Aim — to determine the factors associated with unfavorable prognosis (repeated hospitalization, death) within 2-year follow-up after the first decompensation of chronic heart failure with preserved ejection fraction (CHFprEF). Material and methods. 117 patients aged 71.6±9.1 years were enrolled. Women accounted for 65.8%. Most of patients suffered from hypertension and atrial fibrillation. Follow-up included monthly telephone surveys for the first 6 months and every three months thereafter. Results. Mortality was 11.9%. Repeated hospitalization was required in 33.3% of patients. Combined endpoint was reached in 45.3% of patients. The factors associated with unfavorable prognosis were cardiac asthma at admission, moderate right ventricular enlargement, increased NT-proBNP level, hyponatremia, increased cystatin C level and decreased glomerular filtration rate (GFR) according to CKD-EPI formula including the values of creatinine and cystatin. At the same time only hyponatremia and cardiac asthma at admission showed statistical significance in multivariate analysis. Conclusion. Significant factors associated with unfavorable outcome within 2-year follow-up after the first decompensation of CHFprEF were clinical and biochemical severity of the initial decompensation, as well as systemic manifestations of heart failure.