Current status of emergency treatment for acute heart failure:a single-center analysis

Cui Xinwei; Liu Jiaqi; Chen Fengying

doi:10.3969/j.issn.1002-1949.2025.10.008

Abstract：Objective To collect and summarize the clinical characteristics,treatment measures,curative effect of patients with acute heart failure(AHF)in the emergency department of the Affiliated Hospital of Inner Mongolia Medical University,as well as the follow-up data of 1 month,6 months and 1 year after discharge,to analyze the treatment status and prognosis of AHF in our region in recent years.Methods This prospective,single-center observational study enrolled acute heart failure patients admitted to the Emergency Department of the Affiliated Hospital of Inner Mongolia Medical University between March 2023 and March 2024.Data collected included age,gender,etiology,comorbidities,symptoms,physical signs,imaging findings and laboratory results,treatment regimens,and prognosis.Follow-up concluded on March 31,2025.Results This study included 166 AHF patients with complete clinical data.The median age was 68.00(59.00,75.00)years old.The median hospital stay was8.00(6.00,11.00)days.The main etiologies of AHF were coronary artery disease(65 cases,39.16%),cardiomyopathy(33 cases,19.88%),arrhythmia(28 cases,16.87%),and hypertension(21 cases,12.65%).Among them,132 cases(79.52%)were complicated with respiratory diseases,and 100 cases(60.24%)were complicated with coronary heart disease.Clinical manifestations:Over 85%of patients presented with dyspnea and fatigue,while more than half of the patients with chest tightness or chest pain;most crackles were indentified in 133 patients(80.1%),while a galloping rhythm was noted in 98 patients(59.04%).NYHA class Ⅲ and Ⅳ heart failure accounted for 58 cases(34.94%)and 55 cases(33.13%),respectively.Imaging and lab findings:Meanleftventricularejection fraction(LVEF)was(42.21±11.19)%,and77 patients(46.39%)were classified as having heart failure with reduced ejection fraction(HFrEF).NT-proBNP was5 315.00(2 206.50,12 148.50)pg/mL.Treatment measures:In the drug treatment,162 patients(97.59%)received oral diuretics,146 patients(87.95%)intravenous diuretics,160 patients(96.39%)spironolactone,147 patients(88.55%)recombinant human brain natriuretic peptide within 3 days of admission,49 patients(29.52%)nitrates,40 patients(24.10%)digoxin,101 patients(60.84%)β-blockers,75 patients(45.18%)sacubitril/valsartan,and 44 patients(26.51%)SGLT2 inhibitors.In non-drug treatment,All patients received oxygen therapy(159,95.78%via nasal cannula),with 30 patients(18.07%)undergoing PCI and2 patients(1.20%)pacemaker implantation.All-cause mortality rates were 5.4%at 1 month,14.3%at 6 months,and 18.7%at 1 year.Corresponding readmission rates were 9.0%,14.5%,and 20.5%,while the combined mortality or rehospitalization rates reached 13.5%,24.7%,and 37.6%at the same time points,respectively.Conclusions Early identification and management of underlying causes in AHF patients are crucial in the emergency department.Prompt pharmacological intervention,supportive care,and bedside ultrasound-guided volume optimization can effectively relieve symptoms such as pulmonary edema.This targeted approach helps mitigate AHF manifestations,reduce hospitalization duration,and improve outcomes.