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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) · pp. 11–18

DOI
10.21776/ub.hsj.2020.001.02.3
ISSN
2721-9984, 2721-9976
Published
2020-07-22
Publisher
Universitas Brawijaya
Language
en

Abstract

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

Keywords

Collaboration network of the authors

40 authors · 279 co-authorship links · showing the 40 most connected

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  • University of Brawijaya
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Co-authorOrganisationJoint articles
Ardian RizalAffiliation unknown37
Cholid Tri TjahjonoAffiliation unknown30
Indra PrasetyaAffiliation unknown28
Budi SatrijoAffiliation unknown27
Setyasih AnjarwaniAffiliation unknown24
Djanggan SargowoAffiliation unknown23
Novi KurnianingsihAffiliation unknown22
Heny MartiniAffiliation unknown19
Sasmojo WiditoAffiliation unknown15
Wella KarolinaAffiliation unknown10
Valerinna YogibuanaAffiliation unknown8
Adhika Prastya WikanandaAffiliation unknown7
Tri AstiawatiAffiliation unknown7
Nikhen NoverikeAffiliation unknown6
Muhammad Rizki FadlanAffiliation unknown6
Dadang HendrawanAffiliation unknown5
Imelda KrisnasariAffiliation unknown5
Jonny Karunia FajarAffiliation unknown4
Fitranti Suciati LaitupaAffiliation unknown4
Ayu Asri Devi AdityawatiAffiliation unknown4
Pawik SupriadiAffiliation unknown4
Wira Kimahesa AnggoroAffiliation unknown4
Ratna PancasariAffiliation unknown4
Hayla Iqda MillisaniAffiliation unknown3
Lukitasari Ayu GaluhAffiliation unknown3
Putri Annisa KamilaUniversity of Brawijaya3
Olivia HandayaniAffiliation unknown3
Fahmy RusnantaAffiliation unknown3
Oktafin Srywati PamunaAffiliation unknown3
Seprian WidasmaraAffiliation unknown3
Lutfi Hafiz ZunardiAffiliation unknown3
Tonny AdriyantoAffiliation unknown2
Anita Surya SantosoAffiliation unknown2
Puspa LestariAffiliation unknown2
Dedy IrawanAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (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>