AIMS: Chronic heart failure (HF) is recognized as an important public health problem but little attention has been focused on acute-stage HF. METHODS AND RESULTS: Nationwide, prospective, observational study setting 206 cardiology centres with intensive cardiac care units. During 3 months, 2807 patients diagnosed as having de novo acute HF (44%) or worsening chronic HF (56%) were enrolled. Acute pulmonary oedema was the presenting clinical feature in 49.6% of patients, cardiogenic shock in 7.7%, and worsened NYHA functional class in 42.7% of cases. Anaemia (Hb<12 g/dL) was present in 46% of patients, renal dysfunction (creatinine > or =1.5 mg%) in 47%, and hyponatraemia (< or =136 mEq/L) in 45%. An ejection fraction (EF)>40% was found in 34% of cases. Intravenous diuretics, nitrates, and inotropes were given to 95, 51, and 25% of patients, respectively. The median duration of hospital stay was 9 days. In-hospital mortality rate was 7.3%. Older age, use of inotropic drugs, elevated troponin, hyponatraemia, anaemia, and elevated blood urea nitrogen were independent predictors of all-cause death; prior revascularization procedures and elevated blood pressure were indicators of a better outcome. The rehospitalization rate within 6 months was 38.1%, all-cause mortality from discharge to 6 months was 12.8%. CONCLUSION: Acute HF is an ominous condition, needing more research activity and resources.
AIMS: Chronic heart failure (HF) is recognized as an important public health problem but little attention has been focused on acute-stage HF. METHODS AND RESULTS: Nationwide, prospective, observational study setting 206 cardiology centres with intensive cardiac care units. During 3 months, 2807 patients diagnosed as having de novo acute HF (44%) or worsening chronic HF (56%) were enrolled. Acute pulmonary oedema was the presenting clinical feature in 49.6% of patients, cardiogenic shock in 7.7%, and worsened NYHA functional class in 42.7% of cases. Anaemia (Hb<12 g/dL) was present in 46% of patients, renal dysfunction (creatinine > or =1.5 mg%) in 47%, and hyponatraemia (< or =136 mEq/L) in 45%. An ejection fraction (EF)>40% was found in 34% of cases. Intravenous diuretics, nitrates, and inotropes were given to 95, 51, and 25% of patients, respectively. The median duration of hospital stay was 9 days. In-hospital mortality rate was 7.3%. Older age, use of inotropic drugs, elevated troponin, hyponatraemia, anaemia, and elevated blood ureanitrogen were independent predictors of all-cause death; prior revascularization procedures and elevated blood pressure were indicators of a better outcome. The rehospitalization rate within 6 months was 38.1%, all-cause mortality from discharge to 6 months was 12.8%. CONCLUSION: Acute HF is an ominous condition, needing more research activity and resources.
Authors: Mihai Gheorghiade; Muthiah Vaduganathan; Andrew Ambrosy; Michael Böhm; Umberto Campia; John G F Cleland; Francesco Fedele; Gregg C Fonarow; Aldo P Maggioni; Alexandre Mebazaa; Mandeep Mehra; Marco Metra; Savina Nodari; Peter S Pang; Piotr Ponikowski; Hani N Sabbah; Michel Komajda; Javed Butler Journal: Heart Fail Rev Date: 2013-03 Impact factor: 4.214
Authors: Alexandre Mebazaa; Antonis A Pitsis; Alain Rudiger; Wolfgang Toller; Dan Longrois; Sven-Erik Ricksten; Ilona Bobek; Stefan De Hert; Georg Wieselthaler; Uwe Schirmer; Ludwig K von Segesser; Michael Sander; Don Poldermans; Marco Ranucci; Peter C J Karpati; Patrick Wouters; Manfred Seeberger; Edith R Schmid; Walter Weder; Ferenc Follath Journal: Crit Care Date: 2010-04-28 Impact factor: 9.097
Authors: Stephan von Haehling; Joerg C Schefold; Lea Majc Hodoscek; Wolfram Doehner; Marwan Mannaa; Stefan D Anker; Mitja Lainscak Journal: Clin Res Cardiol Date: 2010-02 Impact factor: 5.460
Authors: John R Teerlink; Marco Metra; Valerio Zacà; Hani N Sabbah; Gadi Cotter; Mihai Gheorghiade; Livio Dei Cas Journal: Heart Fail Rev Date: 2009-12 Impact factor: 4.214
Authors: Jalal K Ghali; Jareer O Farah; Suleiman Daifallah; Hassan A Zabalawi; Hammam D Zmily Journal: Drug Des Devel Ther Date: 2009-12-29 Impact factor: 4.162