doiSerbia

Are de novo acute heart failure and acutely worsened chronic heart failure two subgroups of the same syndrome?

Banović Marko (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Vasiljević-Pokrajčić Zorana (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Vujisić-Tešić Bosiljka (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Stanković Sanja (Klinička laboratorija, Urgentni centar, Klinički centar Srbije, Beograd)
Nedeljković Ivana (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Petrović Olga (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Otašević Petar (Institut za kardiovaskularne bolesti 'Dedinje', Beograd)
Boričić-Kostić Marija (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Petrović Milan (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Trifunović Danijela (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)
Ostojić Miodrag (Institut za kardiovaskularne bolesti, Klinički centar Srbije, Beograd)

Introduction. Acute heart failure (AHF) is one of the most common diseases in emergency medicine, associated with poor prognosis and high in-hospital and long-term mortality. Objective. To investigate clinical presentation of patients with de novo AHF and acute worsening of chronic heart failure (CHF) and to identify differences in blood levels of biomarkers and echocardiography findings. Methods. This prospective study comprised 64 consecutive patients being grouped according to the onset of the disease into patients with the de novo AHF (45.3%), and patients with acute worsening of CHF (54.7%). Results. Acute congestion (60%) was the most common manifestation of de novo AHF, whereas pulmonary oedema (43.1%) was the most common manifestation of acutely decompensated CHF. Patients with acutely decompensated CHF had significantly higher blood values of creatinine (147.10 vs 113.16 μmol/l; p<0.05), urea (12.63 vs 7.82 mmol/l; p<0.05), BNP (1440.11 vs 712.24 pg/ml; p<001) and NTproBNP (9097.00 vs 2827.70 pg/ml; p<0.01) on admission, and lower values of M-mode left ventricular ejection fraction (LVEF) during hospitalization (49.44% vs 42.94%; p<0.05). The follow-up after one year revealed still significantly higher BNP (365.49 vs 164.02 pg/ ml; p<0.05) and lower average values of both LVEF in patients with acutely worsened CHF (46.62% vs 54.41% and 39.52% vs 47.88%; p<0.05). Conclusion. Considering differences in clinical severity on admission, echocardiography and natriuretic peptide values during hospitalization and after one year follow-up, de novo AHF and acutely worsened CHF are two different subgroups of the same syndrome.

Keywords: acute heart failure, echocardiography, natriuretic Peptides