Clinical assessment of hypoperfusion in acute heart failure – evergreen or antique?

Circulation Journal : Official Journal of the Japanese Circulation Society
Simone FreaFiorenzo Gaita

Abstract

Cold hemodynamic profile assessed on physical examination predicts survival, although it has low specificity and low reproducibility. We herein propose a new cold profile definition (Cold Modified 2014), including renal and hepatic damage. The aim of the study was to evaluate the additional prognostic value of clinical and laboratory identification of hypoperfusion over hypotension in the setting of advanced acute heart failure (AHF). After preliminary analysis on derivation cohort, we studied 223 consecutive NYHA III-IV patients admitted with AHF requiring intensive care. Cold Modified 2014 definition included non-invasive hemodynamic assessment, renal and hepatic injury. Primary endpoint was a composite of cardiac death, urgent heart transplantation and mechanical circulatory support at 6 months. In the validation cohort (age, 60.5 ± 12.8 years; ejection fraction 25.6 ± 8.2%, systolic blood pressure [SBP] 104.3 ± 26.1 mmHg) 77 reached the composite endpoint. Among SBP, ADHERE model, cold profile at admission and INTERMACS profile at 48 h, cold profile had the best diagnostic accuracy. On multivariate analysis only cold profile and INTERMACS predicted events, while SBP <115 mmHg and high risk on ADHERE did not. Cold Modified 2...Continue Reading

References

May 28, 2003·Journal of the American College of Cardiology·Anju NohriaLynne W Stevenson
Jan 13, 2004·Journal of the American College of Cardiology·Daniel E FormanHarlan M Krumholz
Aug 18, 2004·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoUNKNOWN Acute Dialysis Quality Initiative workgroup
Feb 3, 2005·JAMA : the Journal of the American Medical Association·Gregg C FonarowUNKNOWN ADHERE Scientific Advisory Committee, Study Group, and Investigators
Feb 19, 2005·European Journal of Heart Failure·Lynne Warner Stevenson
Sep 27, 2005·The American Journal of Cardiology·Anju NohriaLynne Warner Stevenson
Oct 6, 2005·JAMA : the Journal of the American Medical Association·Cynthia BinanayUNKNOWN ESCAPE Investigators and ESCAPE Study Coordinators
May 8, 2007·European Journal of Heart Failure·Marco MetraUNKNOWN Heart Failure Association of the European Society of Cardiology
Feb 26, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Hisahito ShinagawaTohru Izumi
Feb 14, 2009·Journal of the American College of Cardiology·Wilfried MullensW H Wilson Tang
Jun 2, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lynne Warner StevensonJames K Kirklin
Dec 21, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Andrew J BoyleJeffrey J Teuteberg
Jan 7, 2011·Critical Care : the Official Journal of the Critical Care Forum·Markus NoveanuChristian Mueller
Mar 12, 2011·American Heart Journal·Enrico FiaccadoriAderville Cabassi
Mar 29, 2011·International Journal of Cardiology·Nuccia MoriciAntonio Mafrici
Jul 21, 2012·Interactive Cardiovascular and Thoracic Surgery·Matteo AttisaniMauro Rinaldi
Dec 5, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiro ShirakabeKyoichi Mizuno
Jul 11, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Kaoru Dohi, Masaaki Ito
Aug 30, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Domenico ScrutinioFabrizio Oliva

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Citations

Jul 8, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Taiki SakaguchiYoshio Yasumura
Oct 28, 2019·Journal of Clinical Medicine·Margot Aalders, Wouter Kok
May 24, 2020·Journal of Alzheimer's Disease : JAD·Jack C de la Torre
Jul 1, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Simone FreaFiorenzo Gaita
Mar 8, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Alessandro GalluzzoGaetano Maria De Ferrari

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