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Observational Study
. 2023 Nov 19;13(11):e075302.
doi: 10.1136/bmjopen-2023-075302.

Prognostic significance and clinical determinants of residual dyspnoea at discharge in acute heart failure: a single-centre, prospective observational study

Mateusz Garus  1 , Maksym Jura  2 , Mateusz Guzik  2 , Robert Zymliński  2 , Gracjan Iwanek  2 , Piotr Ponikowski  2 , Jan Biegus  2
Affiliations
Observational Study

Prognostic significance and clinical determinants of residual dyspnoea at discharge in acute heart failure: a single-centre, prospective observational study

Mateusz Garus et al. BMJ Open. .

Abstract

Objective: This study aimed to assess the prognostic significance of residual (discharge) dyspnoea in acute heart failure (AHF) patients.

Design: Single-centre, prospective observational study.

Setting: Patients hospitalised for decompensated AHF in a single cardiology centre, in Poland.

Participants: All patients (n=202) who survived the hospitalisation with the primary diagnosis of AHF and were discharged from the hospital.

Primary and secondary outcome measures: 1-year all-cause mortality; and the composite endpoint of 1-year all-cause mortality and rehospitalisation for the HF (whichever occurred first).

Results: On admission, 159 (78.7%) AHF patients presented dyspnoea at rest, while residual resting dyspnoea at discharge was present in 16 patients (7.9%). There were 48 (24%) patients with moderate/severe exertional dyspnoea at discharge. In the multivariable model, the resting dyspnoea at discharge was related to a higher risk of both 1-year mortality and composite outcome, with HR (95% CI) 8.0 (3.7 to 17.3) and 5.1 (2.6 to 10.2), respectively, both p<0.0001. Analogically, moderate or severe residual dyspnoea at discharge was related to the heightened risk of study both outcomes, with HR (95% CI) 3.1 (1.8 to 5.4) and 1.8 (1.1 to 2.9), respectively, p<0.01.

Conclusions: Among AHF patients the residual dyspnoea at discharge was unexpectedly common and was associated with an unfavourable outcome during 1-year follow-up.

Keywords: Acute Heart Failure; dyspnea; outcome.

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Conflict of interest statement

Competing interests: PP reports personal fees from Boehringer Ingelheim, AstraZeneca, Servier, Bristol Myers Squibb, Amgen, Novartis, Merck, Pfizer, Berlin Chemie, and grants and personal fees from Vifor Pharma. All other authors have nothing to declare.

Figures

Figure 1
Figure 1
The number of patients reporting dyspnoea at rest in subsequent days of hospitalisation.
Figure 2
Figure 2
The Kaplan-Meier curves for 1-year mortality by residual dyspnoea at discharge. Log rankp=0.0001. Red line—patients without dyspnoea at discharge. Blue line—patients with dyspnoea at discharge.
See this image and copyright information in PMC

References

    1. McDonagh TA, Metra M, Adamo M, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC). with the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail 2021;24:4–131. 10.1002/ejhf.2333 - DOI - PubMed
    1. Zannad F, Garcia AA, Anker SD, et al. Clinical outcome endpoints in heart failure trials: a European society of cardiology heart failure association consensus document. Eur J Heart Fail 2013;15:1082–94. 10.1093/eurjhf/hft095 - DOI - PubMed
    1. Lala A, McNulty SE, Mentz RJ, et al. Relief and recurrence of congestion during and after hospitalization for acute heart failure: insights from diuretic optimization strategy evaluation in acute decompensated heart failure (DOSE-AHF). Circ Heart Fail 2015;8:741–8. 10.1161/CIRCHEARTFAILURE.114.001957 - DOI - PMC - PubMed
    1. Rubio-Gracia J, Demissei BG, Ter Maaten JM, et al. Prevalence, predictors and clinical outcome of residual congestion in acute decompensated heart failure. Int J Cardiol 2018;258:185–91. 10.1016/j.ijcard.2018.01.067 - DOI - PubMed
    1. Ambrosy AP, Cerbin LP, Armstrong PW, et al. Body weight change during and after hospitalization for acute heart failure: patient characteristics, markers of congestion, and outcomes: findings from the ASCEND-HF trial. JACC Heart Fail 2017;5:1–13. 10.1016/j.jchf.2016.09.012 - DOI - PMC - PubMed

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