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Heart Failure V: Medical Management

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...

Heart Failure II: Pathophysiology

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...

Heart Failure I: Introduction

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...

Heart Failure VI: Adjunct Therapies

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.

Heart Failure VII: Nursing Interventions

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...

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Related Experiment Video

Updated: Nov 18, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Acute Hemodynamic Index Predicts In-Hospital Mortality in Acute Decompensated Heart Failure.

Renata R T Castro^1,2,3, Luka Lechnewski⁴, Alan Homero⁴

¹Brigham and Womens Hospital - Medicine, Boston - EUA.

Arquivos Brasileiros De Cardiologia

|February 10, 2021

Summary

The acute hemodynamic index (AHI) can predict in-hospital mortality in patients with decompensated heart failure. This simple bedside tool may aid emergency room assessments for heart failure prognosis.

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Last Updated: Nov 18, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

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Published on: June 10, 2025

Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis

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Published on: June 30, 2023

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Area of Science:

Cardiology
Clinical Medicine
Medical Diagnostics

Background:

Physical examination for decompensated heart failure (HF) prognosis is unreliable.
The acute hemodynamic index (AHI) was developed using heart rate and pulse pressure, considering hemodynamic responses to stress.

Purpose of the Study:

To assess the in-hospital prognostic capability of the AHI in patients with decompensated HF.

Main Methods:

A prospective, multicenter observational study utilized data from the BREATHE registry.
Prognostic ability was evaluated using ROC analyses, C-statistics, AIC, and multivariate regression.
Statistical significance was set at p < 0.05.

Main Results:

Data from 463 patients with low ejection fraction heart failure were analyzed; in-hospital mortality was 9%.
A low AHI (≤ 4 mmHg⋅bpm) was associated with a 2.5-fold increased risk of in-hospital mortality.
AHI independently predicted in-hospital mortality (AUC: 0.607, p = 0.010), even after adjusting for covariates.

Conclusions:

The AHI is an independent predictor of in-hospital mortality in acute decompensated HF.
This simple bedside index shows potential utility in emergency settings for heart failure prognosis.