{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:22:46Z","timestamp":1755224566658,"version":"3.43.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Paediatric acute heart failure (AHF) differs from adult cases, and less numerous population limits research aimed at improving clinical practice and prognosis. We aimed to evaluate outcomes and prognostic factors in the paediatric population of AHF patients with left ventricular ejection fraction (EF) &amp;lt; 50%, or systemic right ventricular fractional area change &amp;lt;40%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This single-centre retrospective cohort study included 162 consecutive paediatric patients hospitalized for new-onset AHF with systolic dysfunction or the first exacerbation with reported systolic dysfunction of chronic heart failure (CHF). Patients were categorized into two subgroups: those with &amp;gt;5% improvement in EF on follow-up echocardiography before discharge (n = 115) and those with EF deterioration, \u22645% EF improvement, or death during hospitalization (n = 47). The study contained 58% males and 42% females. The median age was 1 [interquartile range (IQR) 0\u20138] year, 14 (IQR 2\u2013101) months. The mortality rate was 12.3%. Acute heart failure aetiologies included congenital heart defects (51.2%), cardiomyopathy (20.4%), infections (14.2%), arrhythmias (11.7%), and others (2.5%). Our study demonstrated independent factors of worse outcomes: cardiomyopathies aetiology [odds ratio (OR) 2.762 (1.210\u20136.307)], older age [OR 1.006 (1.000\u20131.011)], and factors of better prognosis: infective aetiology [OR 0.083 (0.010\u20130.664)], higher EF [OR 0.953 (0.905\u20130.999)], oxygen saturation (SpO2) [OR 0.951 (0.905\u20130.992)]. In contrast to CHF exacerbation, de novo AHF had better outcomes (P = 0.014).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Acute heart failure with systolic dysfunction in children has an unfavourable prognosis, however most patients improved during hospitalization. In our study, cardiomyopathy aetiology predicted worse outcomes. In turn, infective aetiology, younger age, higher EF, and SpO2 were independent factors of better prognosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuaf049","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T15:06:20Z","timestamp":1743606380000},"page":"443-452","source":"Crossref","is-referenced-by-count":0,"title":["Acute heart failure with systolic dysfunction in paediatric patients: aetiology, risk factors, and in-hospital prognosis"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3753-7218","authenticated-orcid":false,"given":"Kamila","family":"Kurkiewicz-Sawczak","sequence":"first","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3449-8751","authenticated-orcid":false,"given":"Filip","family":"Sawczak","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Poznan University of Medical Sciences , Dluga 1\/2, Poznan 61-848 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Baszkowski","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]},{"name":"The Student Scientific Society, Poznan University of Medical Sciences , Poznan ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinga","family":"Walska-\u015awierc","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malwina","family":"Baturo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weronika","family":"Pelczar-P\u0142achta","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominika","family":"Wysocka","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Ka\u0142u\u017cna-Oleksy","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Poznan University of Medical Sciences , Dluga 1\/2, Poznan 61-848 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waldemar","family":"Bobkowski","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Poznan University of Medical Sciences , Szpitalna 27\/33, Poznan 60-572 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"2025081214352420100_zuaf049-B1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2025081214352420100_zuaf049-B2","doi-asserted-by":"crossref","first-page":"e898","DOI":"10.1542\/peds.2008-2198","article-title":"Acute heart failure syndromes in the pediatric emergency department","volume":"124","author":"Macicek","year":"2009","journal-title":"Pediatrics"},{"key":"2025081214352420100_zuaf049-B3","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1093\/eurheartj\/ehad195","article-title":"2023 focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure","volume":"44","author":"McDonagh","year":"2023","journal-title":"Eur Heart J"},{"key":"2025081214352420100_zuaf049-B4","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1161\/CIRCULATIONAHA.123.066605","article-title":"Sacubitril\/valsartan in pediatric heart failure (PANORAMA-HF): a randomized, multicenter, double-blind trial","volume":"150","author":"Shaddy","year":"2024","journal-title":"Circulation"},{"key":"2025081214352420100_zuaf049-B5","doi-asserted-by":"crossref","first-page":"1274990","DOI":"10.3389\/fcvm.2023.1274990","article-title":"Does sacubitril\/valsartan work in children with heart failure? 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