Table 1.
Baseline characteristics.
| All patient (n = 85) |
Decreasing tier (n = 28) |
Minimal tier (n = 28) |
Increasing tier (n = 29) |
|||||
|---|---|---|---|---|---|---|---|---|
| Baseline | Discharge | Baseline | Discharge | Baseline | Discharge | Baseline | Discharge | |
| Age (y) | 78 (72–85) | 78 (70–85) | 78 (68–83) | 78 (74–87) | ||||
| Male, n (%) | 54 (63) | 13 (46) | 21 (75) | 20 (69) | ||||
| NYHA class, n (%) | ||||||||
| II | 2 [2] | 37 [44] * | 0 (0) | 15 (54) * | 2 [7] | 12 [43] | 0 (0) | 10 [34] |
| III | 43 (51) | 16 [19] * | 14 (50) | 4 [14] * | 11 [39] | 4 [14] | 18 (62) | 8 [28] * |
| IV | 40 (47) | 0 (0) * | 14 (50) | 0 (0) | 15 (54) | 0 (0) * | 11 [38] | 0 (0) |
| Pleural effusion, n (%) | 65 (76) | 24 [28] * | 21 (75) | 13 (46) * | 21 (75) | 7 [25] * | 23 (79) | 4 [14] *☨ |
| BW (kg) | 58.1 (48.0–68.3) | 54.5 (43.5–61.3) * | 54.7 (44.0–61.0) | 49.0 (42.6–61.3) * | 62.8 (50.8–69.7) | 55.1 (43.0–62.0) * | 58.0 (48.1–68.2) | 55.0 (44.1–59.1) * |
| BW change (kg) | −6.3 (−9.4–−3.7) | −4.5 (−9.5–−2.5) | −7.4 (−9.2–−4.0) | −6.0 (−9.8–−3.5) | ||||
| SBP (mmHg) | 137 (118–162) | 111 (99–125) * | 140 (125–168) | 115 (101–128) * | 131 (112–146) | 113 (99–122) * | 124 (110–154) | 103 (96–126) * |
| HR (bpm) | 91 (72–112) | 70 (62–80) * | 97 (77–112) | 71 (62–83) * | 80 (68–102) | 70 (59–80) * | 83 (64–102) | 70 (62–79) |
| prior HF hospitalization, n (%) | 42 (49) | 11 [39] | 13 (46) | 18 (62) | ||||
| Hemoglobin (g/dL) | 11.1 (9.4–12.8) | 11.6 (9.5–13.1) * | 10.9 (9.2–12.4) | 10.8 (9.2–12.5) | 11.1 (9.7–13.3) | 11.7 (10.3–12.9) * | 11.2 (9.3–12.8) | 11.9 (9.5–13.9) |
| BUN (mg/dL) | 25 [18–39] | 31 (23–46) * | 29 (18–49) | 24 (15–50) | 24 [17–31] | 29 (23–45) * | 23 [18–36] | 35 (26–48) |
| Creatinine (mg/dL) | 1.09 (0.88–1.68) | 1.28 (0.92–1.88) * | 1.07 (0.75–1.85) | 1.12 (0.80–2.18) | 1.07 (0.89–1.45) | 1.17 (1.01–1.48) | 1.43 (0.93–1.76) | 1.47 (0.93–2.06) * |
| Plasma Na (mEq/L) | 141 (138–143) | 139 (136–141) * | 140 (137–143) | 139 (137–142) | 142 (140–143) | 140 (137–141) * | 140 (138–143) | 137 (135–139) *☨ |
| Plasma K (mEq/L) | 4.1 (3.8–4.6) | 4.4 (4.0–4.7) | 4.1 (3.8–4.7) | 4.2 (3.8–4.9) * | 4.0 (3.7–4.6) | 4.4 (4.0–4.7) | 4.3 (3.7–4.7) | 4.4 (4.2–4.7) |
| Plasma Cl (mEq/L) | 106 (103–108) | 101 (99–104) * | 104 (99–108) | 102 (99–104) | 107 (104–108) | 102 (101–104) * | 105 (102–108) | 100 (97–103) * |
| BNP (pg/mL) | 881 (475–1570) | 323 (168–564) * | 1100 (498–1598) | 502 (220–736) * | 788 (516–1743) | 312 (209–439) * | 881 (458–1565) | 231 (140–420) *☨ |
| NT-pro BNP (pg/mL) | 6839 (3293–20016) | 2779 (1127–5766) * | 10,195 (4257–29303) | 5370 (2060–9457) * | 6909 (3219–20016) | 2339 (1083–4029) * | 5268 (3038–10770) | 1724 (1034–3188) *☨ |
| PRA (ng/mL/h) | 0.8 (0.3–2.2) | 2.8 (1.0–7.2) | 0.9 (0.3–3.4) | 0.6 (0.3–1.6) * | 0.6 (0.3–1.5) | 2.0 (1.3–3.3) * | 1.4 (0.6–2.4) | 12 [7–18] *☨ |
| LLoQ of PRA, n (%) | 8 [9] | 3 [4] | 2 [7] | 3 [11] | 3 [11] | 0 (0) | 3 [10] | 0 (0) ☨ |
| Aldosterone (pg/mL) | 83 (47–142) | 113 (68–186) * | 64 (44–165) | 72 (42–137) | 84 (36–130) | 97 (67–143) | 88 (65–150) | 183 (130–233) *☨ |
| WRF, n (%) | 20 [24] | 7 [25] | 5 [19] | 8 [29] | ||||
| LVDd (mm) | 58 (51–66) | 58 (51–65) * | 56 (50–61) | 56 (49–62) | 61 (53–66) | 58 (52–62) | 61 (51–71) | 62 (52–67) * |
| LVEF (%) | 34 [27–40] | 33 [25–40] * | 35 (26–48) | 33 [24–44] | 32 [26–38] | 33 [26–38] | 34 [28–41] | 34 [24–41] |
| E/e prime | 23 [18–32] | 19 [13–23] * | 22 [18–36] | 19 [14–24] | 23 [19–31] | 20 [13–22] * | 23 [16–34] | 18 [13–24] * |
| LAVI (ml/m2) | 69 (50–81) | 54 (42–71) * | 71 (48–78) | 56 (46–70) | 71 (54–97) | 53 (41–72) * | 62 (45–86) | 54 (41–75) |
| AF or AFL, n (%) | 29 [34] | 8 [29] | 10 [36] | 11 [38] | ||||
| Ischemic etiology, n (%) | 26 [31] | 9 [32] | 7 [25] | 10 [34] | ||||
| Hypertention, n (%) | 58 (68) | 23 (82) | 20 (71) | 15 (52) ☨ | ||||
| Diabates mellitus, n (%) | 32 [38] | 12 [43] | 10 [36] | 10 [34] | ||||
| Oral medications, n (%) | ||||||||
| ACE-inhibitors or ARBs, n (%) | 53 (62) | 66 (78) * | 17 (61) | 19 (68) | 16 (57) | 21 (75) | 20 (69) | 26 (90) |
| BB, n (%) | 60 (71) | 76 (89) * | 16 (57) | 25 (89) * | 23 (82) | 25 (89) | 21 (72) | 26 (90) |
| Carvedilol equivalent, mg | 7.5 (0–11.25) | 10 [5–15] * | 6.25 (0–11.875) | 10 [5–20] * | 8.75 (3.125–11.875) | 10 [5–15] | 5 (0–12.5) | 10 (2.5–10) |
| Loop diuretics, n (%) | 44 (52) | 63 (74) * | 9 [32] | 17 (61) | 15 (54) | 22 (79) | 20 (69) ☨ | 24 (83) |
| Furosemide equivalent, mg | 10 (0–40) | 20 (0–40) * | 0 (0–40) | 20 (0–40) * | 5 (0–40) | 20 [10–40] | 30 (0–40) | 20 [20–40] |
| MRA, n (%) | 15 [18] | 39 (46) * | 7 [25] | 10 [36] | 2 [7] | 12 [43] * | 6 [21] | 17 (59) * |
| Hospitalization length (days) | 17 [11–26] | 20 [11–33] | 15 [10–22] | 18 [11–26] | ||||
Data are presented median (25th to 75th percentiles) for continuous variables, or n (%). *p < 0.05 vs on admission data. †<0.05 showed significant differences between the tiers at the same phase. ACE, angiotensin-converting enzyme; AF, atrial fibrillation; AFL, atrial flutter; ARB, angiotensin receptor blocker; BB, beta-blocker; BNP, B-type natriuretic peptide; E/e’, the ratio between early mitral inflow velocity and mitral annular early diastolic velocity; eGFR, estimated glomerular filtration rate; HF, heart failure; HR, heart rate; LAVI, left arterial volume index; LLoQ: Lower Limit of Quantification, LVDd, left ventricular end-diastolic dimension; LVEF left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NT-proBNP, N-termial pro B-type natriuretic peptide; PRA, plasma renin activity; NYHA, New York Heart Association; SBP, systolic blood pressure; WRF, worsening renal failure.