Details

Autor(en) / Beteiligte

• Kimura, Takanari
• Yamada, Takahisa
• Watanabe, Tetsuya
• Morita, Takashi
• Furukawa, Yoshio
• Tamaki, Shunsuke
• Kawasaki, Masato
• Kikuchi, Atsushi
• Kawai, Tsutomu
• Seo, Masahiro
• Nakamura, Jun
• Kayama, Kiyomi
• Kawahira, Masatsugu
• Ueda, Kunpei
• Sakamoto, Daisuke
• Ito, Shota
• Kougame, Takehiro
• Chang, Yongchol
• Fukunami, Masatake

Titel

Abstract 14608: Prognostic Value of Diuretic Resistance in Patients Admitted for Acute Decompensated Heart Failure With Reduced, Mid-range, or Preserved Left Ventricular Ejection Fraction

Ist Teil von

• Circulation (New York, N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A14608-A14608

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• BackgroundDiuretic resistance is associated with poor clinical outcome in patients with acute decompensated heart failure (ADHF). However, little information is available on the prognostic significance of diuretic resistance in ADHF patients, relating to reduced, mid-range, or preserved left ventricular ejection fraction (LVEF).MethodsWe studied 400 consecutive patients who were admitted for ADHF and survived to discharge. Diuretic resistance (DR) was defined by furosemide dose per body weight (BW) at discharge. Patients were classified by DR, and high dose group (higher DR) was defined by furosemide dose of > median value of DR (0.580). The endpoint was a composite of all-cause mortality and unplanned hospitalization for worsening heart failure.ResultsThere were 139 patients with heart failure with reduced LVEF (HFrEF, LVEF<40%), 86 with mid-range LVEF (HFmrEF, 40%≤LVEF<50%) and 175 with preserved LVEF (HFpEF, LVEF≥50%). There was no significant difference in DR among the three groups (HFrEF; median 0.541 [IQR 0.360-0.786] mg/kg vs HFmrEF; 0.606 [0.398-0.820] mg/kg vs HFpEF; 0.624 [0.380-0.935] mg/kg, p=NS). During follow-up of 2.4±1.6 years, 195 patients reached the endpoint (HFrEF, n=67, HFmrEF, n=44, and HFpEF, n=84). In multivariate Cox analysis, DR was significantly associated with the endpoint independently of age, estimated glomerular filtration rate, plasma brain natriuretic peptide level and LVEF only in HFpEF patients (p<0.0001). Kaplan-Meier analysis showed that the risk of the endpoint was significantly higher in the patients with higher DR in HFpEF patients, but not in HFrEF or HFmrEF patients (Figure).ConclusionsIn this study, higher DR was shown to be associated with poor clinical outcome in HFpEF patients admitted with ADHF.