4%), arrhythmias (7.9%) and hypertensive selleck chemicals llc crisis (5.7%). The differences in etiologies between de-novo and acute decompensation of chronic heart failure are shown in Figure Figure33.Figure 2In-hospital mortality according to syndromes of acute heart failure. Statistical significance denoted as ** <0.001; *<0.050. ADHF - Acute decompensated heart failure, AHF - Acute heart failure.Figure 3The differences in etiologies between de-novo and acute decompensation of chronic heart failure. ADCHF - Acute decompensation of chronic heart failure, De-novo - Acute heart failure de-novo.Coronary angiography and percutaneous coronary intervention in patients with AHFAt admission 29.5% of patients had coronary revascularization by percutaneous coronary intervention or coronary artery bypass grafting in their medical history.

During hospitalization coronary angiography was performed in 45.5% of patients, more often in younger patients <70 years old (69.8% versus 55.6%; P < 0.01) and in men (50.6% versus 41.0%; P < 0.001). Coronary angiography findings at the time of discharge were known in 62.6% of hospitalized patients in total. There were significant differences among syndromes of AHF (acute decompensated heart failure - 64.7%, hypertensive HF - 32.4%, pulmonary edema - 66.8%, cardiogenic shock - 70%, AHF with high output - 28.8%, and right AHF - 39.7%; P < 0.001). Percutaneous coronary intervention was performed in 25.3% of patients, in 80.4% of patients with AHF and myocardial infarction with ST segment elevations, in 38.5% of patients with AHF and myocardial infarction without ST elevations and in 4.

9% of patients without ACS.During the course of hospitalization, noradrenaline was used in 19.0%, adrenaline in 8.9%, dobutamine in 10.0%, dopamine in 8.7% and levosimendan in 3.7% of patients. The use of vasopressors and inotropes according to the clinical syndromes is shown in detail in Table Table4.4. Administration of adrenaline was associated with in-hospital resuscitation (88.3%) and also with high in-hospital mortality (84.4%). Adrenaline only was used in 15% of all administrations; the most often combination was with noradrenaline in 34.7%. Although vasopressors were also administrated to patients with other syndromes then cardiogenic shock, these patients did not meet the criteria for cardiogenic shock according to the attending physicians.

They had either no signs of tissue hypoperfusion and the treatment with vasopressors was only short-term with low doses or vasopressors were administered for another indication than cardiogenic shock, such as hemorrhagic Drug_discovery shock, septic shock, hypovolemia, and so on. Hemodialysis was used in 2.4% of hospitalized patients, intra-aortic balloon contrapulsation (IABC) was used in 3.5% (N = 144) of all hospitalized patients (according to syndromes: in cardiogenic shock in 79.9% of patients; in pulmonary edema in 9.0% of patients; in acute decompensated heart failure in 11.