Author + information
- Yu Horiuchia,b,
- Shuzou Tanimotoa,b,
- Mahbub Latifa,b,
- Kevin Urayamaa,b,
- Kazuyuki Yahagia,b,
- Jiro Aokia,b,
- Hiroyoshi Nakajimaa,b,
- Kazuhiro Haraa,b and
- Kengo Tanabea,b
Background: Acute decompensated heart failure (ADHF) is a heterogeneous disease. Identifying clinically important subgroups may improve to understand pathophysiologies and treatment strategies.
Methods: A total of 344 ADHF patients were retrospectively observed by a non-hierarchical cluster analysis of 75 clinical variables.
Results: Four clusters were identified. Cluster 1 (69 patients) had chronic kidney disease with the highest brain natriuretic peptide (BNP) and was less likely to be treated with angiotensin converting enzyme inhibitor (ACE-I) or β-blocker at discharge. Cluster 2 (69 patients) was elderly patients with ischemic etiology and hypertension (HTN). They had the highest systolic blood pressure and had type 2 respiratory failure which was treated with mechanical ventilation. Cluster 3 (56 patients) was young patients with obesity and HTN. They had the lowest ejection fraction (EF) with high BNP and were the most likely to be treated with ACE-I or β-blocker at discharge. Cluster 4 (150 patients) was elderly and had the highest prevalence of atrial fibrillation. They had the highest EF and were less likely to be treated with vasodilators or inotropes. The composite of death or HF hospitalization within 12 months occurred in 33%, 25%, 25% and 31%, respectively (Figure 1). Death occurred in 14%, 5.8%, 1.8% and 11%, respectively (Figure 2).
Conclusions: Cluster analysis could result in clinically relevant categories of ADHF with different etiologies, clinical manifestations and treatments.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-287
- 2017 American College of Cardiology Foundation