title: Design and rationale of the URGENT Dyspnea study: an international, multicenter, prospective study.
abstract: BACKGROUND
  Dyspnea is a key target in both clinical management and clinical trials of acute heart failure syndromes and its relief important to patients, clinicians, investigators, and regulatory approval agencies. Despite its importance, the impact of early therapy on dyspnea is not well known. The severity of dyspnea may also be influenced by the conditions under which it is measured (ie, sitting up or lying down). URGENT Dyspnea (Ularitide Global Evaluation in Acute Decompensated Heart Failure) is a prospective multicenter study designed to address these issues.
  
  
  RESULTS
  Consenting adult patients with dyspnea secondary to acute heart failure syndromes are eligible. Patients must be interviewed within one hour of first physician evaluation, typically in an emergency department or acute care setting, with dyspnea assessed by the patient using both a 5-point Likert scale and 10-point visual analog scale in the sitting (60 degrees) and then supine (20 degrees ) position if symptomatically able. Improvement of dyspnea by change in Likert and visual analog scale scores at 6 h is the primary endpoint.
  
  
  CONCLUSIONS
  Timing of dyspnea measurement and the conditions under which it is measured may influence dyspnea severity and this may have significant implications for future acute heart failure syndromes clinical trial design that target dyspnea.
authors.affiliation: Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. ppang@northwestern.edu
authors.forename: Peter S
authors.initials: PS
authors.lastname: Pang
authors.forename: Miguel
authors.initials: M
authors.lastname: Tavares
authors.forename: Sean P
authors.initials: SP
authors.lastname: Collins
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
authors.forename: Judd
authors.initials: J
authors.lastname: Hollander
authors.forename: Markku
authors.initials: M
authors.lastname: Nieminen
authors.forename: Chadwick
authors.initials: C
authors.lastname: Miller
authors.forename: D Mark
authors.initials: DM
authors.lastname: Courtney
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Kirk
authors.forename: Josep
authors.initials: J
authors.lastname: Masip
authors.forename: Alexander
authors.initials: A
authors.lastname: Parkhomenko
authors.forename: Cezar
authors.initials: C
authors.lastname: Macarie
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Jindrich
authors.initials: J
authors.lastname: Spinar
authors.forename: Richard
authors.initials: R
authors.lastname: Nowak
authors.forename: Dimitar
authors.initials: D
authors.lastname: Raev
authors.forename: Alan B
authors.initials: AB
authors.lastname: Storrow
authors.forename: Vladimir
authors.initials: V
authors.lastname: Spisak
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hamdy
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mebazaa
authors.forename: Mihai
authors.initials: M
authors.lastname: Gheorghiade
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002986:Clinical Trials as Topic / Q000379:methods*; D004417:Dyspnea / Q000628:therapy*; D006333:Heart Failure; D006801:Humans; D015337:Multicenter Studies as Topic / Q000379:methods*; D018579:Patient Selection; D011446:Prospective Studies; D012107:Research Design; D012720:Severity of Illness Index; D013997:Time Factors