Hospital at home for acute decompensation of chronic heart failure. A series of 201 patients

• DOI: 10.1016/j.ejim.2013.08.060
• Publication Date: 2013-10-11T07:27:39Z
• Authors: O. Rodríguez; S. Fernández; J.A. Ortín; J. Aibar; N. Seijas; A. Orquin; C. Hernández
• Keywords: 2. Zero hunger; 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Background: It is well known that in heart failure with preserved ejection fraction, comorbidities have a higher incidence. Obesity and metabolic syndrome can be called an underlying risk factor for cardiovascular disease. Aim: We aimed to correlate the presence of obesity and metabolic syndrome in patients with heart failure with preserved ejection fraction with diagnostic and prognostic markers of heart failure with preserved ejection fraction, quality of life and risk of depression. Materials and methods: 93 patients with heart failure with preserved fraction ejection, which have undergone complete physical examination, echocardiographic evaluation, determination of pro-BNP were included. Quality of life was assessed by the Minnesota questionnaire and the risk of depression by the Fahrenberg scale. Inclusion criteria: Sinus rhythm, pro-BNP N 125 ng/ml, EF N 45%, symptoms and signs of heart failure. Exclusion criteria: Atrial fibrillation, severe valvular disease, severe COPD, GFR b30 ml/kg/min, hemoglobin b 8 g%, cancer. The diagnosis of metabolic syndrome is consistent with International Diabetes Federation (IDF) criteria (2005). Statistical analysis was performed by t-test: Two-Sample Assuming Unequal Variances and Anova test. Results: In the study group 64% were women and 36% men, 66% were in NYHA class II and 34% in NYHA class III. Of these 56% are obese, 32% are overweight and only 12%were normal weight. 42% of patients were diagnosed with metabolic syndrome. Of these 54%were in NYHA class II and 46% in NYHA class III. Between Body Mass Index (BMI) and Minnesota score acceptable correlation exists (r b 0.25) but statistically insignificant. Between BMI and risk for depression scores there is no revealed statistical significant correlation (r = 0.21, p = 0.13). Result regarding the correlation between BMI and value pro-BNP value (r = 0.07, p = 0.6) was also similar. No correlation was found between the presence of metabolic syndrome and pro-BNP value (p = 0.56) or the score of quality of life inMinnesota questionnaire (p = 0.54), or the risk of depression (p = 0.14). Conclusion: Although these two pathological entities are included cardiovascular risk factors do not correlate with diagnosis marker or with quality of life or risk of depression in patients with heart failurewith preserved ejection fraction.