Open AccessPrognostički pokazatelji prve i ponovljene hospitalizacije kod pacijenata sa srčanim zatajivanjem s reduciranom ejekcijskom frakcijom lijeve klijetke
Author(s) -
Kristina Selthofer-Relatić,
Mato Tomić,
Anto Stažić,
Jerko Arambašić,
Kristina Kralik,
Jure Mirat
Publication year - 2020
Publication title -
collegium antropologicum
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.138
H-Index - 42
eISSN - 1848-9486
pISSN - 0350-6134
DOI - 10.5671/ca.44.3.5
Subject(s) - medicine , ejection fraction , cardiology , heart failure , atrial fibrillation , diabetes mellitus , ventricle , troponin , comorbidity , incidence (geometry) , myocardial infarction , physics , optics , endocrinology
Heart failure with reduced ejection fraction (HFrEF) is aprogressive clinical syndrome defined by changes in the myocardial structure,which lead to predominant systolic myocardial function impairment, with a leftventricle ejection of fraction ≤40%. The rehospitalization burden in HFrEFpatients (pts) remains very high, with poor quality of life, increasedmortality and large healthcare expenditures. In this research project, weinvestigated the risk factors for first and repeated hospitalization in ptswith HFrEF. This retrospective study included 50 adult pts with a diagnosis ofHFrEF and who were within the age range of 55 to 89 years old and of bothsexes. Demographic and clinical data (HFrEF etiology, renal functionparameters, complete blood count, markers of nflammation, electrocardiogram, troponin I, NTproBNP, echocardiographicparameters and comorbidities data) were collected from the pts’ medicalhistories. Statistical analysis was performed via Fischer’s exact test, theShapiro-Wilk test and the Spearman correlation coefficient. This study included70% male and 30% female HFrEF pts. Males were younger in both group of pts andhad a higher incidence of rehospitalization. The most important HFrEF etiologicrisk factors are arterial hypertension (82%), coronary heart disease (54%),atrial fibrillation (52%) and diabetes mellitus (40%). The most important noncardiaccomorbidity related with the first HFrEF hospitalization is pneumonia (P=0.03),while progression of left ventricle systolic and diastolic dysfunction isrelated to rehospitalization risk (left ventricle end systolic diameter,P=0.003; diastolic dysfunction degree, P=0.04). The troponin level wasassociated with an increased risk of rehospitalization, but this was not statisticallysignificant at this sample size (troponin I, p=0.10). Following the first andrepeated hospitalizations of HFrEF pts, comorbidities, ageing and genderdifference are crucial to HFrEF development, while echocardiographic parametersand biomarkers critically affect HFrEF rehospitalization risk.