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Survival in acute heart failure in intensive cardiac care unit: a prospective study

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Abstract

The aim of this study is to identify the best predictors of mortality among clinical, biochemical and advanced echocardiographic parameters in acute heart failure (AHF) patients admitted to coronary care unit (CCU). AHF is a clinical condition characterized by high mortality and morbidity. Several studies have investigated the potential prognostic factors that could help the risk assessment of cardiovascular events in HF patients, but at the moment it has not been found a complete prognostic score (including clinical, laboratory and echocardiographic parameters), univocally used for AHF patients. Patients (n = 118) admitted to CCU due to AHF de novo or to an exacerbation of chronic heart failure were enrolled. For each patient, clinical and biochemical parameters were reported as well as the echocardiographic data, including speckle tracking echocardiography analysis. These indexes were then related to intra- and extrahospital mortality. At the end of the follow-up period, the study population was divided into two groups, defined as ‘survivors’ and ‘non-survivors’. From statistical analysis, C-reactive protein (CRP) (AUC = 0.75), haemoglobin (AUC = 0.71), creatinine clearance (AUC = 0.74), left atrial strain (AUC = 0.73) and freewall right ventricular strain (AUC = 0.76) showed the strongest association with shortterm mortality and they represented the items of the proposed risk score, whose cut-off of 3 points is able to discriminate patients at higher risk of mortality. AHF represents one of the major challenges in CCU. The use of a combined biochemical and advanced echocardiographic score, assessed at admission, could help to better predict mortality risk, in addition to commonly used indexes.

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Authors and Affiliations

  1. Department of Cardiovascular Diseases, University of Siena, Siena, Italy

    Carlotta Sciaccaluga, Giulia Elena Mandoli, Chiara Nannelli, Francesca Falciani, Cosimo Rizzo, Nicolò Sisti, Chiara Carrucola, Mariangela Vigna, Eufemia Incampo, Maria Luisa Parisella, Oreste De Vivo, Francesco Contorni, Mario Stricagnoli, Antonio Pagliaro, Flavio D’Ascenzi, Serafina Valente, Sergio Mondillo & Matteo Cameli

  2. School of Cardiology, University of Bari, Bari, Italy

    Margherita Ilaria Gioia

  3. Department of Internal Medicine, University of Siena, Siena, Italy

    Antonio D’Errico & Giovanni Donati

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  1. Carlotta Sciaccaluga
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  2. Giulia Elena Mandoli
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Correspondence to Nicolò Sisti.

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Sciaccaluga, C., Mandoli, G.E., Nannelli, C. et al. Survival in acute heart failure in intensive cardiac care unit: a prospective study. Int J Cardiovasc Imaging 37, 1245–1253 (2021). https://doi.org/10.1007/s10554-020-02109-8

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  • DOI: https://doi.org/10.1007/s10554-020-02109-8

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