recommended: 1. Twelve-lead electrocardiogram (ECG). (Class I, Level of Evidence C) 2. Assessment of B-type natriuretic peptide (BNP) or N-terminal (NT) pro BNP levels. (Class I, Level of Evidence B) 3. Diagnostic blood tests include complete blood count, lipid profile, and serum urea, electrolytes, and iron (transferrin saturation and ferritin), fasting blood glucose, glycated hemoglobin (HbA1c), and kidney (creatinine), liver, and thyroid function tests. (Class I, Level of Evidence C) 4. Echocardiography. (Class I, Level of Evidence C) 5. Chest radiography. (Class I, Level of Evidence C) [3] 

The prescription rate for angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker (ARB)/angiotensin Receptor Neprilysin Inhibitor (ARNI) was 76.8%. In detail, the prescription rate for ACEIs, ARBs, and ARNI was 14.2%, 50.7%, and 12.0%, respectively. Furthermore, 66.5% and 50.0% of patients were on beta-blockers and mineralocorticoid receptor antagonist (MRA), respectively, while only 17.5% of patients were on SGLT2 inhibitors. In HFrEF patients, the prescription rate of for ACEI/ARB/ARNI, beta blockers, MRA and SGLT2 inhibitors were 86.5%, 75.3%, 64.3%, and 23.0% [4] 

Natriuretic peptide has a short half-life, which changes with hemodynamic stress or LV filling pressure, reflecting the severity of HF. A higher NYHA functional Classification or pulmonary congestion correlates with a higher concentration of natriuretic peptide. [3]  Among the 1,932 patients included in the study, the proportion of NYHA class IV was 26.8% in the death group and 21.5% in the survival group. The median NT-proBNP level was 9,003.0 pg/mL (25th–75th percentile: 3,366.0–22,663.5) in the death group and 4,193.5 pg/mL (25th–75th percentile: 1,729.5–9,657.3) in the survival group. [5] 

The study uncovered exome-wide significant associations for heart failure and rare predicted loss-of-function variants in TTN, MYBPC3, FLNC and BAG3 using exome sequencing of 376,334 individuals. [6]

[1] Heart Failure Statistics 2024 Update: A Report From the Korean Society of Heart Failure. Int J Heart Fail. 2024 Apr;6(2):56-69.  [2] Prevalence and socio-economic burden of heart failure in an aging society of South Korea. BMC Cardiovasc Disord. (2016) 16: 215 [3] Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Definition and Diagnosis. Int J Heart Fail. 2023 Apr 17;5(2):51-65. [4] Rationale, Design, and Interim Observations of the Steady Movement With Innovating Leadership for Heart Failure (SMILE HF) Registry: A Multicenter Prospective Cohort Registry for Patients With Acute Heart Failure. Int J Heart Fail. 2024 Jul;6(3):129-136. [5] Relation of Renal Function with Left Ventricular Systolic Function and NT-proBNP Level and Its Prognostic Implication in Heart Failure with Preserved versus Reduced Ejection Fraction: an analysis from the Korean Heart Failure (KorHF) Registry. Korean Circ J. 2017 Sep;47(5):727-741. [6] Common-variant and rare-variant genetic architecture of heart failure across the allele-frequency spectrum. Nat Genet. 2025 Apr;57(4):829-838.