Identification and Clinical Impact of Preserved Left Ventricular Ejection Fraction in Patients Admitted with Acute Decompensated Heart Failure

Detalhes bibliográficos
Autor(a) principal: Goldraich, Lívia
Data de Publicação: 2008
Outros Autores: Borges, Aníbal Pires, Seewald, Rafael, Blom, Melissa, Clausell, Nadine, Beck-da-Silva, Luis, Rohde, Luis Eduardo
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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spelling 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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