Original article Impact of clinical and echocardiographic parameters assessed during acute decompensation of chronic heart failure on 3-year survival

Abstract

Background: It is unclear whether established risk factors affecting the prognosis of chronic heart failure (CHF) have the same predictive value when assessed during acute haemodynamic decompensation of CHF. Aim: To investigate the impact of selected clinical and echocardiographic parameters assessed in patients with CHF during emergency admission due to acute CHF decompensation, on 3-year survival. Methods: This retrospective study involved 100 consecutive patients with CHF (60 women and 40 men at the mean age of 70.4±9.8 years), admitted to hospital due to angina pectoris symptoms or pulmonary oedema. In the echocardiographic study performed within the first 48 hours of in-hospital stay, standard parameters as well as right ventricular systolic pressure (RVSP) were evaluated. In order to identify biological, clinical and echocardiographic factors affecting 3-year survival, both uni- and multivariable Cox proportional hazards regression analyses were carried out. Results: Forty-four patients died during 3-year follow-up. Univariate regression analysis revealed that age >60 years, sodium serum concentration <140 mmol/L, RVSP >35 mmHg and reduced left ventricular ejection fraction <50% were associated with an increased risk of death. However, multivariate regression analysis showed that only age and sodium concentration were independent risk factors. Conclusions: Age of over 60 years and sodium concentration below 140 mmol/L seen during acute decompensation were found to be independent predictors of unfavourable outcome in terms of mortality in 3-year follow-up of patients with CHF.