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A Journal on Heart and Vascular Diseases

Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2005 December;53(6):523-36

language: English

Importance of myocardial damage in acute decompensated heart failure: changing the paradigm from a passive to an active process

Perna E. R., Címbaro Canella J. P., Macin S. M.


Acute decompensated heart failure (ADHF) is a highly prevalent condition, with elevated short and longterm morbidity and mortality. Clinical deterioration is triggered by many factors that could promote minor myocardial damage (MMD), and the main tools for diagnosis are cardiac troponins T and I. The aim of this article is to review of the current knowledge about the prevalence and prognostic role of MMD in ADHF. Increased levels of troponins has been reported in up to half of patients admitted for ADHF, and they were associated with higher in-hospital incidence of refractory heart failure and death, as well as with poor longterm outcome. Moreover, MMD was an independent prognostic marker of events. The availability of MMD markers has changed the risk stratification in ADHF. Among the emerging approach applying this thought is the combined use with natriuretic peptides as marker of ventricular overload, which has improved the risk-stratification. The concept that an active process, either primary or secondary, has a prognostic implication during ADHF must be incorporated to the clinical practice.

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