Premium
Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre‐RELAX‐AHF study
Author(s) -
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
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq132
Subject(s) - medicine , heart failure , placebo , visual analogue scale , relaxin , cardiology , physical therapy , alternative medicine , pathology , hormone
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.