Eren Mehmet, Zoghi Mehdi, Tuncer Mustafa, Çavuşoğlu Yüksel, Demirbağ Recep, Şahin Mahmut, Serdar Osman Akın, Onrat Ersel, Mutlu Haşim, Dursunoğlu Dursun, Yılmaz Mehmet Birhan, Temizhan Ahmet
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2016 Dec;44(8):637-646. doi: 10.5543/tkda.2016.07572.
The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches.
Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country.
Mean age was 62±13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%. Coronary heart disease and hypertension were found in 61% and 53% of the patients, respectively. Valvular heart disease was the underlying cause in 46% of heart failure patients. The most frequent factor associated with decompensation was noncompliance with treatment, observed in 34% of patients. Systolic blood pressure was 125±28 mmHg and heart rate was 93±22 beats/minute in the cohort. The most common findings on physical examination were inspiratory fine crackles (84%), peripheral edema (64%), and cold extremities in 34%. Mean ejection fraction (EF) measured at admission was 33±13%. Preserved EF (?%40) was present in 20% of patients. On admission, 60%, 46%, and 40% of patients were using angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, or aldosterone antagonist, respectively. In-hospital events were reported as 3.4% death, 1.6% stroke and 2% myocardial infarction.
Compared to previous data collected around the world, AHF patients in Turkey were younger, had more frequently valvular heart disease as the underlying cause, and were more noncompliant with medical treatment, but overall mortality was lower. Drugs shown to reduce mortality, and which also form the basis of guideline-directed medical therapy, are still used inadequately.
本研究的目的是通过对诊断和治疗方法的评估，建立一个土耳其急性心力衰竭（AHF）住院患者的全国数据库。
使用基于互联网的调查收集患者数据。从全国36个参与的医疗中心共招募了588名患者。
平均年龄为62±13岁，38%的患者为女性。新发AHF与研究队列的比例为24%。分别有61%和53%的患者患有冠心病和高血压。瓣膜性心脏病是46%的心衰患者的潜在病因。与失代偿相关的最常见因素是治疗依从性差，在34%的患者中观察到。队列中的收缩压为125±28 mmHg，心率为93±22次/分钟。体格检查中最常见的发现是吸气性细湿啰音（84%）、外周水肿（64%）和34%的四肢冰冷。入院时测得的平均射血分数（EF）为33±13%。20%的患者射血分数保留（≥40%）。入院时，分别有60%、46%和40%的患者使用血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂、β受体阻滞剂或醛固酮拮抗剂。报告的住院事件为3.4%死亡、1.6%中风和2%心肌梗死。
与世界各地先前收集的数据相比，土耳其的AHF患者更年轻，瓣膜性心脏病作为潜在病因更为常见，且治疗依从性更差，但总体死亡率较低。已证明可降低死亡率且也是指南指导药物治疗基础的药物使用仍不足。
