Left ventricular global function index as a predictor of unfavorable course of chronic heart failure in the post-hospitalization period

Aim. To identify clinical and instrumental predictors of post-hospitalization complications in patients with decompensation of chronic heart failure (CHF).

Material and methods. The study included 56 patients hospitalized due to decompensation of CHF (40 (71.4 %) men) aged between 61 and 88 years. Mean observation time was 9 ± 2.9 months. Depending on outcomes at primary endpoint (repeat hospitalization and / or death due to cardiovascular disease), 2 patient groups were formed: 30 patients with an event at the primary endpoint and 26 without it. All patients included in the study underwent bioimpedance analysis (InBody 770), echocardiography (Toshiba Applio 500), 6-minute walk test, quality of life assessment using the Minnesota Living with Heart Failure Questionnaire, and frailty screening using the “Age is not a liability” questionnaire. Bioimpedance analysis allowed to assess total body water, extracellular water, their ratio, body mass index, and percentage of fat tissue. The left ventricular global function index (LVGFI) was calculated using volumetric heart parameters measured during echocardiography.

Results. Mean LVGFI value in the group without complications was 15.8 ± 5.4 %; in the group with complications, 12 ± 3.8 %. Threshold LVGFI value for prediction of repeat hospitalization due to CHF within 1 year was 13.05 % with sensitivity of 67 % and specificity of 66 % (area under the ROC curve 0.706; 95 % confidence interval 0.567–0.845; p = 0.004). Bioimpedance signs of water retention at discharge did not show significant correlation with repeat hospitalizations due to CHF (p = 0.475). In patients with CHF and preserved left ventricular ejection function, LVGFI in the group with complications was lower than in the group without complications (p = 0.044). Obesity was not significantly associated with unfavorable outcomes in both the group with complications and the group without them (p = 0.732 and 0.412, respectively).

Conclusion. LVGFI value < 13.05 % is associated with repeat hospitalizations due to CHF in the 1^st year after a decompensation episode (sensitivity 67 %, specificity 66 %). Bioimpedance signs of water retention do not significantly correlate with repeat hospitalization due to CHF.