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[Non-invasive prognostic parameters in chronic heart failure]
J Spinar1, J Vítovec, L Spinarová
1II. interní klinika FN U sv. Anny, Brno.
Insights
Pulmonary congestion signs and cardiothoracic index are key predictors of one-year mortality in chronic heart failure patients. This finding aids in better prognosis for high-risk individuals.
Area of Science:
- Cardiology
- Clinical Medicine
- Prognostics
Context:
- Investigated 125 patients with chronic heart failure (CHF) due to ischemic heart disease or dilated cardiomyopathy.
- All patients presented with NYHA functional class II-IV symptoms.
- Baseline echocardiography showed ejection fraction < 40% and/or cardiothoracic index > 50%.
Purpose:
- To identify baseline clinical, laboratory, and auxiliary indicators predicting one-year mortality in CHF patients.
- To evaluate the prognostic significance of various patient parameters.
Summary:
- One-year mortality was 15.2% (19 deaths) in the study cohort.
- Pulmonary congestion and cardiothoracic index were highly significant predictors (p < 0.001).
- Other significant indicators included sodium, urea, ergometric test duration, and body weight; echocardiographic measures and NYHA class were not significant.
Impact:
- The study highlights pulmonary congestion and cardiothoracic index as crucial prognostic markers.
- A new four-grade classification for pulmonary congestion improves prognostic accuracy for high-risk CHF patients.
- Findings can refine risk stratification and management strategies for chronic heart failure.
Abstract:
The relationship between baseline clinical, laboratory and auxiliary indicators on the one-year mortality was investigated in 125 patients with chronic heart failure caused by ischaemic heart disease or cardiomyopathy associated with dilatation. During the baseline examination all patients had cardiac symptoms-functional class NYHA II-IV- and their ejection fraction assessed by echocardiography was < 40% and/or their cardiothoracic index was > 50%. Within twelve months after the baseline examination 19 (15.2%) patients died. Signs of pulmonary congestion and the cardiothoracic index were the most significant prognostic indicator of the one-year mortality (p < 0.001). As to other indicators, the following were statistically significant: sodium level, urea level, the duration of the ergometric test and the patients' body weight. Statistical significance was not recorded in echocardiographic indicators and the NYHA classification. These data, in particular the newly introduced four-grade classification of pulmonary congestion, make it possible to assess a more accurate prognosis of high risk patients with chronic heart failure.