title: In-hospital worsening heart failure.
abstract: Acute worsening heart failure (WHF) is seen in a sizable portion of patients hospitalized for heart failure, and is increasingly being recognized as an entity that is associated with an adverse in-hospital course. WHF is generally defined as worsening heart failure symptoms and signs requiring an intensification of therapy, and is reported to be seen in anywhere from 5% to 42% of heart failure admissions. It is difficult to ascertain the exact epidemiology of WHF due to varying definitions used in the literature. Studies indicate that WHF cannot be precisely predicted on the basis of baseline variables assessed at the time of admission. Recent data suggest that some experimental therapies may reduce the risk of development of WHF among hospitalized heart failure patients, and this is associated with a reduction in risk of subsequent post-discharge cardiovascular mortality. In this respect, WHF holds promise as a endpoint for acute heart failure clinical trials to better elucidate the benefit of targeted novel therapies. Better understanding of the pathophysiology and a consensus on the definition of WHF will further improve our epidemiological and clinical understanding of this entity.
authors.affiliation: Stony Brook University, Stony Brook, NY, USA.
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
authors.affiliation: Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Mihai
authors.initials: M
authors.lastname: Gheorghiade
authors.affiliation: Cardiology Division, Emory University, Atlanta, GA, USA.
authors.forename: Anita
authors.initials: A
authors.lastname: Kelkar
authors.affiliation: Cardiology Division, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: Department of Cardiology, Charite Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Anker
authors.affiliation: Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Greene
authors.affiliation: Stony Brook University, Stony Brook, NY, USA.
authors.forename: Lampros
authors.initials: L
authors.lastname: Papadimitriou
authors.affiliation: Department of Emergency Medicine, Vanderbilt University, Nashville, TN, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Collins
authors.affiliation: Cardiovascular Center, University Hospital, Zurich, Switzerland.
authors.forename: Frank
authors.initials: F
authors.lastname: Ruschitzka
authors.affiliation: Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Clyde W
authors.initials: CW
authors.lastname: Yancy
authors.affiliation: Cardiology Division, University of California San Francisco, San Francisco, CA, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Teerlink
authors.affiliation: Cardiology Division, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Kirkwood
authors.initials: K
authors.lastname: Adams
authors.affiliation: Momentum Research, Durham, NC, USA.
authors.forename: Gadi
authors.initials: G
authors.lastname: Cotter
authors.affiliation: Medical University, Clinical Military Hospital, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
authors.forename: G Michael
authors.initials: GM
authors.lastname: Felker
authors.affiliation: Cardiology Division, University of Brescia, Brescia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
authors.affiliation: Cardiology Division, University of Athens, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
mesh_terms: D018450:Disease Progression; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D011379:Prognosis; D055502:Secondary Prevention / Q000379:methods; D000067251:Symptom Flare Up; D035703:Therapies, Investigational / Q000379:methods*
keywords: Acute heart failure; Worsening heart failure