scholarly journals A Practical Risk Score for Prediction of Early Readmission after a First Episode of Acute Heart Failure with Preserved Ejection Fraction

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 198
Author(s):  
Marilena-Brîndușa Zamfirescu ◽  
Liviu Nicolae Ghilencea ◽  
Mihaela-Roxana Popescu ◽  
Gabriel Cristian Bejan ◽  
Ileana Maria Ghiordanescu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Risk Score ◽  
Secondary Outcome ◽  
First Episode ◽  
Preserved Ejection Fraction ◽  
Time Integral ◽  
Baseline Characteristics

Background: The first admission for acute heart failure with preserved ejection fraction (HFpEF) drastically influences the short-term prognosis. Baseline characteristics may predict repeat hospitalization or death in these patients. Methods: A 103 patient-cohort, admitted for the first acute HFpEF episode, was monitored for six months. Baseline characteristics were recorded and their relation to the primary outcome of heart failure readmission (HFR) and secondary outcome of all-cause mortality was assessed. Results: We identified six independent determinants for HFR: estimated glomerular filtration rate (eGFR) (p = 0.07), hemoglobin (p = 0.04), left ventricle end-diastolic diameter (LVEDD) (p = 0.07), E/e’ ratio (p = 0.004), left ventricle outflow tract velocity-time integral (LVOT VTI) (p = 0.045), and diabetes mellitus (p = 0.06). Three of the variables were used to generate a risk score for HFR: LVEDD, E/e’, LVOT VTI -DEI Score = − 28.763 + 4.558 × log (LVEDD (mm)) + 1.961 × log (E/e’ ratio) + 1.759 × log (LVOT VTI (cm)). Our model predicts a relative amount of 20.50% of HFR during the first 6 months after the first acute hospitalization within the general population with HFpEF with a DEI Score over −0.747. Conclusions: We have identified three echocardiographic parameters (LVEDD, E/e’, and LVOT VTI) that predict HFR following an initial acute HFpEF hospitalization. The prognostic DEI score demonstrated good accuracy.

Acute heart failure with preserved ejection fraction and long-term Readmisions

2008 ◽  
Vol 7 ◽  
pp. 62-63
Author(s):  
J NUNEZ ◽  
L MAINAR ◽  
G MINANA ◽  
R ROBLES ◽  
J SANCHIS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

Do Patients With Acute Heart Failure and Preserved Ejection Fraction Have Heart Failure at Follow-Up: Implications of the Framingham Criteria

2020 ◽  
Vol 26 (8) ◽  
pp. 673-684
Author(s):  
CAMILLA HAGE ◽  
ULRIKA LÖFSTRÖM ◽  
ERWAN DONAL ◽  
EMMANUEL OGER ◽  
AGNIESZKA KAPŁON-CIEŚLICKA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

scholarly journals Trimethylamine N‐oxide and outcomes in patients hospitalized with acute heart failure and preserved ejection fraction

2021 ◽  
Author(s):  
Yoshiharu Kinugasa ◽  
Kensuke Nakamura ◽  
Hiroko Kamitani ◽  
Masayuki Hirai ◽  
Kiyotaka Yanagihara ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

Prognostic role of sonographic decongestion in patients with acute heart failure with reduced and preserved ejection fraction: a multicentre study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N.R Pugliese ◽  
M Mazzola ◽  
G Bandini ◽  
G Barbieri ◽  
S Spinelli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Vena Cava ◽  
Composite Endpoint ◽  
Clinical Findings ◽  
Preserved Ejection Fraction ◽  
Net Reclassification Improvement ◽  
B Lines

Abstract Aims Our aim was to assess the dynamic changes of pulmonary congestion (PC) through variations of sonographic B-lines, in addition to conventional clinical, biohumoral and echocardiographic findings, to improve prognostic stratification of patients admitted for acute heart failure with reduced and preserved ejection fraction (HFrEF, HFpEF). Methods In this multicenter, prospective, observational study, lung ultrasound was performed in all patients at admission and before discharge by trained investigators, blinded to clinical findings and outcomes. Results We enrolled 208 consecutive patients admitted for acute heart failure (125 HFrEF, 83 HFpEF, mean age 75.9±11.7 years, 36% females, mean ejection fraction 38%). After 180-day follow-up, 38 composite endpoint events occurred (cardiovascular deaths or HF re-hospitalisations). In a multivariate model, B-lines at discharge had independent prognostic value in the overall population together with NT-proBNP, moderate-to-severe mitral regurgitation (MR) and inferior vena cava diameter at admission. When dividing the population in HFrEF and HFpEF, B-lines at discharge was the only independent parameter to predict events in all subgroups. At ROC analysis, a cut-off of B-lines>15 at discharge displayed the highest accuracy in predicting adverse events (AUC=0.80, p<0.0001). The identification of patients unable to halve B-lines during hospitalization (ΔB-lines%), in addition to B-lines >15 at discharge, improved event classification (integrated discrimination improvement=4%, p=0.01; continuous net reclassification improvement=22.8%, p=0.04). Conclusions The presence of residual subclinical sonographic PC at discharge predicts adverse events in the whole spectrum of acute HF patients, independently of conventional biohumoral and echocardiographic parameters. The dynamic evaluation of pulmonary decongestion during hospital stay can further improve patient risk stratification. Funding Acknowledgement Type of funding source: None

Abstract 16170: Impact of Anemia on Outcomes in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Monil Majmundar ◽  
Ashish Kumar ◽  
Rajkumar P Doshi ◽  
Palak shah ◽  
Mariam Shariff ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Publication Bias ◽  
Meta Analysis ◽  
Final Analysis ◽  
Study Data ◽  
Curve Analysis ◽  
Secondary Outcome ◽  
Preserved Ejection Fraction ◽  
All Cause Mortality

Introduction: The effect of anemia on outcomes in Heart failure with preserved ejection fraction (HFpEF) patients is not well-established. Some previous studies have shown increased mortality and hospitalizations in HFpEF patients with anemia. Hypothesis: We hypothesize that anemia affects all-cause mortality and hospitalization in HFpEF patients. Methods: A review of literature for studies comparing outcomes in HFpEF with and without anemia was done in PubMed, MEDLINE, and EMBASE databases through June 1st, 2020. The standard definitions of HFpEF and anemia were used for inclusion criteria. Two investigators extracted the study data independently. The primary outcome of interest was all-cause mortality. The secondary outcome was all-cause hospitalizations. We used the PM estimator of Tau with Knapp-Hartung adjustment to pool adjusted hazard ratio (HR) and 95% confidence interval (CI). P curve analysis was used to assess publication bias. R version 3.6.2 was used for all statistical analyses. Results: Seven studies (23,424 patients) were included in the final analysis. Anemia in patients with HFpEF was associated with higher rates of all-cause mortality [HR: 1.35, 95% CI: 1.17-1.55]. Additionally, anemia in HFpEF patients was associated with higher rates of all-cause hospitalization [HR: 1.22, 95% CI: 1.03-1.44]. P curve analysis for all-cause mortality didn’t report publication bias or P hacking (Figure) . Conclusions: Anemia in HFpEF patients was associated with higher rates of all-cause mortality and all-cause hospitalizations compared to HFpEF patients without anemia.

scholarly journals Improving risk stratification in heart failure with preserved ejection fraction by combining two validated risk scores

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000961 ◽  
Author(s):  
Kalyani Anil Boralkar ◽  
Yukari Kobayashi ◽  
Kegan J Moneghetti ◽  
Vedant S Pargaonkar ◽  
Mirela Tuzovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Risk Score ◽  
Multivariable Analysis ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Risk Scores ◽  
Preserved Ejection Fraction ◽  
Hospitalised Patients ◽  
All Cause Mortality

IntroductionThe Intermountain Risk Score (IMRS) was developed and validated to predict short-term and long-term mortality in hospitalised patients using demographics and commonly available laboratory data. In this study, we sought to determine whether the IMRS also predicts all-cause mortality in patients hospitalised with heart failure with preserved ejection fraction (HFpEF) and whether it is complementary to the Get with the Guidelines Heart Failure (GWTG-HF) risk score or N-terminal pro-B-type natriuretic peptide (NT-proBNP).Methods and resultsWe used the Stanford Translational Research Integrated Database Environment to identify 3847 adult patients with a diagnosis of HFpEF between January 1998 and December 2016. Of these, 580 were hospitalised with a primary diagnosis of acute HFpEF. Mean age was 76±16 years, the majority being female (58%), with a high prevalence of diabetes mellitus (36%) and a history of coronary artery disease (60%). Over a median follow-up of 2.0 years, 140 (24%) patients died. On multivariable analysis, the IMRS and GWTG-HF risk score were independently associated with all-cause mortality (standardised HRs IMRS (1.55 (95% CI 1.27 to 1.93)); GWTG-HF (1.60 (95% CI 1.27 to 2.01))). Combining the two scores, improved the net reclassification over GWTG-HF alone by 36.2%. In patients with available NT-proBNP (n=341), NT-proBNP improved the net reclassification of each score by 46.2% (IMRS) and 36.3% (GWTG-HF).ConclusionIMRS and GWTG-HF risk scores, along with NT-proBNP, play a complementary role in predicting outcome in patients hospitalised with HFpEF.

Sign in / Sign up

Export Citation Format

Share Document