PMID- 12767667
OWN - NLM
STAT- MEDLINE
DCOM- 20030610
LR  - 20201216
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 41
IP  - 10
DP  - 2003 May 21
TI  - Clinical assessment identifies hemodynamic profiles that predict outcomes in 
      patients admitted with heart failure.
PG  - 1797-804
AB  - OBJECTIVES: This study was designed to determine the relevance of a proposed 
      classification for advanced heart failure (HF). Profiles based on clinical 
      assessment of congestion and perfusion at the time of hospitalization were 
      compared with subsequent outcomes. BACKGROUND: Optimal design of therapy and 
      trials for advanced HF remains limited by the lack of simple clinical profiles to 
      characterize patients. METHODS: Prospective analysis was performed for 452 
      patients admitted to the cardiomyopathy service at the Brigham and Women's 
      Hospital with a diagnosis of HF. Patients were classified by clinical assessment 
      into four profiles: profile A, patients with no evidence of congestion or 
      hypoperfusion (dry-warm, n = 123); profile B, congestion with adequate perfusion 
      (wet-warm, n = 222); profile C, congestion and hypoperfusion (wet-cold, n = 91); 
      and profile L, hypoperfusion without congestion (dry-cold, n = 16). Other 
      standard predictors of outcome were included and patients were followed for the 
      end points of death (n = 117) and death or urgent transplantation (n = 137) at 
      one year. RESULTS: Survival analysis showed that clinical profiles predict 
      outcomes in HF. Profiles B and C increase the risk of death plus urgent 
      transplantation by univariate (hazard ratio [HR] 1.83, p = 0.02) and multivariate 
      analyses (HR 2.48, p = 0.003). Moreover, clinical profiles add prognostic 
      information even when limited to patients with New York Heart Association (NYHA) 
      class III/IV symptoms (profile B: HR 2.23, p = 0.026; profile C: HR 2.73, p = 
      0.009). CONCLUSIONS: Simple clinical assessment can be used to define profiles in 
      patients admitted with HF. These profiles predict outcomes and may be used to 
      guide therapy and identify populations for future investigation.
FAU - Nohria, Anju
AU  - Nohria A
AD  - Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 
      Francis Street, Boston, MA 02115, USA.
FAU - Tsang, Sui W
AU  - Tsang SW
FAU - Fang, James C
AU  - Fang JC
FAU - Lewis, Eldrin F
AU  - Lewis EF
FAU - Jarcho, John A
AU  - Jarcho JA
FAU - Mudge, Gilbert H
AU  - Mudge GH
FAU - Stevenson, Lynne W
AU  - Stevenson LW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 9NEZ333N27 (Sodium)
SB  - IM
CIN - J Am Coll Cardiol. 2004 Jan 7;43(1):151; author reply 151. PMID: 14715198
MH  - Blood Pressure
MH  - Female
MH  - Heart Failure/*classification/mortality/physiopathology
MH  - Heart Rate
MH  - *Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Sodium/urine
MH  - Stroke Volume
MH  - Survival Rate
EDAT- 2003/05/28 05:00
MHDA- 2003/06/11 05:00
CRDT- 2003/05/28 05:00
PHST- 2003/05/28 05:00 [pubmed]
PHST- 2003/06/11 05:00 [medline]
PHST- 2003/05/28 05:00 [entrez]
AID - S0735109703003097 [pii]
AID - 10.1016/s0735-1097(03)00309-7 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2003 May 21;41(10):1797-804. doi: 
      10.1016/s0735-1097(03)00309-7.