Improving the EHMRG Prognostic Evaluation of Acute Heart Failure with TAPSE/PASp: A Sequential Approach

Autor: Lorenzo Falsetti, Vincenzo Zaccone, Giovanna Viticchi, Agnese Fioranelli, Ilaria Diblasi, Emanuele Guerrieri, Consuelo Ferrini, Mattia Scarponi, Luca Giuliani, Caterina Scalpelli, Marianna Martino, Adolfo Pansoni, Marinella Luccarini, Maurizio Burattini, Gianluca Moroncini, Nicola Tarquinio
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Diagnostics, Vol 12, Iss 2, p 478 (2022)
Druh dokumentu: article
ISSN: 12020478
2075-4418
DOI: 10.3390/diagnostics12020478
Popis: The Emergency Heart Failure Mortality Risk Grade (EHMRG) can predict short-term mortality in patients admitted for acute heart failure (AHF) in the emergency department (ED). This paper aimed to evaluate if TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can improve in-hospital death prediction in patients at moderate-to-high risk, according to EHMRG score classification. From 1 January 2018 to 30 December 2019, we retrospectively enrolled all the consecutive subjects admitted to our Internal Medicine Department for AHF from the ED. We performed bedside echocardiography within the first 24 h of admission. We evaluated EHMRG and NYHA in the ED, days of admission in Internal Medicine, and in-hospital mortality. We assessed cutoffs with ROC curve analysis and survival with Kaplan–Meier and Cox regression. We obtained a cohort of 439 subjects; 10.3% underwent in-hospital death. Patients with normal TAPSE/PASp in EHMRG Classes 4, 5a, and 5b had higher survival rates (100%, 100%, and 94.3%, respectively), while subjects with pathologic TAPSE/PASp had lower survival rates (81.8%, 78.3%, and 43.4%, respectively) (p < 0.0001, log-rank test). TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can further stratify the risk of in-hospital death evaluated by EHMRG.
Databáze: Directory of Open Access Journals
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