Retrospective analysis of the follow-up data of the patients that applied to the cardiology department with decompensated heart failure in terms of the evaluation of the hospital application and mortality predictor

Introduction: The recurring hospital application and mortality risk of the patients that applied to the hospital with decompensated heart failure is considerably high in the early period and the data concerning biomarkers that can be used in the evaluation of the pulmonary congestion and following-up of the patients are limited. Purpose: Identifying the biomarkers that can be used in predicting the recurring hospital application and mortality risk of the patients with DHF after discharge and detecting biomarkers with congestion correlation. Method: The study was planned as an observational study. The patients that were admitted to the cardiology clinic with decompensated heart failure and that had heart failure diagnosis with low ejection fraction for the last 6 months were evaluated according to the exclusion criteria and 84 patients that were found to be suitable were included in this study. In addition to the basal echocardiography of the patients, B line numbers were calculated using the 28 zone method in the lung ultrasound. Ultrasound and laboratory findings of the patients were evaluated both during decompensated heart failure (DHF) and discharge from the hospital and amount of change were calculated as percentages. Independent risk factors for recurring application to the hospital and mortality were evaluated with cox's multivariate regression model and Everest score, creatinine, NT pro-BNP, B line and VCI expiratory diameter levels were included in the model. Findings: NT pro-BNP, B-line and VCI expiratory diameter were significantly lower during DHF compared to the discharge (p<0,001). NT pro-BNP and B-line levels were found as independent predictors both during DHF and discharge. It was shown that VCI expiratory diameter lost its significance in multivariate analysis when other risk factors were evaluated. It was found that the change in the percentages of the NT pro-BNP and B-line levels demonstrated a high diagnostic performance in predicting the mortality risk. Results: In this study, NT pro-BNP and B-line levels were found as strong prognostic factors in patients with DHF. Furthermore, the findings showed that the respective follow-up and combined evaluation of the biomarkers would be a stronger factor in diagnostic distinction. In order for these findings to be valid in the clinical applications broader randomized and controlled prospective studies are needed.