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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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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
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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0 Themes
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
36. Basic Science
37. Miscellanea
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Real life Heart failure, a heterogeneous population benefiting from a specialized multidisciplinary programme
Session:
Posters 4 - Écran 10 - Insuficiência Cardíaca
Speaker:
Inês Egídio de Sousa
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:
Inês Egídio de Sousa; Inês Lopes da Costa; Inês Nabais; Francisco Pulido Adragão; Patrícia Moniz; Susana Quintão; Lúcia Fernandes; Célia Osana; Luis Campos; Inês Araújo; Cândida Fonseca
Abstract
<p><strong>Introduction:</strong> Heart failure(HF) is a public health problem, affecting a diversified population, growing in prevalence despite therapy and prevention advances. Most Cardiology departments’ registries describe predominantly HF with reduced ejection fraction(HFrEF), while Internal Medicine(IM) mainly reports HF with preserved ejection fraction(HFpEF).</p> <p><strong>Objective:</strong> To evaluate demographics, clinical characteristics and acute management(AM) of a non-selected population hospitalized in an Acute Heart Failure Unit (AHFU) with a multidisciplinary team.</p> <p><strong>Methods:</strong> Retrospective study of consecutive hospitalizations due to decompensated HF in an AHFU, over one year.</p> <p><strong>Results:</strong> Of 181 hospitalizations, 55.2% were men, mean age 76 years. Most patients(77.3%) were admitted from the emergency room and 12.1% were admitted from our Day Hospital(DH). 50.8% had non-HErEF (HEpEF 44.2% and HF with mid-range ejection fraction(HFmrEF) 6.6%) and 49.2% HErEF. The most frequent aetiologies of HF were hypertensive(48.6%), ischemic(44.2%) and valvular(26%). 93% were decompensations of chronic HF. Most decompensation were due to arrhythmias(26%), infection(24.9%), medication non-adherence (24.9%). Patients were admitted in NYHA classes III (35.4%) or IV (64.6%), and at discharge the majority (70.7%) were in class II. Most were on B profile(95.6%) requiring IV diuretics; of these 14.4% evolved to C profile requiring inotropics, 9.4% of which on levosimendan. Mean in-AHFU stay: 8,1days, mortality 6%. Population had high multimorbidity, with an average of 6 comorbidities: arterial hypertension (75.6%), atrial fibrillation (6.2%), chronic Kidney disease (56.4%), diabetes (42.5%), among others (vide image). After discharge, 87.7% were referred to DH, 76,5% HF consultation and 45.7% other speciality evaluation (22.2% Pneumology, 16% Cardiology, 4.3% Nephrology, Endocrinology and IM). Readmission at 30 days was 12.5% (52.4% due to decompensated HF) and mortality 5.3% (45.4% due to HF).</p> <p><strong>Conclusion:</strong> results support epidemiologic data, where HErEF tend to be as prevalent as non-HErEF. Despite differences, AM tends to be similar as most patients are congestive at admission. All groups had similar number of comorbidities, requiring multidisciplinary approach. A specialized and structured HF Program allows integrated care, with systematic and differentiated approach, reflected on our short hospital stay and mortality, inferior to national (9.6 days and 12.5% in 2014, respectively) and international data.</p>
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