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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.

Abstract 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.
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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.