Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.

<h4>Background</h4>Congestive physical findings such as pulmonary rales and third heart sound (S3) are hallmarks of acute heart failure (AHF). However, their role in outcome prediction remains unclear. We sought to investigate the association between congestive physical findings upon adm...

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Autores principales:	Sayoko Negi, Mitsuaki Sawano, Shun Kohsaka, Taku Inohara, Yasuyuki Shiraishi, Takashi Kohno, Yuichiro Maekawa, Motoaki Sano, Tsutomu Yoshikawa, Keiichi Fukuda
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3e7fd2638d674a86b3bbab6a0092a5b1
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spelling	oai:doaj.org-article:3e7fd2638d674a86b3bbab6a0092a5b12021-11-18T08:20:28ZPrognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.1932-620310.1371/journal.pone.0096325https://doaj.org/article/3e7fd2638d674a86b3bbab6a0092a5b12014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24802880/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Congestive physical findings such as pulmonary rales and third heart sound (S3) are hallmarks of acute heart failure (AHF). However, their role in outcome prediction remains unclear. We sought to investigate the association between congestive physical findings upon admission, steady-state biomarkers at the time of discharge, and long-term outcomes in AHF patients.<h4>Methods</h4>We analyzed the data of 133 consecutive AHF patients with an established diagnosis of ischemic or non-ischemic (dilated or hypertrophic) cardiomyopathy, admitted to a single-center university hospital between 2006 and 2010. The treating physician prospectively recorded major symptoms and congestive physical findings of AHF: paroxysmal nocturnal dyspnea, orthopnea, pulmonary rales, jugular venous distension (JVD), S3, and edema. The primary endpoint was defined as rehospitalization for HF.<h4>Results</h4>Majority (63.9%) of the patients had non-ischemic etiology and, at the time of admission, S3 was seen in 69.9% of the patients, JVD in 54.1%, and pulmonary rales in 43.6%. The mean follow-up period was 726 ± 31 days. Patients with pulmonary rales (p < 0.001) and S3 (p = 0.011) had worse readmission rates than those without these findings; the presence of these findings was also associated with elevated troponin T (TnT) levels at the time of discharge (odds ratio [OR] 2.8; p = 0.02 and OR 2.6; p = 0.05, respectively).<h4>Conclusion</h4>Pulmonary rales and S3 were associated with inferior readmission rates and elevated TnT levels on discharge. The worsening of the readmission rate owing to congestive physical findings may be a consequence of on-going myocardial injury.Sayoko NegiMitsuaki SawanoShun KohsakaTaku InoharaYasuyuki ShiraishiTakashi KohnoYuichiro MaekawaMotoaki SanoTsutomu YoshikawaKeiichi FukudaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 5, p e96325 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sayoko Negi Mitsuaki Sawano Shun Kohsaka Taku Inohara Yasuyuki Shiraishi Takashi Kohno Yuichiro Maekawa Motoaki Sano Tsutomu Yoshikawa Keiichi Fukuda Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
description	<h4>Background</h4>Congestive physical findings such as pulmonary rales and third heart sound (S3) are hallmarks of acute heart failure (AHF). However, their role in outcome prediction remains unclear. We sought to investigate the association between congestive physical findings upon admission, steady-state biomarkers at the time of discharge, and long-term outcomes in AHF patients.<h4>Methods</h4>We analyzed the data of 133 consecutive AHF patients with an established diagnosis of ischemic or non-ischemic (dilated or hypertrophic) cardiomyopathy, admitted to a single-center university hospital between 2006 and 2010. The treating physician prospectively recorded major symptoms and congestive physical findings of AHF: paroxysmal nocturnal dyspnea, orthopnea, pulmonary rales, jugular venous distension (JVD), S3, and edema. The primary endpoint was defined as rehospitalization for HF.<h4>Results</h4>Majority (63.9%) of the patients had non-ischemic etiology and, at the time of admission, S3 was seen in 69.9% of the patients, JVD in 54.1%, and pulmonary rales in 43.6%. The mean follow-up period was 726 ± 31 days. Patients with pulmonary rales (p < 0.001) and S3 (p = 0.011) had worse readmission rates than those without these findings; the presence of these findings was also associated with elevated troponin T (TnT) levels at the time of discharge (odds ratio [OR] 2.8; p = 0.02 and OR 2.6; p = 0.05, respectively).<h4>Conclusion</h4>Pulmonary rales and S3 were associated with inferior readmission rates and elevated TnT levels on discharge. The worsening of the readmission rate owing to congestive physical findings may be a consequence of on-going myocardial injury.
format	article
author	Sayoko Negi Mitsuaki Sawano Shun Kohsaka Taku Inohara Yasuyuki Shiraishi Takashi Kohno Yuichiro Maekawa Motoaki Sano Tsutomu Yoshikawa Keiichi Fukuda
author_facet	Sayoko Negi Mitsuaki Sawano Shun Kohsaka Taku Inohara Yasuyuki Shiraishi Takashi Kohno Yuichiro Maekawa Motoaki Sano Tsutomu Yoshikawa Keiichi Fukuda
author_sort	Sayoko Negi
title	Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
title_short	Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
title_full	Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
title_fullStr	Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
title_full_unstemmed	Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
title_sort	prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/3e7fd2638d674a86b3bbab6a0092a5b1
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Prognostic implication of physical signs of congestion in acute heart failure patients and its association with steady-state biomarker levels.

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