Clinical presentations and hemodynamic parameters in patients hospitalized due to acute heart failure stratified by the left-ventricular ejection fraction

Background: Currently, one of the most common causes of hospitalization, especially in the elderly,is heart failure (HF) exacerbation. In nearly 95% of patients, this is caused by fluid overload. Therehave been studies comparing the rates of comorbidities and biochemical disturbances in HF patients;however, their hemodynamic parameters have not yet been assessed. Thus, the aim of this studywas to compare the clinical presentations and hemodynamic parameters assessed via impedancecardiography (ICG) in patients hospitalized due to acute HF, stratified by the left-ventricular ejectionfraction (LVEF). Methods: This study enrolled 102 patients, aged > 18 years, hospitalized due to decompensated HF.Ninety-seven patients (74 men, 23 women) underwent echocardiographic examination. Biochemicaland hemodynamic parameters were assessed on the day of admission and, subsequently, everyother day during hospitalization. Based on echocardiographic findings and the ESC guidelines thestudy group was divided into the following subgroups: HFrEF (EF < 40%), HFpEF (EF > 50%), andHFmrEF (EF 40–49%). Results: The HFrEF group, which constituted 60.8% of patients (n = 58), was predominantly male (P =0.0005); and most had elevated N-terminal pro-brain natriuretic peptide levels (P = 0.0008). The HFpEF andHFmrEF subgroups, jointly (n = 38), were characterized by higher systolic blood pressure (P = 0.0001),and lower hemoglobin levels (P = 0.003). The hemodynamic assessment showed that HFrEF patientshad higher total fluid content (P = 0.005) and lower systolic time ratio (P = 0.0002). Conclusions: Despite similar clinical presentation, patients with HF exhibited different values of hemodynamicand biochemical parameters depending on their LVEF; this indicates non-homogeneity of pathomechanismsand causes of HF decompensation