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Updated: Sep 10, 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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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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Advancements and Challenges in Acute Heart Failure Management in Korea: Initial Report and Insights from the Korean

Huijin Lee1, Eung Ju Kim2, Seong Woo Han3

  • 1Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Journal of Cardiac Failure
|August 22, 2025
PubMed

Insights

The Korean Heart Failure III registry shows improved acute heart failure (AHF) hospital care, but long-term mortality remains high. Hyponatremia is a key predictor of poor outcomes, emphasizing the need for better post-discharge management.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Acute heart failure (AHF) presents a significant global health challenge.
  • The Korean Heart Failure III (KorHF III) registry builds upon previous national data to offer a current assessment of AHF in Korea.
  • Understanding contemporary clinical characteristics, treatment patterns, and outcomes is crucial for improving patient care.

Purpose of the Study:

  • To provide a comprehensive, contemporary evaluation of patients hospitalized with acute heart failure (AHF) in Korea.
  • To analyze clinical characteristics, treatment strategies, and patient outcomes.
  • To identify key factors influencing mortality in AHF patients.

Main Methods:

  • Prospective enrollment of 7,351 AHF patients across 47 tertiary hospitals in Korea from March 2018 to December 2022.
  • Two-year follow-up to assess long-term outcomes.
  • Analysis of patient demographics, comorbidities, etiologies, in-hospital treatments, and mortality rates.

Main Results:

  • Heart failure with reduced ejection fraction (HFrEF) comprised 57.3% of cases, with hypertension and diabetes as common comorbidities.
  • High rates of guideline-directed medical therapy (GDMT) prescription at discharge, including ACEIs/ARBs/ARNIs (74.3%) and beta-blockers (68.5%).
  • In-hospital mortality was 2.2%, while 2-year mortality reached 20.9%, notably higher in HF with preserved ejection fraction (HFpEF). Hyponatremia was significantly associated with both in-hospital and post-discharge mortality.

Conclusions:

  • The KorHF III registry offers the most extensive current data on AHF in Korea.
  • Despite advancements in GDMT prescription and low in-hospital mortality, substantial long-term mortality persists.
  • Improved post-discharge care strategies and recognition of hyponatremia as a critical prognostic indicator are essential for managing AHF effectively.
Abstract

Keywords:
Acute heart failureKorean Heart Failure III registryguideline-directed medical therapyhyponatremia

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