Characteristics and management of acute heart failure patients in a single university hospital center

Laura Venskutonytė, Irena Molytė, Rūta Ablonskytė-Dūdonienė, Vaida Mizarienė, Aušra Kavoliūnienė

Department of Cardiology, Kaunas University of Medicine, Lithuania

Key words: acute heart failure; chronic decompensated heart failure; pulmonary edema; cardiogenic shock; right heart failure.

Summary. Objective. To evaluate the causes of acute heart failure, complications, management, and outcomes.

Material and methods. A total of 200 patients with diagnosed de novo acute heart failure (27.5%) or worsening chronic heart failure (72.5%) were treated at the Department of Cardiology, Hospital of Kaunas University of Medicine, which was participating in the Euro Heart Failure Survey-II (EHFS-II).

The patients were divided into five groups: 1) chronic decompensated heart failure (66.0%); 2) pulmonary edema (13.0%); 3) hypertensive heart failure (7.5%); 4) cardiogenic shock (11.0%); and 5) right heart failure (2.5%).

Results. Hypertensive and coronary heart diseases were the most common underlying conditions of acute heart failure. Noncompliance with the prescribed medications was present as the most frequent precipitating factor in more than half of the cases. Left ventricular ejection fraction of >45% was found in 28.64% of cases. Intravenous diuretics (74.5%), nitrates (44.0%), and heparin (71.0%) were the most widely used in the acute phase. At discharge from hospital, 96.69% of patients were given diuretics; 80.11%, angiotensin-converting enzyme inhibitors; and 62.43%, beta-blockers. The mean duration of inhospital stay was 13 days; death rate was 9.5%: after 3 months and 12 months, it was 7.5% and 11.5%, respectively.

Conclusion. Preserved systolic function, multiple concomitant diseases, and high mortality rates were observed in a substantial proportion of the patients hospitalized due to acute heart failure. The management of the patients in a university hospital center was performed in accordance with the international guidelines.

Correspondence to L. Venskutonytė, Department of Cardiology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: lauvensk@gmail.com

Received 29 April 2008, accepted 6 November 2009