Clinical Characteristics of De Novo Heart Failure and Acute Decompensated Chronic Heart Failure: Are They Distinctive Phenotypes That Contribute to Different Outcomes?

Raffaello, Wilson Matthew; Henrina, Joshua; Huang, Ian; Lim, Michael Anthonius; Suciadi, Leonardo Paskah; Siswanto, Bambang Budi; Pranata, Raymond

doi:10.15420/cfr.2020.20

Cited by 17 publications

(14 citation statements)

References 80 publications

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“…In our study, age and dyspnea were equable between both groups, as were the parameters of hemoglobin, white blood cell and platelet counts. Interestingly, a previous meta-analysis has indicated that a lower age of de novo AHF patients is likely; however, we did not observe such an association [23]. The inflammatory biomarkers, like C-reactive protein, IL-6 and IL-22, were also comparable between both groups, alongside several remodeling markers.…”

Section: Discussioncontrasting

confidence: 60%

Differences in the Biomarker Profile of De Novo Acute Heart Failure versus Decompensation of Chronic Heart Failure

et al. 2021

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The perception of acute heart failure (AHF) as a single entity is increasingly outdated, as distinct patient profiles can be discerned. Key heart failure (HF) studies have previously highlighted the difference in both the course and prognosis of de novo AHF and acute decompensated chronic HF (ADHF). Accordingly, distinct AHF profiles with differing underlying pathophysiologies of disease progression can be shown. We compared a range of selected biomarkers in order to better describe the profile of de novo AHF and ADHF, including the inter alia—serum lactate, bilirubin, matrix metallopeptidase 9 (MMP-9), follistatin, intercellular adhesion molecule 1 (ICAM-1), lipocalin and galectin-3. The study comprised 248 AHF patients (de novo = 104), who were followed up for one year. The biomarker data of the de novo AHF and ADHF profiles was then compared in order to link biomarkers to their prognosis. Our study demonstrated that, although there are similarities between each patient profile, key biomarker differences do exist—predominantly in terms of NTproBNP, serum lactate, bilirubin, ICAM-1, follistatin, ferritin and sTfR (soluble transferrin receptor). ADHF tended to have compromised organ function and higher risks of both one-year mortality and composite endpoint (one-year mortality or rehospitalization for heart failure) hazard ratios (HR) (95% CI): 3.4 (1.8–6.3) and 2.8 (1.6–4.6), respectively, both p < 0.0001. Among the biomarkers of interest: sTfR HR (95% CI): 1.4 (1.04–1.8), NGAL(log) (neutrophil gelatinase-associated lipocalin) HR (95% CI): 2.0 (1.3–3.1) and GDF-15(log) (growth/differentiation factor-15) HR (95% CI): 4.0 (1.2–13.0) significantly impacted the one-year survival, all p < 0.05.

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Section: Discussioncontrasting

confidence: 60%

Differences in the Biomarker Profile of De Novo Acute Heart Failure versus Decompensation of Chronic Heart Failure

et al. 2021

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“…19 New onset heart failure: acutely worsened heart function without known underlying heart disease. 20 CV deaths: deaths that result from an acute myocardial infarction, sudden cardiac death, death due to heart failure, death due to stroke, death due to CV procedures, death due to CV hemorrhage, and death due to other CV causes. 21 Outcome: the occurrence of any of the major adverse CV outcomes and change in echocardiographic parameters in patients was correlated with volume overload determined by the methods described above.…”

Section: Methodsmentioning

confidence: 99%

“…New onset heart failure: acutely worsened heart function without known underlying heart disease. 20 5. CV deaths: deaths that result from an acute myocardial infarction, sudden cardiac death, death due to heart failure, death due to stroke, death due to CV procedures, death due to CV hemorrhage, and death due to other CV causes.…”

Section: Follow-upmentioning

confidence: 99%

Cardiac Evaluation and its Correlation with Volume Status in Maintenance Hemodialysis Patients

Bhattacharyya,

Mahapatra,

Pursnani

et al. 2023

Indian Journal of Clinical Medicine

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Introduction: Fluid overload (FO) in hemodialysis (HD) patients can result in increase in left atrial volume (LAV) and left ventricular mass (LVM). Here, we correlated volume status with cardiac outcome in these patients over a period of 6 months. Methodology: Consecutive clinically euvolumic end stage renal disease (ESRD) patients on thrice weekly maintenance hemodialysis (MHD) for at least 6 months were included. Inferior vena cava (IVC) Collapsibility Index of ≤40% by IVC or B-Line score of ≥15 by lung ultrasound (LUS) or over hydration/extracellular water (OH/ECW) by bioimpedence spectroscopy (BIS) ≥15% were defined as FO. A cut-off of left ventricular mass index (LVMI) ≥115 gm/m2 and LAV index (LAVI) ≥34 mL/m2 on echocardiography were used for defining left ventricular hypertrophy (LVH) and left atrial dilatation (LAD), respectively. The diagnostic value of LUS for OH, considering BIS as the gold standard and correlation between LVMI and LAVI with OH/ECW and LUS score was studied. Results: Among 100 MHD patients, 29% had OH at baseline. Baseline FO was significantly associated with LAD but not LVH. The specificity of LUS in diagnosing FO at 3rd and 6th months was 98% and 95.1%, respectively. OH/ECW on BIS showed a correlation with both LAVI at baseline ( p-value of .03, R2 0.71). B line score determined by LUS did not show a correlation with LAVI at baseline ( p-value of .07, R2 0.49). Conclusion: Routine ultrasound use in HD unit for determining OH and echocardiography screening for LAD would assess and reduce early cardiovascular events.

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“…myocarditis) or toxins. 6 These patients, despite a similar natural course and symptoms, tend to have a better prognosis than acutely decompensated chronic HF. In these patients, the typical mechanism is an acute haemodynamic derangement caused by LV systolic dysfunction.…”

Section: Clinical Approach To Acute Heart Failure: One Size Does Not ...mentioning

confidence: 99%

“…ADHF patients commonly present with pulmonary and/or peripheral congestion, left (and eventually right) ventricular dysfunction, and maladaptive neurohormonal activation in the context of a chronic illness in which exacerbations gradually reduce functional reserve, and in which mortality and HF chronicity are strictly interweaved. 6 Right ventricular dysfunction or frequent HF hospitalizations generally appear in advanced stages of the disease and should be considered as ‘red flags’ for adverse clinical outcomes. For example, in advanced HF patients, INTERMACS profiles take into account risk modifiers as frequent HF hospitalizations that define particularly high-risk situations; furthermore, recurrence of ventricular arrhythmias may denote an advanced state of the disease and is likewise considered a risk modifier due to its potential clinical relevance for patient management.…”

Section: Clinical Approach To Acute Heart Failure: One Size Does Not ...mentioning

confidence: 99%

Acute heart failure: differential diagnosis and treatment

Marini

Manfredi

Battistoni

et al. 2023

European Heart Journal Supplements

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Acute heart failure is a heterogeneous clinical syndrome and is the first cause of unplanned hospitalization in people >65 years. Patients with heart failure may have different clinical presentations according to clinical history, pre-existing heart disease, and pattern of intravascular congestion. A comprehensive assessment of clinical, echocardiographic, and laboratory data should aid in clinical decision-making and treatment. In some cases, a more accurate evaluation of patient haemodynamics via a pulmonary artery catheter may be necessary to undertake and guide escalation and de-escalation of therapy, especially when clinical, echo, and laboratory data are inconclusive or in the presence of right ventricular dysfunction. Similarly, a pulmonary artery catheter may be useful in patients with cardiogenic shock undergoing mechanical circulatory support. With the subsequent de-escalation of therapy and haemodynamic stabilization, the implementation of guideline-directed medical therapy should be pursued to reduce the risk of subsequent heart failure hospitalization and death, paying particular attention to the recognition and treatment of residual congestion.

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Clinical Characteristics of De Novo Heart Failure and Acute Decompensated Chronic Heart Failure: Are They Distinctive Phenotypes That Contribute to Different Outcomes?

Cited by 17 publications

References 80 publications

Differences in the Biomarker Profile of De Novo Acute Heart Failure versus Decompensation of Chronic Heart Failure

Differences in the Biomarker Profile of De Novo Acute Heart Failure versus Decompensation of Chronic Heart Failure

Cardiac Evaluation and its Correlation with Volume Status in Maintenance Hemodialysis Patients

Acute heart failure: differential diagnosis and treatment

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