Acute Decompensated Heart Failure with Reduced Ejection Fraction: Common Etiological Cause and Predictor of Mortality in the Nepalese Population

Abstract

Background: Heart failure with reduced ejection fraction (HFrEF) is one of the most common cardiac diseases causing hospital admission, with a very high short- and long-term mortality rate. The study aims to assess the short-term mortality rate of acute decompensated HFrEF and its correlation with the baseline characteristics in a Nepalese population. Methods: Patients with acute decompensated HFrEF admitted in the unit were prospectively enrolled in this study and were followed up for 3 months. Patients who died and those who did not die were compared using the Chi-square test for categorical variables and Student's t-test was used for the comparison of continuous variables. Results: A total of 100 patients were included in the study. The mean age of the patient was 60 ± 16.18 years, with 55% of the participants being male. Atrial fibrillation was documented in 17% and 16% had bundle branch block. Idiopathic dilated cardiomyopathy was seen in 56% of the participants and was found to be the most common cause of HFrEF, followed by coronary artery disease (18%). Pleural effusion was present in 17% of the patients, out of which bilateral effusion was more common (8%). Twenty-nine percent of the patients died during the 3 months follow-up period. Dyslipidemia, hypertension, ejection fraction, baseline hemoglobin, and creatinine level were significant predictors for mortality (P < 0.05 for all). Conclusion: Dilated cardiomyopathy was the most common cause of acute decompensated HFrEF in the Nepalese population. A very high 3-month mortality rate (29%) was recorded. The presence of cardiovascular risk factors, reduced ejection fraction, baseline hemoglobin, and creatinine levels were significant predictors of mortality in acute decompensated HFrEF patients.

Keywords

• cardiovascular risk factors
• heart failure
• mortality
• reduced ejection fraction