Assessment of Dyspnea in Acute Decompensated Heart Failure
| Autor: | Mason H. Weiss, Jeffrey A. Bakal, Adrian F. Hernandez, Randall C. Starling, Guy Proulx, Christopher M. O'Connor, John J.V. McMurray, Justin A. Ezekowitz, Robert M. Califf, Paul W. Armstrong |
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| Rok vydání: | 2012 |
| Předmět: |
Nesiritide
medicine.medical_specialty COPD Randomization Acute decompensated heart failure business.industry medicine.disease Placebo law.invention Randomized controlled trial Interquartile range law Heart failure Internal medicine medicine Cardiology Physical therapy Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 59:1441-1448 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2011.11.061 |
| Popis: | Objectives This study hypothesized that peak expiratory flow rate (PEFR) would increase with acute heart failure (AHF) treatment over the first 24 h, related to a Dyspnea Index (DI) change and treatment effect. Background Dyspnea is a key symptom and clinical trial endpoint in AHF, yet objective assessment is lacking. Methods In a clinical trial substudy, 421 patients (37 sites) underwent PEFR testing at baseline, 1, 6, and 24 h after randomization to nesiritide or placebo. DI (by Likert scale) was collected at hours 6 and 24. Results Patients were median age 70 years, and 34% were female; no significant differences between nesiritide or placebo patients existed. Median baseline PEFR was 225 l/min (interquartile range [IQR]: 160 to 300 l/min) and increased to 230 l/min (2.2% increase; IQR: 170 to 315 l/min) by hour 1, 250 l/min (11.1% increase; IQR: 180 to 340 l/min) by hour 6, and 273 l/min (21.3% increase; IQR: 200 to 360 l/min) by 24 h (all p Conclusions PEFR increases over the first 24 h in AHF and could serve as an AHF endpoint. Nesiritide had a greater effect than placebo on PEFR, and this predicted patients with moderate/marked improvement in dyspnea, thereby providing an objective metric for assessing AHF. (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure [ASCEND-HF]; NCT00475852 ) |
| Databáze: | OpenAIRE |
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