Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2009;45(11):855-70.
To evaluate the causes of acute heart failure, complications, management, and outcomes.
A total of 200 patients with diagnosed de novo acute heart failure (27.5%) or worsening chronic heart failure (72.5%) were treated at the Department of Cardiology, Hospital of Kaunas University of Medicine, which was participating in the Euro Heart Failure Survey-II (EHFS-II). The patients were divided into five groups: 1) chronic decompensated heart failure (66.0%); 2) pulmonary edema (13.0%); 3) hypertensive heart failure (7.5%); 4) cardiogenic shock (11.0%); and 5) right heart failure (2.5%).
Hypertensive and coronary heart diseases were the most common underlying conditions of acute heart failure. Noncompliance with the prescribed medications was present as the most frequent precipitating factor in more than half of the cases. Left ventricular ejection fraction of >45% was found in 28.64% of cases. Intravenous diuretics (74.5%), nitrates (44.0%), and heparin (71.0%) were the most widely used in the acute phase. At discharge from hospital, 96.69% of patients were given diuretics; 80.11%, angiotensin-converting enzyme inhibitors; and 62.43%, beta-blockers. The mean duration of inhospital stay was 13 days; death rate was 9.5%: after 3 months and 12 months, it was 7.5% and 11.5%, respectively.
Preserved systolic function, multiple concomitant diseases, and high mortality rates were observed in a substantial proportion of the patients hospitalized due to acute heart failure. The management of the patients in a university hospital center was performed in accordance with the international guidelines.
评估急性心力衰竭的病因、并发症、处理方法和转归。
共有 200 例新发急性心力衰竭（27.5%）或慢性心力衰竭恶化（72.5%）患者在考纳斯医科大学医院心脏病科接受治疗，该医院参与了欧洲心力衰竭调查 II（EHFS-II）。患者被分为五组：1）慢性失代偿性心力衰竭（66.0%）；2）肺水肿（13.0%）；3）高血压性心力衰竭（7.5%）；4）心源性休克（11.0%）；和 5）右心衰竭（2.5%）。
高血压和冠心病是急性心力衰竭最常见的基础疾病。超过一半的病例存在最常见的诱发因素，即不遵医嘱服药。左心室射血分数>45%的病例占 28.64%。在急性阶段，最广泛使用的药物是静脉利尿剂（74.5%）、硝酸盐（44.0%）和肝素（71.0%）。出院时，96.69%的患者给予利尿剂；80.11%给予血管紧张素转换酶抑制剂；62.43%给予β受体阻滞剂。住院平均时间为 13 天；死亡率为 9.5%：3 个月和 12 个月时分别为 7.5%和 11.5%。
在因急性心力衰竭住院的患者中，相当一部分患者存在收缩功能保存、多种合并疾病和高死亡率。大学医院中心对患者的处理符合国际指南。
