Impact of clinical and echocardiographic parameters assessed during acute decompensation of chronic heart failure on 3-year survival.
BACKGROUND
It is unclear whether established risk factors affecting the prognosis of chronic heart failure (CHF) have the same predictive value when assessed during acute haemodynamic decompensation of CHF.


OBJECTIVE
To investigate the impact of selected clinical and echocardiographic parameters assessed in patients with CHF during emergency admission due to acute CHF decompensation, on 3-year survival.


METHODS
This retrospective study involved 100 consecutive patients with CHF (60 women and 40 men at the mean age of 70.4+/-9.8 years), admitted to hospital due to angina pectoris symptoms or pulmonary oedema. In the echocardiographic study performed within the first 48 hours of in-hospital stay, standard parameters as well as right ventricular systolic pressure (RVSP) were evaluated. In order to identify biological, clinical and echocardiographic factors affecting 3-year survival, both uni- and multivariable Cox proportional hazards regression analyses were carried out.


RESULTS
Forty-four patients died during 3-year follow-up. Univariate regression analysis revealed that age >60 years, sodium serum concentration <140 mmol/L, RVSP >35 mmHg and reduced left ventricular ejection fraction <50% were associated with an increased risk of death. However, multivariate regression analysis showed that only age and sodium concentration were independent risk factors.


CONCLUSIONS
Age of over 60 years and sodium concentration below 140 mmol/L seen during acute decompensation were found to be independent predictors of unfavourable outcome in terms of mortality in 3-year follow-up of patients with CHF.
Gromadziński
Leszek
L
Oddział Kardiologiczno-Internistyczny, Miejski Szpital Zespolony, ul. Niepodległości 44, 10-045 Olsztyn, Poland. lgol@op.pl
Targoński
Ryszard
R
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D018487:Ventricular Dysfunction, Left / Q000150:complications