Common Precipitants Of Acute Decompensated Heart Failure

Precipitants Of Acute Decompensated Heart Failure

Authors

  • Dr. Ogbemudia, EJ UNIVERSITY OF BENIN / TEACHING HOSPITAL Author
  • Dr. Umuerri, EM Consultant physician and cardiologist Department of medicine Author

Keywords:

Acute decompensated heart failure, precipitant, common

Abstract

Introduction: Acute decompensated heart failure (ADHF) is a common acute heart failure syndrome, and it is often caused by certain factors called precipitants. However, the common precipitants of ADHF in our locale have not been well documented.

Aim: To determine the common factors that precipitate acute decompensated heart failure in our locale.

Materials and Method: This was a retrospective study of acute heart failure patients hospitalized from January 2019 to June 2020 in a university teaching hospital. The age, gender, blood pressures were extracted from the records. Others included the cause of heart failure, precipitant of acute decompensation and left ventricular ejection fraction. The data were managed as appropriate, and p values less than 0.05 were statistically significant.

Results: There were 165 cases of ADHF and 86 (52.1%) were males with a median age of 57 years. Precipitants of ADHF were identified in 128(77.6%) of cases. The prevalence of the precipitants were pneumonia (PMN) 66 (51.5%), poor drug adherence (PDA) 47(36.7%), arrhythmia 38 (29.7%), urinary tract infections (UTI) 16.4% and renal dysfunction (10.2%). The others were acute exacerbation of chronic obstructive pulmonary disease (COPD) (6.3%), severe hypertension (4.7%). The association of PMN, PDA and arrhythmias among age groups yielded p values of 0.019, 0.010 and 0.016, respectively.

Conclusion: Most cases of ADHF (77.6%) are caused by precipitants. Pneumonia, poor drug adherence and arrhythmias are the common precipitants of ADHF, and they are associated with the elderly. Therefore, these factors should be actively sought for during initial evaluation, and measures for prevention initiated.

References

Gheorghiade M, Zannad F, Sopko G, Klein L, Ileana L, Marvin A,et al. Acute heart failure syndromes: current state and framework for future research.Circulation. 2005; 112:3958-3968. doi: 10.1161/CIRCULATIONAHA.105.590091

Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ. The current cost of heart failure to the National Health Service in the UK. Eur J Heart Fail. 2002; 4:361-371. doi: 10.1016/s1388-9842(01)00198-2

Arrigo M, Gayat E, Parenica J, Ishihara S, Zhang J, Choi DJ,et al. Precipitating factors and 90‐day outcome of acute heart failure: a report from the intercontinental GREAT registry. Eur JHeart Fail. 2017;19:201-208.doi: 10.1002/ejhf.682

Berkovitch A, Maor E, Sabbag A, Chernomordik F, Elis A, Arbel Y,et al. Precipitating factors for acute heart failure hospitalization and long-term survival. Medicine. 2015;94:e2330.doi: 10.1097/MD.0000000000002330

Tsuyuki RT, McKelvie RS, Arnold JM, Avezum A Jr,Barretto AC, Carvalho AC,et al. Acute precipitants of congestive heart failure exacerbations. Arch Intern Med. 2001; 161:2337-2342. doi: 10.1001/archinte.161.19.2337

Formiga F, Chivite D, Manito N, Casas S, Llopis F, Pujol R. Hospitalization due to acute heart failure. Role of the precipitating factors. Int JCardiol. 2007;120(2):237-241.doi: 10.1016/j.ijcard.2006.10.004.

Baba MM, Buba F, Talle MA, Abdul H. Pattern, Precipitants and Short Term Outcome of Heart Failure Patients Managed at Federal Medical Centre Nguru, a Tertiary Health Centre in Yobe State Northeastern Nigeria. International Journal of Clinical Medicine. 2018; 9:432-444. doi: 10.4236/ijcm.2018.95037

Ogah OS, Stewart S, Falase AO, Akinyemi JO, Adegbite GD, Alabi AA,et al. Contemporary profile of acute heart failure in Southern Nigeria.Data from the Abeokuta Heart Failure Clinical Registry. JACC Heart Fail. 2014;2:250-259. doi: 10.1016/j.jchf.2013.12.005

Adeoti AO, Ajayi EA, Ajayi AO, Dada SA, Fadare JO, Akolawole M, et al. Pattern and outcome of medical admissions in Ekiti State University Teaching Hospital, Ado-Ekiti- a 5 year review. Am J Med Med Sci. 2015;5:92–98.doi:10.5923/j.ajmms.20150502.06

World Health Organization. World Health OrganizationDefinition of an older or elderlyperson.2011Available from: http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html (Retrieved 2016-04-04).

Restrepo MI, Reyes LF, Anzueto A. Complication of community‐acquired pneumonia (including cardiac complications). Semin Respir Crit Care Med. 2016;37:897– 904.doi: 10.1055/s-0036-1593754

Corrales-Medina VF, Suh KN, Rose G, Chirinos JA, Doucette S, Cameron DW,et al. Cardiac complications in patients with community-acquired pneumonia: a systematic review and meta-analysis of observational studies. PLoS Med. 2011; 8:e1001048. doi: 10.1371/journal.pmed.1001048

Kumar A, Thota V, Dee L, Olson J, Uretz E, Parrillo JE. Tumor necrosis factor alpha and interleukin 1beta are responsible for in vitro myocardial cell depression induced by human septic shock serum. J Exp Med. 1996; 183:949-958. doi: 10.1084/jem.183.3.949

Fonarow GC, Abraham WT, Albert NM, Stough WG, Gheorghiade M, Greenberg BH,et al. OPTIMIZE‐HF Investigators and Hospitals. Factors identified as precipitating hospital admissions for heart failure and clinical outcomes: findings from OPTIMIZE‐HF. Arch Intern Med 2008;168:847– 854.doi:10.1001/archinte.168.8.847

Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation. 2020;141:e139–e596.doi: 10.1161/CIR.0000000000000757

Khand AU, Rankin AC, Kaye GC, Cleland JG. Systematic review of the management of atrial fibrillation in patients with heart failure. Eur Heart J. 2000; 21:614-632. doi: 10.1053/euhj.1999.1767

Ogbemudia EJ, Obasohan AO. Association between common etiologies and precipitants of acute decompensated heart failure. Niger Med J 2019; 60:113-116. doi: 10.4103/nmj.NMJ_63_19

Testa G, Della-Morte D, Cacciatore F, Gargiulo G, D'Ambrosio D, Galizia G,et al. Precipitating factors in younger and older adults with decompensated chronic heart failure: are they different? J Am Geriatr Soc. 2013; 61:1827-1828. doi: 10.1111/jgs.12475

Jackson ML, Neuzil KM, Thompson WW, Shay DK, Yu O, Hanson CA,et al.

The burden of community-acquired pneumonia in seniors: results of a population-based study. Clin Infect Dis. 2004; 39:1642-1650. doi: 10.1086/425615

Kazemian P, Oudit G, Jugdutt BI. Atrial fibrillation and heart failure in the elderly. Heart Fail Rev. 2012;17:597- 613.doi: 10.1007/s10741-011-9290-y

Adhikari S, Gajurel RM, Poudel CM, Shrestha H, Thapa S, Devkota S, et al.Precipitating factors leading to decompensation of heart failure in patients attending a tertiary care centre of Nepal. Nepalese Heart Journal. 2020;17:17-21.doi: 10.3126/njh.v17i1.28798

Common Precipitants of Acute Decompensated Heart Failure

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Published

05/09/2022

How to Cite

1.
Common Precipitants Of Acute Decompensated Heart Failure: Precipitants Of Acute Decompensated Heart Failure. AJTMBR [Internet]. 2022 May 9 [cited 2024 Nov. 8];5(1):10-7. Available from: https://www.ajtmbr.org.ng/index.php/home/article/view/54

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