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Curso de Atualização em Medicina Cardiovascular 2019
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Heart failure hospitalization in patients with reduced ejection fraction in a Heart Failure Clinic
Session:
Posters 3 - Écran 10 - Insuficiência Cardíaca
Speaker:
Daniel Seabra De Carvalho
Congress:
CPC 2019
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Daniel Seabra De Carvalho; Inês Pereira Oliveira; Ana Leal Neto; Aurora Andrade; João A. G. Azevedo; Paula Pinto
Abstract
<p><strong>Introduction: </strong>Heart failure (HF) is a major clinical and public health concern. The high prevalence and clinical course of HF results in increased burden of hospitalizations and health care costs. HF hospitalizations (HFhosp) remain a strong predictor of mortality for existing patients (pts) with HF. Efforts should be made to identify clinical predictors that might help reducing HFhosp.</p> <p><strong>Purpose: </strong>Characterize a cohort of pts with HF with reduced ejection fraction (HFrEF) in a HF Clinic (HFC) who had HFhosp in the previous year and identify clinical and prognostic features.</p> <p><strong>Methods: </strong>Unicentric, retrospective analysis of pts followed in a HFCsince 3/2011. Included pts with reduced ejection fraction (EF) (<50%) and previous diagnosis for at least 6 months; divided in two groups: pts with HFhosp (G1) and no HFhosp (G2) in the previous year.Clinical, demographic, analytical and echocardiographic characteristics and mortality (from cardiovascular (CV) cause (CVm) and non-CV cause (nCVm)) were analysed.</p> <p><strong>Results: </strong>Included 374 pts with a mean age of 60.6 ± 13.2 years. G1 consisting of 68 pts (18%) with male predominance (85vs73%, p=0.032). There were no differences in age between groups. Ischemic etiology was more frequent in G1 (56vs37%, p=0.004). There were no significant differences in CV risk factors prevalence, except for diabetes (50vs29%, p<0.001) and dyslipidaemia (78vs55%, p<0.001). G1 correlated positively with the presence of atrial fibrillation (AF) (50vs31%, p=0.003) and chronic kidney disease (CKD) (52vs26%, p<0.001). HFhosp group were linked to higher values of serum uric acid (p=0.005) and BNP (p<0.001). Left ventricle EF (LVEF) at admission (p=0.041) and during follow-up (FU) (p<0.001) were lower in G1, as well as right ventricle dysfunction (RVD) (p=0.005). On the other hand, G2 had more LVEF recovery (p<0.001). During the FU, G1 had higher mortality (53vs16%, p<0.001), mostly related to mCV (p<0.001). After multivariate analysis adjustment, ischemic etiology, CKD, AF, diabetes and dyslipidaemia remained significantly associated with HFhosp.</p> <p><strong>Conclusion: </strong>In our cohort, HFhosp group had more ischemic etiology and higher prevalence of AF, diabetes, dyslipidaemia and CKD. As expected, G1 showed a marked relationship with HFrEF severity surrogates, namely initial and FU LVEF and RVD. HFhosp had higher mortality rate, particularly related to mCV.</p>
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