The role of commonly used clinical indicators in the diagnosis of acute heart failure

X.-L. Wang, J.-M. Lei, Y. Yuan, L. Feng, Y. Ning, Y.-F. Liu

epartment of Cardiovascular Medicine, Zhongshan City People’s Hospital, Zhongshan City, Guangdong, China. xinliangwwang@sina.com

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• Cardiology

OBJECTIVE: Acute heart failure (AHF) is one of the most commonly seen clinical cases, with a high rate of re-hospitalization and mortality. AHF can be divided into two categories based on the systolic function of the left ventricle, which are heart failure with reduced ejection fraction (HFREF) and heart failure with preserved ejection fraction (HFPEF). Pathogenesis and treatment of the two are quite different. In this article we attempted to explore the value of combined use of clinical and laboratory indicators in the differential diagnosis of AHFREF and AHFPEF.

PATIENTS AND METHODS: AHF patients ≥18 years old without valvular heart disease, acute myocardial infarction, renal dysfunction, ongoing hemodialysis or acute pulmonary embolism were chosen. Patients with left ventricular ejection fraction (LVEF) <0.5 fell into AHFREF group, and the remaining were placed in the AHFPEF group. Binary logistic regression analysis of age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), NT-proBNP, blood glucose, LVEF and cardiothoracic ratio (CTR) as covariates and AHF types as dependent variables.

RESULTS: 166 patients were enrolled and, among them, 66 cases (39.8%) were in the AHFREF group and 100 cases (60.2%) in the AHFPEF group. We chose age, SBP, DBP, HR and NT-pro BNP as covariates in the binary logistic regression analysis, and obtained the regression equation and the results were statistically significant (χ2=32.177, p<0.001). Hosmer-Lemeshow model test was (χ2=8.654, p=0.372). Samples were tested with the remaining approximately 30% of the subjects.

CONCLUSIONS: Combined application of clinical and laboratory indicators, such as age, blood pressure, HR and NT-proBNP play an important role in the differential diagnosis of AHFREF and AHFPEF.

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