Caracterización del síndrome cardio-hepático en pacientes con insuficiencia cardiaca agudizada entre el 2022 y 2023
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Fecha
2024
Autores
Vega Castiblanco, Gabriel Andrés
Manosalva Trillos, Luis Miguel
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
El síndrome cardio-hepático es una complicación frecuente en pacientes con insuficiencia cardiaca agudizada (ICA), caracterizada por la interacción entre la disfunción cardíaca y el daño hepático. Esta condición contribuye significativamente a la morbimortalidad en estos pacientes, particularmente en aquellos con fracción de eyección reducida. En regiones como el Caribe colombiano, la caracterización del síndrome cardio-hepático sigue siendo limitada, lo que resalta la importancia de comprender los factores clínicos y bioquímicos que contribuyen a su desarrollo. Objetivo: Caracterizar el Síndrome Cardio-hepático en Pacientes con Insuficiencia Cardiaca Agudizada entre el 2022 y 2023 en una clínica de Barranquilla entre los años 2022 y 2023 Métodos: Este estudio retrospectivo incluyó a 53 pacientes con diagnóstico de ICA tratados en una clínica de Barranquilla entre 2022 y 2023. Se realizó una caracterización sociodemográfica y clínica de los pacientes, así como una evaluación de los parámetros bioquímicos hepáticos y cardíacos. Las variables principales incluyeron fracción de eyección, biomarcadores hepáticos (bilirrubina total, TGP, TGO) y proBNP. Se emplearon modelos estadísticos multivariados para identificar factores de riesgo asociados al desarrollo de síndrome cardio-hepático. Resultados: El 42% de los pacientes con ICA presentaron características compatibles con síndrome cardio-hepático. La mayoría de estos pacientes presentaron fracción de eyección reducida (HFrEF) y una mayor prevalencia de etiología isquémica de la insuficiencia cardíaca (45%). Los niveles de bilirrubina total y transaminasas fueron significativamente más elevados en los pacientes con síndrome cardio-hepático. Además, la fracción de eyección reducida (HFrEF) se asoció con un riesgo 3.2 veces mayor de desarrollar este síndrome. Los pacientes con síndrome cardio-hepático mostraron una evolución clínica menos favorable (50% de desenlaces no favorables). Conclusiones: El síndrome cardio-hepático es una complicación frecuente en pacientes con ICA, especialmente en aquellos con fracción de eyección reducida. La evaluación temprana de los biomarcadores hepáticos y cardíacos es fundamental para identificar a los pacientes en riesgo de desarrollar este síndrome, y una intervención oportuna podría mejorar los resultados clínicos. Estos hallazgos subrayan la necesidad de un manejo integral que aborde tanto la disfunción cardíaca como las complicaciones hepáticas en esta población
Cardio-hepatic syndrome is a frequent complication in patients with acute decompensated heart failure (ADHF), characterized by the interaction between cardiac dysfunction and liver damage. This condition significantly contributes to morbidity and mortality, particularly in patients with reduced ejection fraction. In regions such as the Colombian Caribbean, the characterization of cardio-hepatic syndrome remains limited, highlighting the importance of understanding the clinical and biochemical factors contributing to its development. Objective: To characterize Cardiohepatic Syndrome in patients with acute heart failure at a clinic in Barranquilla between the years 2022 and 2023. Methods: This retrospective study included 53 patients diagnosed with ADHF treated at a clinic in Barranquilla between 2022 and 2023. A sociodemographic and clinical characterization of the patients was performed, as well as an evaluation of hepatic and cardiac biochemical parameters. Main variables included ejection fraction, hepatic biomarkers (total bilirubin, ALT, AST), and proBNP. Multivariate statistical models were used to identify risk factors associated with the development of cardio-hepatic syndrome. Results: 42% of the patients with ADHF presented features compatible with cardio-hepatic syndrome. Most of these patients had reduced ejection fraction (HFrEF) and a higher prevalence of ischemic etiology of heart failure (45%). Total bilirubin and transaminase levels were significantly higher in patients with cardio-hepatic syndrome. Furthermore, reduced ejection fraction (HFrEF) was associated with a 3.2-fold increased risk of developing this syndrome. Patients with cardio-hepatic syndrome had a less favorable clinical evolution, with 50% showing unfavorable outcomes. Conclusions: Cardio-hepatic syndrome is a frequent complication in patients with ADHF, especially in those with reduced ejection fraction. Early assessment of hepatic and cardiac biomarkers is essential to identify patients at risk of developing this syndrome, and timely intervention may improve clinical outcomes. These findings highlight the need for comprehensive management that addresses both cardiac dysfunction and hepatic complications in this population.
Cardio-hepatic syndrome is a frequent complication in patients with acute decompensated heart failure (ADHF), characterized by the interaction between cardiac dysfunction and liver damage. This condition significantly contributes to morbidity and mortality, particularly in patients with reduced ejection fraction. In regions such as the Colombian Caribbean, the characterization of cardio-hepatic syndrome remains limited, highlighting the importance of understanding the clinical and biochemical factors contributing to its development. Objective: To characterize Cardiohepatic Syndrome in patients with acute heart failure at a clinic in Barranquilla between the years 2022 and 2023. Methods: This retrospective study included 53 patients diagnosed with ADHF treated at a clinic in Barranquilla between 2022 and 2023. A sociodemographic and clinical characterization of the patients was performed, as well as an evaluation of hepatic and cardiac biochemical parameters. Main variables included ejection fraction, hepatic biomarkers (total bilirubin, ALT, AST), and proBNP. Multivariate statistical models were used to identify risk factors associated with the development of cardio-hepatic syndrome. Results: 42% of the patients with ADHF presented features compatible with cardio-hepatic syndrome. Most of these patients had reduced ejection fraction (HFrEF) and a higher prevalence of ischemic etiology of heart failure (45%). Total bilirubin and transaminase levels were significantly higher in patients with cardio-hepatic syndrome. Furthermore, reduced ejection fraction (HFrEF) was associated with a 3.2-fold increased risk of developing this syndrome. Patients with cardio-hepatic syndrome had a less favorable clinical evolution, with 50% showing unfavorable outcomes. Conclusions: Cardio-hepatic syndrome is a frequent complication in patients with ADHF, especially in those with reduced ejection fraction. Early assessment of hepatic and cardiac biomarkers is essential to identify patients at risk of developing this syndrome, and timely intervention may improve clinical outcomes. These findings highlight the need for comprehensive management that addresses both cardiac dysfunction and hepatic complications in this population.
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Insuficiencia cardiaca, Síndrome cardio-hepático, Fracción de eyección reducida, Biomarcadores hepáticos, ProBNP, Daño hepático, Evolución clínica