Search

Aims Echocardiography is known as the most useful diagnostic test in the assessment of patients with heart failure (HF), and the prognostic significance of echocardiographic findings in HF is well known. In this report, we aim to present the prognostic significance of a limited set of echocardiographic parameters obtained within 24 h of admission of patients enrolled in the Rajaie Acute Systolic Heart Failure registry. Methods and results A total of 230 patients with the diagnosis of acute systolic HF (left ventricular ejection fraction ≤ 35%) were enrolled into the study. Transthoracic echocardiography was performed for all study population within 24 h of admission. The primary endpoint of the study was the occurrence of worsening renal function (WRF) during the hospitalization course.Acquiring data of transthoracic echocardiography within 24 h of admission was feasible in all study participants. The median (inter‐quartile range) of left ventricular ejection fraction was 20% (15–23%). Severe right ventricular dysfunction was observed in 21.5% of patients. The grade of inferior vena cava collapse and right ventricular systolic dysfunction were associated with WRF. In multivariable analysis, right ventricular systolic dysfunction was among the independent predictors of WRF [β = 0.8, P = 0.01, odds ratio (OR) = 2.4 (1.2–4.9)] and in‐hospital mortality [β = 0.6, P = 0.04, OR = 1.5 (0.5–4.6)]. Conclusions Echocardiographic parameters are useful for baseline assessment and provide additional information besides other clinical variables for prognostication. Right ventricular dysfunction is the most important risk factor in developing WRF and in‐hospital mortality in patients with acute HF.

Aims A considerable proportion of hospitalized patients for acute decompensated heart failure will be readmitted or die in short‐term follow‐up. In the present study, we aimed to assess the role of admission sodium (Na) and uric acid (UA) levels in the prediction of 30 day post‐discharge heart failure readmission or all‐cause mortality in advanced heart failure patients admitted with acute decompensation. Methods and results One hundred and forty consecutive advanced heart failure patients who were admitted for a recent cardiac decompensation were enrolled in this prospective study. Serum Na and UA levels remained statistically unchanged during index admission (P = 0. 54 and 0.19, respectively). Within 30 days post‐discharge, composite end point of heart failure rehospitalization or all‐cause death occurred in 62 (44.3%) patients (event group). Length of stay was statistically similar between patients in the event and non‐event groups (P = 0.38). No correlations were also found between length of stay and left ventricular ejection fraction, serum Na, UA, erythrocyte sedimentation rate (ESR), high‐sensitivity C‐reactive protein (hs‐CRP), creatinine, and N‐terminal pro b‐type natriuretic peptide (NT‐proBNP) levels (all P > 0.05). Lower left ventricular ejection fraction and Na and higher UA on admission were significantly associated with 30 day event both in univariate and multivariate analyses. Conclusions Given the predictive role of baseline Na and UA for early post‐discharge outcome and the absence of significant changes in their levels during initial hospitalization, admission Na and UA can be considered as prognosticators of acute decompensated heart failure, which their prognostic significance cannot be affected by routine acute heart failure therapy.