Acute Heart Failure developed as worsening of Chronic Heart Failure is associated with increased mortality compared to de novo cases

Degoricija, Vesna; Trbušić, Matias; Potočnjak, Ines; Radulović, Bojana; Terešak, Sanda Dokoza; Pregartner, Gudrun; Berghold, Andrea; Tiran, Beate; Frank, Saša

doi:10.1038/s41598-018-28027-3

Cited by 18 publications

(21 citation statements)

References 37 publications

(43 reference statements)

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“…Out of 152 AHF patients recruited in the study 21–24 , serum samples of 130 patients were subjected to the metabolomic analyses. Of these, 32 (24.6%) died within three months after onset of AHF.…”

Section: Resultsmentioning

confidence: 99%

“…Details of the study and its patient cohort have already been described in depth 21–24 . We conducted a prospective observational single-center study including consecutive hospitalized AHF patients.…”

Section: Methodsmentioning

confidence: 99%

“…The blood sampling and laboratory methods have already been described in previous reports on our AHF cohort 21–24 .…”

Section: Methodsmentioning

confidence: 99%

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Serum Concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are Associated with Increased 3-Month Mortality in Acute Heart Failure Patients

Stryeck

Gastrager

Degoricija

et al. 2019

Sci Rep

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Considering the already established relationship between the extent of the metabolic dysfunction and the severity of heart failure (HF), it is conceivable that the metabolomic profile of the serum may have a prognostic capacity for 3-month mortality in acute heart failure (AHF). Out of 152 recruited patients, 130 serum samples were subjected to the metabolomic analyses. The 3-month mortality rate was 24.6% (32 patients). Metabolomic profiling by nuclear magnetic resonance spectroscopy found that the serum levels of 2-hydroxybutyrate (2-HB), 3-hydoxybutyrate (3-HB), lactate, citrate, and tyrosine, were higher in patients who died within 3 months compared to those who were alive 3 months after onset of AHF, which was confirmed by univariable logistic regression analyses (p = 0.009, p = 0.005, p = 0.008, p<0.001, and p<0.001, respectively). These associations still remained significant for all tested metabolites except for lactate after adjusting for established prognostic parameters in HF. In conclusion, serum levels of 2-HB, 3-HB, tyrosine, and citrate measured at admission are associated with an increased 3-month mortality rate in AHF patients and might thus be of prognostic value in AHF.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Serum Concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are Associated with Increased 3-Month Mortality in Acute Heart Failure Patients

Stryeck

Gastrager

Degoricija

et al. 2019

Sci Rep

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“…[ 3 ] Accordingly, mortality rates are lower and the potential for improvement and possibly recovery is greater in de novo than in chronic HF (CHF). [ 4 , 5 ] However, hospitalisation for de novo HF is still considered a critical event in the trajectory of the disease, given that mortality rates are tripled compared with patients who are never hospitalised. [ 6 ]…”

Section: From Acute Heart Failure Towards Worsening or De Nmentioning

confidence: 99%

Congestion and Diuretic Resistance in Acute or Worsening Heart Failure

2020

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Hospitalisation for acute heart failure (AHF) is associated with high mortality and high rehospitalisation rates. In the absence of evidence-based therapy, treatment is aimed at stabilisation and symptom relief. The majority of AHF patients have signs and symptoms of fluid overload, and, therefore, decongestion is the number one treatment goal. Diuretics are the cornerstone of therapy in AHF, but the treatment effect is challenged by diuretic resistance and poor diuretic response throughout the spectrum of chronic to worsening to acute to post-worsening HF. Adequate dosing and monitoring and evaluation of diuretic effect are important for treatment success. Residual congestion at discharge is a strong predictor of worse outcomes. Therefore, achieving euvolaemia is crucial despite transient worsening renal function.

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“…Study design, inclusion and exclusion criteria as well as patient characteristics for our AHF cohort have been described in our previous reports [17–20]. In brief, we performed a prospective observational study including consecutive hospitalized AHF patients.…”

Section: Methodsmentioning

confidence: 99%

HDL subclasses and mortality in acute heart failure patients

Degoricija¹,

Potočnjak²,

Gastrager³

et al. 2019

Clinica Chimica Acta

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The link between HDL subclasses and the prognosis of cardiovascular diseases remains controversial. We thus evaluated the prognostic value of the HDL subclasses 3 and 2 cholesterol (HDL3-C, HDL2-C) as well as of total HDL-C for 3-month mortality in acute heart failure (AHF) patients. The serum levels of HDL3-C and total HDL-C were determined by detergent-based homogeneous assay. HDL2-C was computed by the difference between total HDL-C and HDL3-C. Out of the 132 analyzed patients, 35 (26.5%) died within three months after onset of AHF. Univariate logistic regression analyses revealed a significant inverse association of HDL3-C (odds ratio (OR) 0.46 per 1-SD increase, 95% confidence interval (CI) 0.27–0.72, p = 0.001) with 3-month mortality, whereas concentrations of total HDL-C and HDL2-C showed no significant association. After adjustment for various laboratory and clinical parameters known to be associated with mortality in heart failure patients, HDL3-C concentrations remained significantly associated with 3-month mortality (OR 0.34 per 1-SD increase, 95% CI 0.15–0.74, p =0.010). We conclude that low admission serum levels of HDL3-C are associated with an increased 3-month mortality in AHF patients, whereas total HDL-C and HDL2-C showed no association. HDL3-C might thus be useful as a prognostic parameter in AHF.

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Acute Heart Failure developed as worsening of Chronic Heart Failure is associated with increased mortality compared to de novo cases

Cited by 18 publications

References 37 publications

Serum Concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are Associated with Increased 3-Month Mortality in Acute Heart Failure Patients

Serum Concentrations of Citrate, Tyrosine, 2- and 3- Hydroxybutyrate are Associated with Increased 3-Month Mortality in Acute Heart Failure Patients

Congestion and Diuretic Resistance in Acute or Worsening Heart Failure

HDL subclasses and mortality in acute heart failure patients

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