Application of noninvasive bioelectrical impedance for lung fluid analysis in acute heart failure patients

초록

Backgrounds: Persistent rapid heart rhythms, such as atrial fibrillation, often lead to Tachycardia-induced Cardiomyopathy (TIC), characterized by reversible dysfunction of the left ventricle (LV). TIC shows a prevalence of about 10% in Korean Acute Heart Failure (KorAHF) registry, but this is actually a clinical suspicion at the time of diagnosis. Purpose: To assess true TIC patients, we focused on individuals who were formally discharged with a diagnosis of TIC and subsequently demonstrated recovery in LV ejection fraction. Methods: This retrospective study analyzed 1,222 hospitalized patients for HF from January 2019 to December 2023 and data analysis was based on the discharge check-list of patients which was completed by the physician at the time of discharge. Results: Mean (SD) age of participants was 70.8 (13.8) years, and 711 (58.2%) were male. The most common cause of HF was ischemic heart disease (n = 534, 43.7%) followed by cardiomyopathy (n = 181, 14.8%), valvular heart disease (n = 120, 9.8%), and TIC (n = 111, 9.1%). Interestingly, among the 111 TIC patients, only 43 (38.7%) exhibited LV recovery as observed through follow-up echocardiography. Additionally, among the 'true TIC' patients who experienced LV recovery, 41 individuals (95.4%) had underlying atrial fibrillation, representing the majority of these cases. Conclusion: Among patients presumed to have TIC at the time of discharge, the proportion of confirmed true TIC cases was relatively low. This finding indicates a need for more precise diagnostic criteria and a better understanding of the condition. Furthermore, the high prevalence of atrial fibrillation among the true TIC patients who achieved LV recovery accentuates the critical importance of early detection and management of atrial fibrillation in TIC patients.