The use of echocardiography and echocardiographic findings in patients hospitalized for acute heart failure

IF 3.7 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

ESC Heart Failure Pub Date : 2025-08-15 DOI:10.1002/ehf2.15268

Koravich Lorlowhakarn, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Aunchalee Jaroenlapnopparat, Palapun Waitayangkoon, Supanee Sinphurmsukskul, Sarawut Siwamogsatham, Sarinya Puwanant, Smonporn Boonyaratavej Songmuang, Aekarach Ariyachaipanich

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引用次数: 0

Abstract

Aims

Transthoracic echocardiography (TTE) is recommended as a key investigation in patients with acute heart failure (AHF) in major guidelines. However, utilization and benefits are yet to be known in Thai patients. The study aims to evaluate the benefits of TTE and identify factors associated with the decision to perform TTE on patients with AHF.

Methods

This is a retrospective study of consecutive patients hospitalized for AHF in a tertiary care hospital in Thailand from July 2017 to June 2019. The patients were identified by the International Classification of Diseases (ICD) coding, and the diagnosis of AHF was confirmed by the Framingham criteria. Characteristics and outcomes of the patients who received TTE and those who did not were compared. Factors determining the use of TTE during hospitalization were identified using regression analysis.

Results

A total of 697 patients were enrolled (mean age 69 ± 14.6 years, 50.5% women, mean ejection fraction 47 ± 18.9%). Of these, 362 patients (51.9%) had TTE during hospitalization. The mean age and comorbidities were similar between groups. The patients with TTE were more likely to be women (54.6% vs. 46.1%, P = 0.03). More severe hospital courses were observed in patients with TTE, including intensive care unit (ICU) admission, mechanical ventilation and inotrope use (26.5% vs. 10.7%, 26.2% vs. 14.9%, and 24% vs. 13.1%, respectively; P < 0.001 for all). The overall in-hospital mortality was 5.5% and not different between groups. The 30 day mortality was lower in patients with TTE but did not reach statistical significance (2.1% vs. 4.7%, P = 0.05). In multivariate analysis, patients with ICU admission [adjusted odds ratio (aOR) = 7.33], longer length of stay (aOR = 3.05), higher haemoglobin (aOR = 1.22) and lower blood urea nitrogen (BUN) level (aOR = 1.37) were independent factors associated with the decision to perform TTE on patients hospitalized for AHF (P < 0.05 for all).

Conclusions

TTE was commonly performed in patients hospitalized for AHF, especially ones with more severe hospital courses. The outcomes were not different in patients who received TTE.

Abstract Image

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急性心力衰竭住院患者超声心动图及超声心动图表现的应用。

目的：经胸超声心动图（TTE）在主要指南中被推荐作为急性心力衰竭（AHF）患者的关键检查。然而，对泰国患者的利用和益处尚不清楚。该研究旨在评估TTE的益处，并确定对AHF患者进行TTE治疗的相关因素。方法：回顾性研究2017年7月至2019年6月在泰国一家三级医院连续住院的AHF患者。采用国际疾病分类（ICD）编码对患者进行鉴定，采用Framingham标准确诊AHF。比较接受TTE治疗和未接受TTE治疗的患者的特征和结果。采用回归分析确定住院期间使用TTE的影响因素。结果：共纳入697例患者（平均年龄69±14.6岁，女性50.5%，平均射血分数47±18.9%）。其中362例（51.9%）患者在住院期间发生TTE。两组患者的平均年龄和合并症相似。TTE患者以女性居多（54.6%比46.1%,P = 0.03）。在TTE患者中观察到更严重的住院过程，包括重症监护病房（ICU）入住、机械通气和肌力使用（分别为26.5%对10.7%、26.2%对14.9%和24%对13.1%）；结论：AHF住院患者，尤其是病程较重的AHF住院患者常行TTE治疗。接受TTE治疗的患者的结果没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine

CiteScore

7.00

自引率

7.90%

发文量

461

审稿时长

12 weeks

期刊介绍： ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.