Department of Internal Medicine, Pontificia Universidad Javeriana, Carrera 7 no 40-62, Bogotá, Colombia.
Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia.
Ther Adv Cardiovasc Dis. 2023 Jan-Dec;17:17539447231184984. doi: 10.1177/17539447231184984.
Diuretic efficiency (DE) is an independent predictor of all-cause mortality in acute heart failure (HF) at long-term follow-up. The performance of DE in advanced HF and the outpatient scenario is unclear.
Survival function analysis on a retrospective cohort of patients with advanced HF followed at the outpatient clinic of Hospital Universitario San Ignacio (Bogotá, Colombia) between 2017 and 2021. DE was calculated as the average of total diuresis in milliliters divided by the dose of IV furosemide in milligrams for each 6-h session, considering all the sessions in which the patient received levosimendan and IV furosemide. We stratified DE in high or low using the median value of the cohort as the cutoff value. The primary outcome was a composite of all-cause mortality and HF hospitalizations during a 12-month follow-up. Kaplan-Meier curves and log-rank test were used to compare patients with high and low DE.
In all, 41 patients (66.5 ± 13.2 years old, 75.6% men) were included in the study, with a median DE of 24.5 mL/mg. In total, 20 patients were categorized as low and 21 as high DE. The composite outcome occurred more often in the high DE group (13 5, log-rank test = 0.0385); the all-cause mortality rate was 29.2% and was more frequent in the high DE group (11 1, log-rank test = 0.0026).
In patients with advanced HF on intermittent inotropic therapy, a high DE efficiency is associated with a higher risk of mortality or HF hospitalization in a 12-month follow-up period.
在长期随访中，利尿剂效率（DE）是急性心力衰竭（HF）全因死亡率的独立预测因子。在晚期 HF 和门诊环境中，DE 的表现尚不清楚。
对 2017 年至 2021 年在哥伦比亚波哥大圣伊格纳西奥大学医院（Hospital Universitario San Ignacio）门诊接受治疗的晚期 HF 患者进行回顾性队列生存功能分析。DE 通过将每个 6 小时疗程中总尿量除以 IV 呋塞米剂量（毫克）来计算，考虑到患者接受左西孟旦和 IV 呋塞米的所有疗程。我们使用队列中位数作为截断值将 DE 分层为高或低。主要结局是 12 个月随访期间全因死亡率和 HF 住院的复合结局。Kaplan-Meier 曲线和对数秩检验用于比较 DE 高和低的患者。
共有 41 名患者（66.5±13.2 岁，75.6%为男性）纳入研究，DE 中位数为 24.5 mL/mg。共有 20 名患者被归类为低 DE 组，21 名患者被归类为高 DE 组。高 DE 组更常发生复合结局（13 5，对数秩检验 = 0.0385）；全因死亡率为 29.2%，高 DE 组更常见（11 1，对数秩检验 = 0.0026）。
在接受间歇性正性肌力治疗的晚期 HF 患者中，高 DE 效率与 12 个月随访期间的死亡率或 HF 住院风险增加相关。
