Decompensation triggers of various phenotypes of chronic heart failure

Aim

To investigate etiology, clinical and demographic characteristics, and triggers of decompensation in patiets with different phenotypes of chronic heart failure (CHF).

Material and methods

We studied 350 patients (meanage 72.1±12.3 years, 47.4% females) admitted for decompensation of CHF. The patients were distributed into the three groups according to the left ventricular ejection fraction (LVEF) at admission, that is, low (<40%), intermediate (40-50%) and preserved (≥50%).

Results

In the whole cohort, the percentage of patients with low LVEF was 43.1%, with intermediate LVEF was 23.4%, and with preserved LVEF was 33.4%. The triggers of CHF decompensation included low adherence to treatment (25.7%), atrial fibrillation (24.0%), high blood pressure (14.9%), excessive salt intake (6.3%), and bronchopulmonary infection (7.7%). In 21.1% of patients, the cause of CHF deterioration was not established. In patients with low LVEF, low adherence to treatment and atrial fibrillation were detected in 33.8% and 23.8% of cases, respectively, whereas in patients with intermediate LVEF, atrial fibrillation was more common (30.5%) than low adherence to treatment (23.2%). The decompensations of CHF with preserved LVEF were usually due to high blood pressure (25.6%) or atrial fibrillation (19.7%).

Conclusion

Low adherence to treatment, atrial fibrillation, and high blood pressure are the main triggers of CHF decompensation in patients with either low (low adherence to treatment), intermediate (atrial fibrillation) or preserved LVEF (high blood pressure).

Key words

Chronic heart failure, ejection fraction, predictor, trigger, decompensation of heart failure.