Clinical scenario 1 is associated with winter onset of acute heart failure

Area of Science:

• Cardiology
• Environmental Health
• Clinical Medicine

Background:

• Seasonal variations in acute heart failure (AHF) onset have been reported.
• Cold weather is a potential trigger for AHF, but patient-specific factors remain unclear.
• Clinical Scenario (CS) classification aids AHF management, prompting investigation into its relation with winter AHF.

Purpose of the Study:

• To investigate the relationship between Clinical Scenario (CS) classification and the winter onset of acute heart failure (AHF) in Japan.
• To identify clinical characteristics of AHF patients experiencing winter onset.
• To determine if CS classification influences seasonal AHF patterns.

Main Methods:

• Retrospective analysis of 582 patients hospitalized for AHF.
• Comparison of AHF frequency across four seasons within each CS group (CS1, CS2, CS3).
• Multivariate analysis to identify risk factors for winter AHF onset in CS1 patients.

Main Results:

• A significant increase in AHF during winter was observed exclusively in CS1 patients (systolic blood pressure [SBP] >140 mmHg).
• No significant winter predominance of AHF was found in CS2 (SBP 100-140 mmHg) or CS3 (SBP <100 mmHg).
• Lack of loop diuretic use was identified as a significant risk factor for winter AHF admission in CS1 patients (OR 0.562, P=0.006).

Conclusions:

• Acute heart failure shows a winter predominance solely within the CS1 patient group.
• The absence of loop diuretic use is a notable risk factor for winter-onset AHF in CS1 patients.
• Further research is warranted to explore the efficacy of loop diuretics in preventing winter AHF among CS1 patients.