PMID- 29261675
OWN - NLM
STAT- In-Process
LR - 20171222
IS - 1932-6203 (Electronic)
IS - 1932-6203 (Linking)
VI - 12
IP - 12
DP - 2017
TI - The limited prognostic role of echocardiograms in short-term follow-up after
acute decompensated heart failure: An analysis of the Korean Heart Failure
(KorHF) Registry.
PG - e0188938
LID - 10.1371/journal.pone.0188938 [doi]
AB - BACKGROUND: The prognostic values of the left ventricular ejection fraction
(LVEF) and end-diastolic dimension (LVEDD) have primarily been shown among
patients with chronic heart failure (HF), with little representation of patients
with acute HF (AHF). Therefore, we investigated the value of these
echocardiographic parameters in predicting clinical outcomes among patients in
the Korean Heart Failure (KorHF) Registry. METHODS: The KorHF Registry consists
of 3,200 patients who were hospitalized with AHF from 2005 to 2009. The
Kaplan-Meier method was used to estimate survival and readmission, and
differences were assessed using the log-rank test. Predictors of survival were
identified using univariate and multivariate Cox proportional hazards regression
analyses. RESULTS: Echocardiograms from 2,910 of the 3,200 patients (90.9%) were
evaluated. The median LVEF and LVEDD (37% and 56 mm, respectively) were used as
cut-offs for the binary transformation of each parameter. The cumulative
death-free survival rates for all patients did not significantly differ based on
LVEF or LVEDD quartiles; however, an LVEF greater than the median was associated
with a better prognosis in ischemic HF patients (log-rank test; p = 0.039). Among
ischemic HF patients, LVEF (dichotomized) was a significant predictor of death in
a Cox model after adjusting for a history of HF, age, systolic blood pressure
(SBP), serum sodium, sex, diabetes mellitus (DM), chronic obstructive pulmonary
disease (COPD), chronic kidney disease (CKD), acute myocardial infarction (AMI),
atrial fibrillation (Af) and anemia (hazard ratio (HR) 1.475, 95% confidence
interval (CI) 1.099-1.979, p = 0.010). The cumulative readmission-free survival
rates significantly differed among ischemic HF patients only when based on LVEDD
quartiles (log-rank test; p = 0.001). In multivariate Cox proportional hazards
regression analyses, LVEDD (dichotomized) remained a significant variable only
among patients with ischemic HF after adjusting for sex, age, AMI, DM, COPD,
serum sodium, SBP, blood urea nitrogen (BUN) and anemia (HR 1.401, 95% CI
1.067-1.841, p = 0.015). CONCLUSIONS: Among ischemic AHF patients in the KorHF
Registry, LVEF is associated with mortality, whereas LVEDD is only associated
with readmission in a binary transformed form.
FAU - Kim, Sung Hea
AU - Kim SH
AUID- ORCID: http://orcid.org/0000-0003-3538-3745
AD - Department of Cardiology, Konkuk University School of Medicine, Dongtan Sacred
Heart Hospital, Hwaseong, Korea.
FAU - Kim, Hyun-Joong
AU - Kim HJ
AD - Department of Cardiology, Konkuk University School of Medicine, Dongtan Sacred
Heart Hospital, Hwaseong, Korea.
FAU - Han, Seongwoo
AU - Han S
AD - Department of Cardiology, Hallym University College of Medicine, Dongtan Sacred
Heart Hospital, Hwaseong, Korea.
FAU - Yoo, Byung-Su
AU - Yoo BS
AD - Department of Internal Medicine, Yonsei University Wonju Christian Hospital,
Wonju, Korea.
FAU - Choi, Dong-Ju
AU - Choi DJ
AD - Department of Internal Medicine, Seoul National University College of Medicine,
Bundang Hospital, Seongnam, Korea.
FAU - Kim, Jae-Joong
AU - Kim JJ
AD - Department of Internal Medicine, University of Ulsan College of Medicine, Asan
Medical Center, Seoul, Korea.
FAU - Jeon, Eun-Seok
AU - Jeon ES
AD - Department of Internal Medicine, Sungkyunkwan University College of Medicine,
Samsung Medical Center, Seoul, Korea.
FAU - Cho, Myeong-Chan
AU - Cho MC
AD - Cardiology Department, Chungbuk National University College of Medicine,
Cheongju, Korea.
FAU - Chae, Shung Chull
AU - Chae SC
AD - Department of Internal Medicine, Kyungpook National University College of
Medicine, Daegu, Korea.
FAU - Ryu, Kyu-Hyung
AU - Ryu KH
AD - Department of Cardiology, Hallym University College of Medicine, Dongtan Sacred
Heart Hospital, Hwaseong, Korea.
LA - eng
PT - Journal Article
DEP - 20171219
PL - United States
TA - PLoS One
JT - PloS one
JID - 101285081
PMC - PMC5736190
EDAT- 2017/12/21 06:00
MHDA- 2017/12/21 06:00
CRDT- 2017/12/21 06:00
PHST- 2017/03/24 00:00 [received]
PHST- 2017/11/15 00:00 [accepted]
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2017/12/21 06:00 [medline]
AID - 10.1371/journal.pone.0188938 [doi]
AID - PONE-D-17-11532 [pii]
PST - epublish
SO - PLoS One. 2017 Dec 19;12(12):e0188938. doi: 10.1371/journal.pone.0188938.
eCollection 2017.