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Objective: To compare profile, clinical characteristics and outcomes of patients admitted with acute heart failure and reduced ejection fraction to those patients with preserved ejection fraction. Study Design: Descriptive cross sectional study. Place and Duration of Study: The study was carried out at Armed Forces Institute of Cardiology & National Institute of Heart Diseases from April to November 2016. Material and Methods: All patients presenting to AFIC ER and diagnosed with acute heart failure were included in this study. Echocardiography was done for all the patients. Baseline characteristics, clinical profile, lab investigations and outcomes were documented. Results: A total of 288 patients were included in this study, 223 (77.4%) patients had reduced ejection fraction (EF) <50% (HFrEF), 65 (22.5%) patients had preserved EF >50% HFpEF. Significantly higher numbers of female patients were seen in HFpEF group (0.04). Patients with preserved EF were significantly more hypertensive than patients with reduced EF (75.5% vs 54.0%, p-value 0.05), similarly systolic blood pressure >161 mmHg and diastolic blood pressure >101 mmHg was observed in patients with preserved EF as compared to patients with reduced EF. Heart failure complications including valvular heart disease (severe MR) and atrial fibrillation were more frequent in patients with preserved EF as compared to patients with reduced EF (10.8% vs 2.6% p 0.05 and 9.0% vs 1.3% p 0.04). Cardiogenic shock was more commonly encountered in patients with reduced EF (30.1% vs 4.6% p 0.03). NSTEMI was diagnosed in 15.6 (35.0%) patients with........

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