Clinical grading of pediatric heart failure in Egypt: a single-center study

Heba Safar
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Abstract

Background The inability of the heart to satisfy the demands of the target tissues’ metabolism as a result of alterations to the cardiac anatomy or function is known as heart failure (HF). Objective With a focus on the relationship between HF grade and other factors, the study sought to investigate clinical, laboratory, mortality, and severity of HF in children. Patients and methods From April 2022 to September 2022, an analytical cross-sectional study was conducted in the Pediatric Department of the Fayoum University, Faculty of Medicine. A total of 30 children with congestive HF, ranging in age from 3 days to 10 years, made up the study group. The patients’ medical information was gathered from medical records kept in hospital patient files. For grading, the original Ross Classification for pediatric HF was applied. The diagnosis was clinically and echocardiographically verified. Results and conclusion For clinical and therapy evaluation, the severity of HF was determined according to Ross classification. HF cases of classes II, III, and IV were reported in 53.3, 33.3, and 13.3% of the current study population, respectively. A large proportion of the research group patients had anemia (80%), hypoalbuminemia (73.3%), and higher creatinine levels (40%), whereas a lesser proportion had lower sodium and calcium levels. Hypokalemia brought on by diuretics is uncommon in the research group (6.7%). Because anemia correlates well with Ross classification and the quantity of cardiac drugs taken, it has a negative effect on the severity of congestive HF and treatment regimens, with P value less than 0.05. The other side of the coin is that additional adverse effects are brought on by higher drug use. The main causes of death in patients with congestive HF were verified to be severe infections and malnutrition by the high mean of C-reactive protein and low mean of albumin, among nonsurvived cases, with P value less than 0.05.
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埃及儿童心力衰竭的临床分级:一项单中心研究
背景:由于心脏解剖结构或功能的改变,心脏不能满足靶组织代谢的需要被称为心力衰竭(HF)。目的研究HF分级与其他因素的关系,探讨儿童HF的临床、实验室、死亡率和严重程度。2022年4月至2022年9月,在法尤姆大学医学院儿科进行了一项分析性横断面研究。共有30名充血性心力衰竭儿童,年龄从3天到10岁不等,组成了研究组。患者的医疗信息是从医院患者档案中保存的医疗记录中收集的。在分级时,采用最初的罗斯小儿心衰分级。诊断经临床和超声心动图证实。结果与结论根据Ross分级法确定HF的严重程度,用于临床及治疗评价。II、III和IV级HF病例分别占当前研究人群的53.3%、33.3%和13.3%。大部分研究组患者有贫血(80%)、低白蛋白血症(73.3%)和较高的肌酐水平(40%),而较少比例的患者有较低的钠和钙水平。利尿剂引起的低钾血症在研究组中并不常见(6.7%)。由于贫血与Ross分级及心脏药物用量有良好的相关性,因此对充血性HF的严重程度及治疗方案有负向影响,P值小于0.05。硬币的另一面是,更多的药物使用带来了额外的不良影响。在未存活病例中,c反应蛋白均值高,白蛋白均值低,证实了充血性HF患者的主要死亡原因为严重感染和营养不良,P值均小于0.05。
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