The impact of early standard therapy on dyspnoea in patients
with acute heart failure: the URGENT-dyspnoea study

J 2010

The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study

MEBAZAA, Alexandre; Peter S PANG; Miguel TAVARES; Sean P COLLINS; Alan B STORROW et al.

Základní údaje

Originální název

The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study

Autoři

Vydání

European Heart Journal, OXFORD, OXFORD UNIV PRESS, 2010, 0195-668X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 10.052

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1093/eurheartj/ehp458

UT WoS

000276892800016

Klíčová slova anglicky

Acute heart failure; Dyspnoea; Orthopnoea

Příznaky

Mezinárodní význam

Změněno: 22. 4. 2013 17:06, Soňa Böhmová

Anotace

V originále

Aims The vast majority of acute heart failure (AHF) trials to date have targeted dyspnoea. However, they enrolled patients relatively late and did not standardize their methods of dyspnoea measurement. URGENT Dyspnoea was designed to determine changes in dyspnoea in response to initial, standard therapy in patients presenting with AHF using a standardized approach. Methods and results URGENT Dyspnoea was an international, multi-centre, observational cohort study of AHF patients managed conventionally and enrolled within 1 h of first hospital medical evaluation. Patient-assessed dyspnoea was recorded in the sitting position at baseline and at 6 hours by Likert and visual analog scales. Less symptomatic patients were placed supine to determine whether this provoked worsening dyspnoea (orthopnoea). Of the 524 patients with AHF, the mean age was 68 years, 43% were women, and 83% received intravenous diuretics. On a 5-point Likert scale, dyspnoea improvement was reported by 76% of patients after 6 h of standard therapy. Supine positioning (orthopnoea test) led to worse dyspnoea in 47% of patients compared to sitting upright. Conclusion When sitting upright, dyspnoea in the sitting position improves rapidly and substantially in patients with AHF after administration of conventional therapy, mainly intra-venous diuretics. However, many patients remain orthopnoeic. Improving the methodology of clinical trials in AHF by standardizing the conditions under which dyspnoea is assessed could enhance their ability to identify effective treatments. Relief of orthopnoea is clinically valuable and may represent a useful goal for clinical trials.

Citovat

MEBAZAA, Alexandre; Peter S PANG; Miguel TAVARES; Sean P COLLINS; Alan B STORROW; Said LARIBI; Stephanie ANDRE; Daniel Mark COURTNEY; Jennifer HASA; Jindřich ŠPINAR; Josep MASIP; William Frank PEACOCK; Karen SLIWA; Etienne GAYAT; Gerasimos FILIPPATOS; John G F CLELAND a Mihai GHEORGHIADE. The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study. European Heart Journal. OXFORD: OXFORD UNIV PRESS, 2010, roč. 31, č. 7, s. 832-841. ISSN 0195-668X. Dostupné z: https://doi.org/10.1093/eurheartj/ehp458.

@article{919707,
   author = {Mebazaa, Alexandre and Pang, Peter S and Tavares, Miguel and Collins, Sean P and Storrow, Alan B and Laribi, Said and Andre, Stephanie and Courtney, Daniel Mark and Hasa, Jennifer and Špinar, Jindřich and Masip, Josep and Peacock, William Frank and Sliwa, Karen and Gayat, Etienne and Filippatos, Gerasimos and Cleland, John G F and Gheorghiade, Mihai},
   article_location = {OXFORD},
   article_number = {7},
   doi = {https://doi.org/10.1093/eurheartj/ehp458},
   keywords = {Acute heart failure; Dyspnoea; Orthopnoea},
   language = {eng},
   issn = {0195-668X},
   journal = {European Heart Journal},
   title = {The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study},
   volume = {31},
   year = {2010}
}

TY  - JOUR
ID  - 919707
AU  - Mebazaa, Alexandre - Pang, Peter S - Tavares, Miguel - Collins, Sean P - Storrow, Alan B - Laribi, Said - Andre, Stephanie - Courtney, Daniel Mark - Hasa, Jennifer - Špinar, Jindřich - Masip, Josep - Peacock, William Frank - Sliwa, Karen - Gayat, Etienne - Filippatos, Gerasimos - Cleland, John G F - Gheorghiade, Mihai
PY  - 2010
TI  - The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study
JF  - European Heart Journal
VL  - 31
IS  - 7
SP  - 832-841
EP  - 832-841
PB  - OXFORD UNIV PRESS
SN  - 0195668X
KW  - Acute heart failure
KW  - Dyspnoea
KW  - Orthopnoea
N2  - Aims The vast majority of acute heart failure (AHF) trials to date have targeted dyspnoea. However, they enrolled patients relatively late and did not standardize their methods of dyspnoea measurement. URGENT Dyspnoea was designed to determine changes in dyspnoea in response to initial, standard therapy in patients presenting with AHF using a standardized approach. Methods and results URGENT Dyspnoea was an international, multi-centre, observational cohort study of AHF patients managed conventionally and enrolled within 1 h of first hospital medical evaluation. Patient-assessed dyspnoea was recorded in the sitting position at baseline and at 6 hours by Likert and visual analog scales. Less symptomatic patients were placed supine to determine whether this provoked worsening dyspnoea (orthopnoea). Of the 524 patients with AHF, the mean age was 68 years, 43% were women, and 83% received intravenous diuretics. On a 5-point Likert scale, dyspnoea improvement was reported by 76% of patients after 6 h of standard therapy. Supine positioning (orthopnoea test) led to worse dyspnoea in 47% of patients compared to sitting upright. Conclusion When sitting upright, dyspnoea in the sitting position improves rapidly and substantially in patients with AHF after administration of conventional therapy, mainly intra-venous diuretics. However, many patients remain orthopnoeic. Improving the methodology of clinical trials in AHF by standardizing the conditions under which dyspnoea is assessed could enhance their ability to identify effective treatments. Relief of orthopnoea is clinically valuable and may represent a useful goal for clinical trials.
ER  -

MEBAZAA, Alexandre; Peter S PANG; Miguel TAVARES; Sean P COLLINS; Alan B STORROW; Said LARIBI; Stephanie ANDRE; Daniel Mark COURTNEY; Jennifer HASA; Jindřich ŠPINAR; Josep MASIP; William Frank PEACOCK; Karen SLIWA; Etienne GAYAT; Gerasimos FILIPPATOS; John G F CLELAND a Mihai GHEORGHIADE. The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study. \textit{European Heart Journal}. OXFORD: OXFORD UNIV PRESS, 2010, roč.~31, č.~7, s.~832-841. ISSN~0195-668X. Dostupné z: https://doi.org/10.1093/eurheartj/ehp458.

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