Most Read Articles
2 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 2 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.

Clinical congestion persists after intensive treatment in heart failure patients

17 Oct 2019

While intensive treatment decreases the prevalence of clinical congestion, it remains sufficiently common in patients with heart failure, a recent study has found.

The study included 588 patients (mean age, 77±8 years; 60 percent male) with chronic heart failure and New York Heart Association (NYHA) functional class II. The primary study outcomes were survival and hospitalization-free heart failure survival. Congestion-related signs and symptoms analysed were NYHA III, orthopnoea, paroxysmal nocturnal dyspnoea, rales, jugular venous distension, peripheral pitting oedema and hepatomegaly.

The prevalence rates of congested-related symptoms were high at baseline but decreased over a median follow-up of 27.2 months. In the same time frame, 39 percent of the participants died.

Upon multivariate Cox regression analysis, Clinical Congestion Index, a composite of the aforementioned seven variables, emerged as a significantly predictive variable for death at baseline (hazard ratio [HR], 1.13, 95 percent CI, 1.04–1.22) and at 1 (HR, 1.17, 1.06–1.29), 3 (HR, 1.17, 1.05–1.31), 12 (HR, 1.14, 1.00–1.29) and 18 (HR, 1.25, 1.08–1.45) months.

Similarly, the Index was significantly correlated with death or hospitalization for heart failure at all time points: baseline (HR, 1.12, 1.05–1.20) and 1 (HR, 1.16, 1.07–1.26), 3 (HR, 1.23, 1.12–1.35), 6 (HR, 1.25, 1.13–1.39), 12 (HR, 1.20, 1.08–1.34) and 18 (HR, 1.35, 1.03–1.77) months.

“Intensification of therapy for heart failure resulted in significant reduction of congestion during the initial 6 months. However, congestion persisted or relapsed in a significant proportion of patients,” said researchers. “Still, it remains to be determined how to best achieve decongestion and if it is possible in all patients.”

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
2 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 2 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
3 days ago
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.