Clinical and laboratory characteristics of short-term mortality in Egyptian patients with acute heart failure.
Clinical and laboratory characteristics of short-term mortality in Egyptian patients with acute heart failure.
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DOI：
10.1016/j.ehj.2017.02.003
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Omera MA
中科院分区：
文献类型：
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作者：
Abdellah AT;Mohamed AD;Hendawi HA;Omera MA
确定急性心力衰竭（AHF）患者短期死亡率的临床和实验室预测因素。我们对 120 名连续到急诊科就诊的急性心力衰竭患者进行了一项前瞻性、单中心研究。所有患者均接受临床、实验室、心电图和超声心动图评估。就诊后 30 天内报告短期死亡率。平均年龄为 59.29 ± 10.1 岁，其中 55.8% 为男性，50.8% 为吸烟者。常见的 AHF 表现为呼吸困难（91.7%）、胸闷（62.5%）和下肢水肿（54.2%）。缺血性心脏病、糖尿病和高血压分别占 72.5%、43.3% 和 35% 的患者。 29 名患者报告短期死亡（24.16%）；其中大部分在院内死亡（19例，65.52%）。以下参数与短期死亡率显着相关：缺氧 (P < 0.001)、心动过速 (P < 0.01)、颈静脉压升高 (JVP) (P < 0.001)、低收缩压 (P < 0.01)、PR 间期延长 (P < 0.007)、心房颤动 (AF) (P < 0.038)、左束支传导阻滞 (LBBB) (P < 0.04)、肾功能受损 (P < 0.007)、贫血 (P < 0.029)、低钠血症 (P < 0.006)、低蛋白血症 (P < 0.005)、左心室扩张 (LV) (P < 0.001)、低 LV射血分数 (LVEF) (P < 0.001) 和左心房扩张 (LA) (P < 0.002)。 ROC曲线分析显示，低LVEF（≤24%）、扩张的左心室舒张末期内径（LVESD）≥66.5毫米、扩张的左心室收缩末期直径（LVESD）≥53.5毫米、扩张的左心室直径≥48毫米、血清肌酐升高≥1.6mg/dl和血清白蛋白降低≤3g/dl可以显着预测短期死亡率急性心力衰竭患者。可变的临床、实验室、心电图和超声心动图参数与短期死亡率相关。我们的研究表明，低 LVEF、扩张的 LV 直径、扩张的 LA 直径、肾功能受损和低血清白蛋白可以预测急性心力衰竭患者的短期死亡率。
To identify the clinical and laboratory predictors of short-term mortality in patients with acute heart failure (AHF). We conducted a prospective, single center study on 120 consecutive patients presented with acute heart failure to the emergency department. All patients had clinical, laboratory, electrocardiographic and echocardiographic evaluation. Short-term mortality was reported within 30 days of presentation. Mean age was 59.29 ± 10.1 years, 55.8% were males and 50.8% were smokers. The common AHF presentations were dyspnea (91.7%), chest tightness (62.5%) and lower limb edema (54.2%). Ischemic heart disease, diabetes and hypertension were present in 72.5%, 43.3% and 35% of patients, respectively. Short-term mortality was reported in 29 patients (24.16%); most of them died in-hospital (19 patients, 65.52%). The following parameters were significantly associated with short-term mortality: hypoxia (P < 0.001), tachycardia (P < 0.01), raised jugular venous pressure (JVP) (P < 0.001), low systolic blood pressure (P < 0.01), prolonged PR interval (P < 0.007), atrial fibrillation (AF) (P < 0.038), left bundle branch block (LBBB) (P < 0.04), impaired kidney function (P < 0.007), anemia (P < 0.029), hyponatremia (P < 0.006), hypoalbuminemia (P < 0.005), dilated left ventricle (LV) (P < 0.001), low LV ejection fraction (LVEF) (P < 0.001), and dilated left atrium (LA) (P < 0.002). ROC curve analysis showed that low LVEF (≤24%), dilated LV end diastolic diameter (LVESD) ≥ 66.5 mm, dilated LV end systolic diameter (LVESD) ≥ 53.5 mm, dilated LA diameter ≥ 48 mm, increased serum creatinine ≥ 1.6 mg/dl, and decreased serum albumin ≤ 3 g/dl can significantly predict short-term mortality in patients with acute heart failure. Variable clinical, laboratory, electrocardiographic and echocardiographic parameters were associated with short-term mortality. Our study showed that low LVEF, dilated LV diameter, dilated LA diameter, impaired kidney function and low serum albumin can predict short-term mortality in patients with acute heart failure.