The performance of STIs and clinical scores alone and their combination to predict short term prognosis of acute decompensated heart failure.

Acute heart failure is a leading cause of hospitalization and death.Prediction of these adverse events is still challenging.

STI is an old technique based on the recording of two parameters: electrocardiogram and phonocardiogram, and from them measuring the different systolic intervals:

pre-ejection period (PEP),electro-mechanic activation time (EMAT), Left ventricular ejection time (LVET) and systolic time ratio (RTS) were measured.

The aim of these study is to demonstrate whether systolic time intervals (STIs) can improve clinical scores EFFECT (Enhanced Feedback for Effective Cardiac Treatment) and GWTG-HF (Get With the Guidelines-Heart Failure) for predicting 30 day mortality and readmission in patients with acute decompensated heart failure (ADHF) in the ED.

Inclusion Criteria:

• non traumatic dyspnea
• age more than 18 years old.

Exclusion Criteria:

• ECG diagnostic for acute myocardial infarction
• ischemic chest pain within the prior 24 hours
• history of a heart transplant
• pericardial effusion
• chest wall deformity suspected of causing dyspnea
• coma
• shock,Mechanical Ventilation, vasopressor drugs
• arrhythmia serious and sustained,
• pace maker
• severe mitral valve disease,
• severe pulmonary arterial hypertension
• renal failure with creatinine >350micromol/l

all patients aged more than 18 years admitted to the ED with the diagnosis of acute decompensated heart failure