Identifying Key Factors Contributing to Acute Decompensated Heart Failure in Patients with Left Ventricular Dysfunction: A Cross-Sectional Study

Abstract

Objectives: This study aims to identify the spectrum of factors contributing to acute decompensated heart failure (ADHF) in patients with established left ventricular dysfunction.

Methodology: We conducted a prospective cross-sectional study over six months (October 24, 2021, to April 24, 2022) at the Department of Cardiology, Medical Teaching Institute, Khyber Teaching Hospital (MTI-KTH) Peshawar. Using a non-probability consecutive sampling technique, a sample size of 100 patients was determined with the WHO sample size calculator. We evaluated factors including dietary noncompliance, medication adherence, infections, arrhythmias, acute coronary ischemia, uncontrolled hypertension, and anemia in patients with decompensated heart failure. The study included both genders, aged 30 to 80, with diabetes and hypertension but without ischemic heart disease. Data were analyzed using IBM-SPSS 23, with the Chi-square test applied for statistical analysis.

Results: Dietary noncompliance was observed in 51% of patients, while 52% adhered to their medication regimen. Contributing factors included poor attitude (16%), financial difficulties (17%), inadequate guidance (9%), and illiteracy (6%). Infections were prevalent, with pulmonary infections in 29%, urinary tract infections (UTI) in 1%, sepsis in 6%, and both UTI and sepsis in 64%. Cardiac conditions showed that 90% had no arrhythmias, 8% had atrial fibrillation (AF), and 1% each had other supraventricular tachycardia (SVT) and sustained ventricular tachycardia (VT). Acute coronary syndrome (ACS) was present in 47% of patients. The mean age was 61.6 ± 11.7 years. Only hypertension showed a significant correlation with acute decompensation.

Conclusion: The main factors contributing to ADHF were uncontrolled hypertension, dietary noncompliance, anemia, and medication nonadherence. Addressing these modifiable factors through regular monitoring could reduce ADHF incidence and improve patient outcomes.