{"title":"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。","authors":"Koravich Lorlowhakarn, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Aunchalee Jaroenlapnopparat, Palapun Waitayangkoon, Supanee Sinphurmsukskul, Sarawut Siwamogsatham, Sarinya Puwanant, Smonporn Boonyaratavej Songmuang, Aekarach Ariyachaipanich","doi":"10.1002/ehf2.15268","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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%, <i>P</i> = 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; <i>P</i> < 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%, <i>P</i> = 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 (<i>P</i> < 0.05 for all).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 5","pages":"3678-3687"},"PeriodicalIF":3.7000,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15268","citationCount":"0","resultStr":"{\"title\":\"The use of echocardiography and echocardiographic findings in patients hospitalized for acute heart failure\",\"authors\":\"Koravich Lorlowhakarn, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Aunchalee Jaroenlapnopparat, Palapun Waitayangkoon, Supanee Sinphurmsukskul, Sarawut Siwamogsatham, Sarinya Puwanant, Smonporn Boonyaratavej Songmuang, Aekarach Ariyachaipanich\",\"doi\":\"10.1002/ehf2.15268\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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%, <i>P</i> = 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; <i>P</i> < 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%, <i>P</i> = 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 (<i>P</i> < 0.05 for all).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11864,\"journal\":{\"name\":\"ESC Heart Failure\",\"volume\":\"12 5\",\"pages\":\"3678-3687\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15268\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESC Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15268\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESC Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15268","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
The use of echocardiography and echocardiographic findings in patients hospitalized for acute heart failure
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.
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.
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