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Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study

AIMS: Although dyspnoea is the most common cause of admission for acute heart failure (AHF), more needs to be known about its clinical course and prognostic significance. METHODS AND RESULTS: The Pre-RELAX-AHF study randomized 232 subjects with AHF to placebo or four doses of relaxin and evaluated e...

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Autores principales: Metra, Marco, Teerlink, John R., Felker, G. Michael, Greenberg, Barry H., Filippatos, Gerasimos, Ponikowski, Piotr, Teichman, Sam L., Unemori, Elaine, Voors, Adriaan A., Weatherley, Beth Davison, Cotter, Gad
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944016/
https://www.ncbi.nlm.nih.gov/pubmed/20732868
http://dx.doi.org/10.1093/eurjhf/hfq132
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author Metra, Marco
Teerlink, John R.
Felker, G. Michael
Greenberg, Barry H.
Filippatos, Gerasimos
Ponikowski, Piotr
Teichman, Sam L.
Unemori, Elaine
Voors, Adriaan A.
Weatherley, Beth Davison
Cotter, Gad
author_facet Metra, Marco
Teerlink, John R.
Felker, G. Michael
Greenberg, Barry H.
Filippatos, Gerasimos
Ponikowski, Piotr
Teichman, Sam L.
Unemori, Elaine
Voors, Adriaan A.
Weatherley, Beth Davison
Cotter, Gad
author_sort Metra, Marco
collection PubMed
description AIMS: Although dyspnoea is the most common cause of admission for acute heart failure (AHF), more needs to be known about its clinical course and prognostic significance. METHODS AND RESULTS: The Pre-RELAX-AHF study randomized 232 subjects with AHF to placebo or four doses of relaxin and evaluated early (6–24 h Likert scale) and persistent [change in visual analogue scale area under the curve (VAS AUC) through Day 5] dyspnoea relief. Worsening heart failure (WHF) was defined as worsening AHF signs and symptoms requiring additional therapy. Patients were followed until Day 180. Early dyspnoea relief was observed in only 25% of all patients, and VAS AUC at 5 days was 45% over baseline values in all patients (32% placebo; 50% all relaxin-treated patients). Worsening heart failure to Day 5 was observed in 16% of all patients (21% placebo; 14% relaxin). Lack of persistent dyspnoea relief and WHF were associated with a longer length of initial hospital stay and worse 60-day outcomes. CONCLUSION: Dyspnoea relief in patients admitted with AHF is often incomplete, and many may show WHF after the initial stabilization. Both lack of persistent dyspnoea relief and in-hospital WHF predict a longer length of stay and worse outcome.
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spelling pubmed-29440162010-09-27 Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study Metra, Marco Teerlink, John R. Felker, G. Michael Greenberg, Barry H. Filippatos, Gerasimos Ponikowski, Piotr Teichman, Sam L. Unemori, Elaine Voors, Adriaan A. Weatherley, Beth Davison Cotter, Gad Eur J Heart Fail Clinical Trial AIMS: Although dyspnoea is the most common cause of admission for acute heart failure (AHF), more needs to be known about its clinical course and prognostic significance. METHODS AND RESULTS: The Pre-RELAX-AHF study randomized 232 subjects with AHF to placebo or four doses of relaxin and evaluated early (6–24 h Likert scale) and persistent [change in visual analogue scale area under the curve (VAS AUC) through Day 5] dyspnoea relief. Worsening heart failure (WHF) was defined as worsening AHF signs and symptoms requiring additional therapy. Patients were followed until Day 180. Early dyspnoea relief was observed in only 25% of all patients, and VAS AUC at 5 days was 45% over baseline values in all patients (32% placebo; 50% all relaxin-treated patients). Worsening heart failure to Day 5 was observed in 16% of all patients (21% placebo; 14% relaxin). Lack of persistent dyspnoea relief and WHF were associated with a longer length of initial hospital stay and worse 60-day outcomes. CONCLUSION: Dyspnoea relief in patients admitted with AHF is often incomplete, and many may show WHF after the initial stabilization. Both lack of persistent dyspnoea relief and in-hospital WHF predict a longer length of stay and worse outcome. Oxford University Press 2010-10 2010-08-22 /pmc/articles/PMC2944016/ /pubmed/20732868 http://dx.doi.org/10.1093/eurjhf/hfq132 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: journals.permissions@oxfordjournals.org. http://creativecommons.org/licenses/by-nc/2.5/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
spellingShingle Clinical Trial
Metra, Marco
Teerlink, John R.
Felker, G. Michael
Greenberg, Barry H.
Filippatos, Gerasimos
Ponikowski, Piotr
Teichman, Sam L.
Unemori, Elaine
Voors, Adriaan A.
Weatherley, Beth Davison
Cotter, Gad
Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title_full Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title_fullStr Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title_full_unstemmed Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title_short Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study
title_sort dyspnoea and worsening heart failure in patients with acute heart failure: results from the pre-relax-ahf study
topic Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944016/
https://www.ncbi.nlm.nih.gov/pubmed/20732868
http://dx.doi.org/10.1093/eurjhf/hfq132
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