Venny Kurniawati, Anna Fuji Rahimah, Cholid Tri Tjahjono, Mohammad Saifur Rohman, Yoga Waranugraha
Introduction: Congestion is the main problem in Acute Heart Failure (AHF) patients. Hemodynamic congestion should be treated to decrease the progression and improve the outcome of AHF. This study assessed the congestion index's ability, a simple echocardiography parameter to predict the clinical outcomes of AHF patients in a short-term period. Methods: We had conducted a prospective cohort study from January 2108 to July 2019. At the hospital discharge, all participants were free from clinical congestion. A congestion index of ≥ 30 mmHg was defined as hemodynamic congestion. The congestion index was estimated using a combination of estimated right atrial pressure (eRAP) and estimated pulmonary capillary wedge pressure (ePCWP) measured using echocardiography. AHF rehospitalization and mortality due to cardiovascular cause for 30 days following hospital discharge was registered. Results: A total of 62 AHF patients were involved. AHF mortality and rehospitalization rates were 12.9% and 20.9%, respectively. Patient with congestion index ≥ 30 mmHg had a higher 30-day rehospitalization (10 [66.7%] vs 3 [6.4%]; P = 0.000; CI 95% OR 7.53 [3.11-18.2]) and cardiovascular mortality (7 [46.7%] vs 1 [2.1%] P = 0,000; CI 95% OR 5.90 [2.95-11.78]). Congestion index revealed good performance to predict 30-day rehospitalization (cut off 30 mmHg; sensitivity 92.9%; specificity 91.7%; AUC 0.91) and mortality (cut off 31 mmHg; sensitivity 87.5%; specificity 81.5%; AUC 0.89) in AHF patients. Conclusion: Congestion index could predict 30-day AHF rehospitalization and mortality following hospital discharge. Our study provided the preliminary results regarding the usefulness of the congestion index as the predictor of AHF rehospitalization and mortality. © 2020, Brawijaya University. All rights reserved.
Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Cardiology and Vascular Medicine, Prof. Dr. Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia