Clinical Characteristics of Acute Decompensated Heart Failure With Rapid Onset of Symptoms

Background: Few reports regarding the definition, epidemiology, and pathophysiology of acute decompensated heart failure (ADHF) are available. The clinical characteristics of 194 consecutive ADHF patients with abrupt onset of symptoms were investigated. Methods and Results: Patients with acute coronary syndromes including acute myocardial infarction., acute pneumonia, severe valvular disease, and end-stage renal disease that required dialysis therapy were excluded. Patients were divided into 2 groups: rapid-progression group, onset within 24 hours before admission (n = 78), and gradual-progression group, onset more than 24 hours before admission (n 52). No significant differences were observed in the age, gender, prescriptions, and hematological data between the 2 groups. The proportion of patients who drank excessive water was higher in the rapid-progression group. Systolic blood pressure, diastolic blood pressure, heart rate, left ventricular ejection fraction, and left ventricular wall thickness were greater in patients in the rapid-progression group. Indexes indicating left ventricular diastolic function were significantly deteriorated in the rapid-progression group. Conclusion: Excessive water intake, acute hypertension, and diastolic dysfunction are associated with the pathophysiology of abrupt-onset ADHF Hypertensive patients with diastolic dysfunction should be treated cautiously to prevent the occurrence of ADHF. (J Cardiac Fail 2009:15:300-304)