Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure
Autor(a) principal: | |
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Data de Publicação: | 2008 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Clinical and Biomedical Research |
Texto Completo: | https://seer.ufrgs.br/index.php/hcpa/article/view/5049 |
Resumo: | Background. Identification and clinical impact of preserved EF (ejection fraction) on in-hospital outcomes in patients with acute decompensated heart failure (HF) remain poorly defined. Methods. Consecutive admissions for decompensated HF, defined by Boston criteria equal to or higher than to 8 points, at a tertiary care hospital in Brazil were included. Preserved systolic function was defined as left ventricular EF ? 50%. Approximately 80 clinical variables based on history, physical examination, laboratory and echocardiographic data were evaluated to identify predictors of preserved EF at admission. Included patients were followed up through hospitalization to discharge or death. Results. Overall, 721 consecutive HF admissions were enrolled (66 ? 13 years, EF = 42 ? 17%, 50% male) and preserved EF was identified in 224 (31%). Patients with acute decompensated HF and preserved EF presented with distinctive clinical characteristics: older age, female gender, non-ischemic etiology, higher prevalence of chronic atrial fibrillation, lower hemoglobin levels, lower pulse pressure and wider QRS complexes. No significant differences were observed on in-hospital mortality according to quintiles of EF, but we observed a trend toward increased clinical complications in patients with higher EF. Conclusions. Preserved EF is a prevalent and morbid condition among hospitalized HF patients. |
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Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart FailureIdentificação e Impacto Clínico de Fração de Ejeção Preservada em Pacientes Admitidos por Insuficiência Cardíaca DescompensadaInsuficiência Cardíaca DescompensadaFração de ejeção preservadadesfechos intra-hospitalaresCardiologiaBackground. Identification and clinical impact of preserved EF (ejection fraction) on in-hospital outcomes in patients with acute decompensated heart failure (HF) remain poorly defined. Methods. Consecutive admissions for decompensated HF, defined by Boston criteria equal to or higher than to 8 points, at a tertiary care hospital in Brazil were included. Preserved systolic function was defined as left ventricular EF ? 50%. Approximately 80 clinical variables based on history, physical examination, laboratory and echocardiographic data were evaluated to identify predictors of preserved EF at admission. Included patients were followed up through hospitalization to discharge or death. Results. Overall, 721 consecutive HF admissions were enrolled (66 ? 13 years, EF = 42 ? 17%, 50% male) and preserved EF was identified in 224 (31%). Patients with acute decompensated HF and preserved EF presented with distinctive clinical characteristics: older age, female gender, non-ischemic etiology, higher prevalence of chronic atrial fibrillation, lower hemoglobin levels, lower pulse pressure and wider QRS complexes. No significant differences were observed on in-hospital mortality according to quintiles of EF, but we observed a trend toward increased clinical complications in patients with higher EF. Conclusions. Preserved EF is a prevalent and morbid condition among hospitalized HF patients.A identificação e o impacto clínico da fração de ejeção (FE) preservada em pacientes hospitalizados por insufici-ência cardíaca (IC) descompensada permanecem pouco estudados. Métodos. Foram analisadas admissões consecuti-vas por IC descompensada em um hospital terciário brasileiro. A inclusão foi realizada a partir de pontuação igual ou superior a 8 pontos no escore de Boston para definição de IC. FE preservada foi definida como FE de ventrículo es-querdo ? 50%. Cerca de 80 variáveis clínicas, laboratoriais e prognósticas foram obtidas ao longo da internação até o óbito ou a alta hospitalar através de protocolo estruturado. Resultados. Foram incluídas 721 admissões consecutivas por IC descompensada (idade= 66 ?13 anos, FEVE= 42 ?17%, 50% do sexo masculino). A prevalência de FE preser-vada foi de 31%. Pacientes com valores mais elevados de FE apresentaram características clínicas significativamente distintas das de pacientes com disfunção sistólica, tais como idade avançada, predominância do sexo feminino, maior proporção de etiologia não-isquêmica, prevalência elevada de fibrilação atrial crônica, níveis inferiores de hemoglobina, pressão de pulso reduzida e complexos QRS alargados. Não foi observada diferença significativa na mortalidade intra-hospitalar de acordo com quintis de FE, porém houve uma tendência para um aumento de complicações clínicas em pacientes com FE elevada. Conclusões. FE preservada é uma condição prevalente e responsável por significativa morbi-mortalidade entre pacientes brasileiros hospitalizados por IC descompensada.HCPA/FAMED/UFRGS2008-08-26info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliado por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/5049Clinical & Biomedical Research; Vol. 28 No. 2 (2008): Revista HCPAClinical and Biomedical Research; v. 28 n. 2 (2008): Revista HCPA2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSporhttps://seer.ufrgs.br/index.php/hcpa/article/view/5049/3335Goldraich, LíviaBorges, Aníbal PiresSeewald, RafaelBlom, MelissaClausell, NadineBeck-da-Silva, LuisRohde, Luis Eduardoinfo:eu-repo/semantics/openAccess2020-01-16T16:16:53Zoai:seer.ufrgs.br:article/5049Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2020-01-16T16:16:53Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.none.fl_str_mv |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure Identificação e Impacto Clínico de Fração de Ejeção Preservada em Pacientes Admitidos por Insuficiência Cardíaca Descompensada |
title |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
spellingShingle |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure Goldraich, Lívia Insuficiência Cardíaca Descompensada Fração de ejeção preservada desfechos intra-hospitalares Cardiologia |
title_short |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
title_full |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
title_fullStr |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
title_full_unstemmed |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
title_sort |
Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure |
author |
Goldraich, Lívia |
author_facet |
Goldraich, Lívia Borges, Aníbal Pires Seewald, Rafael Blom, Melissa Clausell, Nadine Beck-da-Silva, Luis Rohde, Luis Eduardo |
author_role |
author |
author2 |
Borges, Aníbal Pires Seewald, Rafael Blom, Melissa Clausell, Nadine Beck-da-Silva, Luis Rohde, Luis Eduardo |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Goldraich, Lívia Borges, Aníbal Pires Seewald, Rafael Blom, Melissa Clausell, Nadine Beck-da-Silva, Luis Rohde, Luis Eduardo |
dc.subject.por.fl_str_mv |
Insuficiência Cardíaca Descompensada Fração de ejeção preservada desfechos intra-hospitalares Cardiologia |
topic |
Insuficiência Cardíaca Descompensada Fração de ejeção preservada desfechos intra-hospitalares Cardiologia |
description |
Background. Identification and clinical impact of preserved EF (ejection fraction) on in-hospital outcomes in patients with acute decompensated heart failure (HF) remain poorly defined. Methods. Consecutive admissions for decompensated HF, defined by Boston criteria equal to or higher than to 8 points, at a tertiary care hospital in Brazil were included. Preserved systolic function was defined as left ventricular EF ? 50%. Approximately 80 clinical variables based on history, physical examination, laboratory and echocardiographic data were evaluated to identify predictors of preserved EF at admission. Included patients were followed up through hospitalization to discharge or death. Results. Overall, 721 consecutive HF admissions were enrolled (66 ? 13 years, EF = 42 ? 17%, 50% male) and preserved EF was identified in 224 (31%). Patients with acute decompensated HF and preserved EF presented with distinctive clinical characteristics: older age, female gender, non-ischemic etiology, higher prevalence of chronic atrial fibrillation, lower hemoglobin levels, lower pulse pressure and wider QRS complexes. No significant differences were observed on in-hospital mortality according to quintiles of EF, but we observed a trend toward increased clinical complications in patients with higher EF. Conclusions. Preserved EF is a prevalent and morbid condition among hospitalized HF patients. |
publishDate |
2008 |
dc.date.none.fl_str_mv |
2008-08-26 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Peer-reviewed Article Avaliado por Pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://seer.ufrgs.br/index.php/hcpa/article/view/5049 |
url |
https://seer.ufrgs.br/index.php/hcpa/article/view/5049 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://seer.ufrgs.br/index.php/hcpa/article/view/5049/3335 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
HCPA/FAMED/UFRGS |
publisher.none.fl_str_mv |
HCPA/FAMED/UFRGS |
dc.source.none.fl_str_mv |
Clinical & Biomedical Research; Vol. 28 No. 2 (2008): Revista HCPA Clinical and Biomedical Research; v. 28 n. 2 (2008): Revista HCPA 2357-9730 reponame:Clinical and Biomedical Research instname:Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS |
instname_str |
Universidade Federal do Rio Grande do Sul (UFRGS) |
instacron_str |
UFRGS |
institution |
UFRGS |
reponame_str |
Clinical and Biomedical Research |
collection |
Clinical and Biomedical Research |
repository.name.fl_str_mv |
Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS) |
repository.mail.fl_str_mv |
||cbr@hcpa.edu.br |
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1799767051287396352 |