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The Role of Congestion Index as Predictor Short-term Clinical Outcome in Patients AHF

Heart Science Journal · Vol. 1 No. 2 (2020) · hlm. 11–18

DOI
10.21776/ub.hsj.2020.001.02.3
ISSN
2721-9984, 2721-9976
Terbit
2020-07-22
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

IntroductionCongestion is the major problem in Acute Heart Failure (AHF) patients. Despite improving clinical congestion, we should assess and treat the hemodynamic congestion to decrease the progression of the disease and improve outcome of AHF patients. This study assess the ability of congestion index, a simple echocardiography parameter using ePCWP + eRAP to predict short-term clinical outcomes of AHF patients compare with NT-proBNP.Methods This prospective cohort study was conducted at Saiful Anwar General Hospital Malang from January 2108 to July 2019. AHF patients treated according to the 2016 ESC guidelines for AHF. Hemodynamic congestion was defined if congestion index (ePCWP+eRAP) at hospital discharge ≥ 30 mmHg.NT-proBNP level, ePCWP and eRAP were measured at 0-12 hours hospital admisssion and at hospital discharge. Clinical follow-up over a period of 30 days, AHF rehospitalization and mortality due to cardiovascular was registered. ResultsThis was a prospective study of 62 patients hospitalized with AHF. All patients were NYHA functional class IV. AHF mortality and rehospitalization rates in this study were 12.9% and 20.9%, respectively. Patient with congestion index ≥30 mmHg showed a higher 30 day rehospitalization [10 [66.7%] vs 3 [6.4%]; P =0.000; CI 95% OR 7.53(3.11-18.2)] and cardiovascular mortality [7 [46.7%] vs 1 [2.1%] P=0,000; CI 95% OR 5.90(2.95-11.78)]. NT-proBNP level at hospital discharge (cut off 5853 pg/mL; sensitivity 92%; specificity 91%; AUC 0.945; P = 0.000) was better than congestion index (cut off 30 mmHg; sensitivity 92.9%; specificity 91.7%; AUC 0.914; P = 0.000) in predicting AHF rehospitalization. For predicting mortality, NT-proBNP level at hospital discharge (cut off 8733 pg/mL; sensitivity 87.5%; specificity 88.9%; AUC 0.940; P = 0.000) were better than congestion index (cut off 31 mmHg; sensitivity 87.5%; specificity 81.5%; AUC 0.890; P = 0.000). ConclusionCongestion index could predict AHF rehospitalization and mortality within 30 days in patients with AHF.  Â

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Rekan penulisOrganisasiArtikel bersama
Ardian RizalUniversity of Brawijaya37
Novi KurnianingsihUniversity of Brawijaya34
Budi SatrijoUniversity of Brawijaya32
Indra PrasetyaUniversity of Brawijaya32
Setyasih AnjarwaniUniversity of Brawijaya32
Heny MartiniUniversity of Brawijaya29
Djanggan SargowoUniversity of Brawijaya29
Sasmojo WiditoUniversity of Brawijaya23
Wella KarolinaUniversity of Brawijaya12
Muhammad Rizki FadlanUniversity of Brawijaya10
Valerinna YogibuanaAfiliasi tidak diketahui9
Adhika Prastya WikanandaUniversity of Brawijaya8
Tri AstiawatiUniversity of Brawijaya8
Dadang HendrawanUniversity of Brawijaya7
Ratna PancasariUniversity of Brawijaya7
Ayu Asri Devi AdityawatiUniversity of Brawijaya7
Nikhen NoverikeUniversity of Brawijaya6
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya6
Fandy HazzyUniversity of Brawijaya5
Imelda KrisnasariUniversity of Brawijaya5
Teguh AryanugrahaUniversity of Brawijaya5
Putri Annisa KamilaUniversity of Brawijaya4
Saskia Dyah HandariUniversity of Brawijaya4
Oktivani Adelathifa RahmaUniversity of Brawijaya4
Tonny AdriyantoUniversity of Brawijaya4
Olivia HandayaniUniversity of Brawijaya4
Anna Fuji RahimahAfiliasi tidak diketahui4
Fahmy RusnantaUniversity of Brawijaya4
Oktafin Srywati PamunaUniversity of Brawijaya4
Seprian WidasmaraUniversity of Brawijaya4
Arif Ranu WicaksonoUniversity of Brawijaya4
Ira Vori NugrohoUniversity of Brawijaya4
Hayla Iqda MillisaniUniversity of Brawijaya3
Lukitasari Ayu Galuh ArdhiUniversity of Brawijaya3
Puspa LestariUniversity of Brawijaya2

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">The Role of Congestion Index as Predictor Short-term Clinical Outcome in Patients AHF</dc:title>
	<dc:creator xml:lang="en">Kurniawati, Veny</dc:creator>
	<dc:creator xml:lang="en">Rahimah, Anna Fuji</dc:creator>
	<dc:creator xml:lang="en">Tri Tjahjono, Cholid</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:creator xml:lang="en">Waranugraha, Yoga</dc:creator>
	<dc:subject xml:lang="en">Acute Heart Failure</dc:subject>
	<dc:subject xml:lang="en">NT-proBNP</dc:subject>
	<dc:subject xml:lang="en">eRAP</dc:subject>
	<dc:subject xml:lang="en">ePCWP</dc:subject>
	<dc:subject xml:lang="en">Congestion index</dc:subject>
	<dc:description xml:lang="en">IntroductionCongestion is the major problem in Acute Heart Failure (AHF) patients. Despite improving clinical congestion, we should assess and treat the hemodynamic congestion to decrease the progression of the disease and improve outcome of AHF patients. This study assess the ability of congestion index, a simple echocardiography parameter using ePCWP + eRAP to predict short-term clinical outcomes of AHF patients compare with NT-proBNP.Methods This prospective cohort study was conducted at Saiful Anwar General Hospital Malang from January 2108 to July 2019. AHF patients treated according to the 2016 ESC guidelines for AHF. Hemodynamic congestion was defined if congestion index (ePCWP+eRAP) at hospital discharge ≥ 30 mmHg.NT-proBNP level, ePCWP and eRAP were measured at 0-12 hours hospital admisssion and at hospital discharge. Clinical follow-up over a period of 30 days, AHF rehospitalization and mortality due to cardiovascular was registered. ResultsThis was a prospective study of 62 patients hospitalized with AHF. All patients were NYHA functional class IV. AHF mortality and rehospitalization rates in this study were 12.9% and 20.9%, respectively. Patient with congestion index ≥30 mmHg showed a higher 30 day rehospitalization [10 [66.7%] vs 3 [6.4%]; P =0.000; CI 95% OR 7.53(3.11-18.2)] and cardiovascular mortality [7 [46.7%] vs 1 [2.1%] P=0,000; CI 95% OR 5.90(2.95-11.78)]. NT-proBNP level at hospital discharge (cut off 5853 pg/mL; sensitivity 92%; specificity 91%; AUC 0.945; P = 0.000) was better than congestion index (cut off 30 mmHg; sensitivity 92.9%; specificity 91.7%; AUC 0.914; P = 0.000) in predicting AHF rehospitalization. For predicting mortality, NT-proBNP level at hospital discharge (cut off 8733 pg/mL; sensitivity 87.5%; specificity 88.9%; AUC 0.940; P = 0.000) were better than congestion index (cut off 31 mmHg; sensitivity 87.5%; specificity 81.5%; AUC 0.890; P = 0.000). ConclusionCongestion index could predict AHF rehospitalization and mortality within 30 days in patients with AHF.   </dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2020-07-22</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/65</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2020.001.02.3</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 1 No. 2 (2020): The Assessment of Diagnostic and Treatment Modality in Heart Failure; 11-18</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2020.001.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/65/324</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2020 Heart Science Journal</dc:rights>
</oai_dc:dc>