engleski

Laboratory parameters in hospitalized acute decompensated heart failure patients according to left ventricular ejection fraction

BACKGROUND-AIM Left ventricular ejection fraction (LVEF) is important in the classification of the heart failure patients because of differing prognosis and response to treatments. Most clinical trials select patients based on ejection fraction (EF). We analyzed the differences in laboratory and clinical data according to LVEF of hospitalized acute decompensated heart failure (ADHF) patients. METHODS Laboratory and clinical data of 915 consecutively hospitalized ADHF patients were collected during the several years. Patients were divided into three groups: with preserved EF (LVEF>50%), with mildly reduced EF (LVEF 41-49%) and with reduced EF (LVEF<40%). RESULTS Hospitalized ADHF patients with reduced EF were significantly younger than patients in other two groups (M=73.29 vs. 78.15 and 77.90 ; p<.001) and they had lower body mass index than patients with preserved EF (M=27.40 vs 28.60 kg/ m2 ; p<.01). Patients with preserved EF had lower heart rate in comparison with other two groups (M=90.44 vs 97.48 and 95.40), but higher systolic pressure comparing to patients with reduced EF (M=140.61 vs 133.71) (p<.001). Frequency of hypertension was lower than expected (χ2 test) in patients with reduced than in patients with mildly reduced and preserved EF (p<.001) and chronic obstructive pulmonary disease was higher than expected in patients with preserved than in patients with reduced EF (p<.01). There were no differences in survival in different LVEF patients’ groups. Patients with reduced EF had higher hemoglobin (M=128.57 vs. 122.61 and 118.74 g/L ; p<.001), and N-terminal pro-Btype natriuretic peptide (NT-proBNP) levels (M=12572.44 vs. 7947.59 and 7012.33 ng/L ; p<.001) than other patients. Also, they had higher eGFR than patients with mildly reduced EF (M=56.73 vs. 51.25 mL/min/1.73 m2 ; p<.05). Highsensitivity C- reactive protein level (hs-CRP) was higher in patients with preserved than in patients with reduced EF (M=38.95 vs. 27.82 mg/L ; p<.05). There was no difference in troponin T levels regarding different LVEF patients’ groups. CONCLUSIONS Determination of routine laboratory parameters and especially NT-proBNP is important in hospital health care of ADHF patients. Preserved EF is associated with more systemic inflammation and higher hs-CRP levels which is also found in our results.

NT-proBNP, left ventricular ejection fraction, ejection fraction

"Cardiovascular diseases and cardiac biomarkers" Clinical Chemistry and Laboratory Medicine (CCLM), vol. 61, no. s1, 2023, pp. s469-s562. https://doi.org/10.1515/cclm-2023-7040