title: Dyspnoea and worsening heart failure in patients with acute heart failure: results from the Pre-RELAX-AHF study.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors: Cardiology, Department of Experimental and Applied Medicine, University of Brescia, Brescia, Italy. metramarco@libero.it
authors: Marco
authors: M
authors: Metra
authors: John R
authors: JR
authors: Teerlink
authors: G Michael
authors: GM
authors: Felker
authors: Barry H
authors: BH
authors: Greenberg
authors: Gerasimos
authors: G
authors: Filippatos
authors: Piotr
authors: P
authors: Ponikowski
authors: Sam L
authors: SL
authors: Teichman
authors: Elaine
authors: E
authors: Unemori
authors: Adriaan A
authors: AA
authors: Voors
authors: Beth Davison
authors: BD
authors: Weatherley
authors: Gad
authors: G
authors: Cotter
mesh_terms: D000368:Aged; D019540:Area Under Curve; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology*; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010147:Pain Measurement; D011379:Prognosis; D013223:Statistics as Topic