Improving the EHMRG Prognostic Evaluation of Acute Heart Failure with TAPSE/PASp: A Sequential Approach

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2022 Feb 25

PMID 35204569

Authors

Lorenzo Falsetti

Vincenzo Zaccone

Giovanna Viticchi

Agnese Fioranelli

Ilaria Diblasi

Emanuele Guerrieri

Consuelo Ferrini

Mattia Scarponi

Luca Giuliani

Caterina Scalpelli

Marianna Martino

Adolfo Pansoni

Marinella Luccarini

Maurizio Burattini

Gianluca Moroncini

Nicola Tarquinio

Affiliations

Soon will be listed here.

Abstract

The Emergency Heart Failure Mortality Risk Grade (EHMRG) can predict short-term mortality in patients admitted for acute heart failure (AHF) in the emergency department (ED). This paper aimed to evaluate if TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can improve in-hospital death prediction in patients at moderate-to-high risk, according to EHMRG score classification. From 1 January 2018 to 30 December 2019, we retrospectively enrolled all the consecutive subjects admitted to our Internal Medicine Department for AHF from the ED. We performed bedside echocardiography within the first 24 h of admission. We evaluated EHMRG and NYHA in the ED, days of admission in Internal Medicine, and in-hospital mortality. We assessed cutoffs with ROC curve analysis and survival with Kaplan-Meier and Cox regression. We obtained a cohort of 439 subjects; 10.3% underwent in-hospital death. Patients with normal TAPSE/PASp in EHMRG Classes 4, 5a, and 5b had higher survival rates (100%, 100%, and 94.3%, respectively), while subjects with pathologic TAPSE/PASp had lower survival rates (81.8%, 78.3%, and 43.4%, respectively) ( < 0.0001, log-rank test). TAPSE/PASp, an echocardiographic marker of ventricular desynchronization, can further stratify the risk of in-hospital death evaluated by EHMRG.

Citing Articles

Clusters of Comorbidities in the Short-Term Prognosis of Acute Heart Failure among Elderly Patients: A Retrospective Cohort Study.

Falsetti L, Viticchi G, Zaccone V, Guerrieri E, Diblasi I, Giuliani L Medicina (Kaunas). 2022; 58(10).

PMID: 36295555 PMC: 9610682. DOI: 10.3390/medicina58101394.

Implementation of EHMRG Risk Model in an Italian Population of Elderly Patients with Acute Heart Failure.

Falsetti L, Zaccone V, Guerrieri E, Perrotta G, Diblasi I, Giuliani L J Clin Med. 2022; 11(11).

PMID: 35683368 PMC: 9181787. DOI: 10.3390/jcm11112982.

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