共查询到20条相似文献，搜索用时 187 毫秒
1.
Colleen Juricek Teruhiko Imamura Ann Nguyen Ben Chung Daniel Rodgers Nitasha Sarswat Gene Kim Jayant Raikhelkar Takeyoshi Ota Tae Song Daniel Burkhoff Gabriel Sayer Valluvan Jeevanandam Nir Uriel 《Journal of cardiac failure》2018,24(4):249-254
Background
Recurrent gastrointestinal bleeding is one of the most significant adverse events in patients with left ventricular assist devices (LVADs).Methods
We enrolled LVAD patients who had received an intramuscular injection of 20?mg octreotide every 4 weeks as secondary prevention for recurrent gastrointestinal bleeding despite conventional medical therapies and repeated transfusions. The frequency of gastrointestinal bleeding and other associated clinical outcomes before and during octreotide therapy were compared.Results
Thirty LVAD patients (66.4?±?8.8 years old, 16 men [53%]) received octreotide therapy for 498.8?±?356.0 days without any octreotide-associated adverse events. The frequency of gastrointestinal bleeding was decreased significantly during octreotide therapy (from 3.4?±?3.1 to 0.7?±?1.3 events/year; P?<?.001), accompanied by significant reductions in red blood cell and flesh frozen plasma transfusions, days in hospital, and need for endoscopic procedures (P?<?.05 for all).Conclusions
Octreotide therapy reduced the frequency of recurrent gastrointestinal bleeding and may be considered for secondary prevention. 相似文献2.
Todd F. Dardas Richard K. Cheng Claudius Mahr Nahush A. Mokadam Jason Smith Keith D. Aaronson Francis D. Pagani Wayne C. Levy 《Journal of cardiac failure》2018,24(4):243-248
Background
The timing of transplant listing after implantation of a left ventricular assist device (LVAD) remains uncertain, given high device complication rates and apparent stability of some LVAD-supported patients. This investigation quantifies the effect of delayed transplant listing and transplantation rates on medium-term survival and LVAD complications.Methods and Results
A Markov model was used to simulate the effects of delaying initial transplant listing after LVAD implantation. Modeled parameters were derived from the Standard Transplant Analysis and Research file. When transplant listing was delayed and 5-year results were examined, fewer persons underwent transplantation (53% in base model vs 51% in 180-day-delay model) and the fraction of deaths while waiting increased (17% in base model vs 21% in 180-day delay model). Life expectancy changed minimally from the base model (3.50 y) when initial listing was delayed by 180 days (3.51 y).Conclusions
Delaying initial transplant listing increased the likelihood of death while waiting for a transplant and decreased the likelihood of transplantation. In aggregate, life expectancy was unchanged by delays in listing. This study suggests that delaying transplant listing with the expectation of providing additional life expectancy is not likely with current LVAD technology. 相似文献3.
Jayne Rosenberger Susan McCrudden Carol McCullough Lu Wang Joni Kime Nancy M. Albert 《Heart & lung : the journal of critical care》2018,47(2):100-106
Background
Experts recommend obtaining one-time dual- (inter)-arm blood pressure (BP) measurements to predict cardiovascular morbidity risk.Objectives
To determine differences in inter-arm systolic (S)/diastolic (D) BPs obtained simultaneously and sequentially and examine associations between patient factors and clinical outcomes and inter-arm BP differences.Method
A comparative study of adults treated in intensive care; multivariable logistic models were created to determine the extent that inter-arm BP differences predicted outcomes.Results
Of 427 adults in intensive care units, 31.8% had differences of >10 mmHg on simultaneous measurement and 35.1% had differences of >10 mmHg on sequential measurement; differences >15 mmHg were 17.9% and 19.8%, respectively. After controlling for patient factors, simultaneous inter-arm DBP differences >15 mmHg were associated with shorter hospital and longer intensive care length of stay (p = 0.031 and 0.029, respectively) and a 79% reduction in the likelihood of discharge to home (p = 0.009).Conclusions
Simultaneous inter-arm DBP differences >15 mmHg were associated with clinical outcomes. 相似文献4.
Yasuyuki Shiraishi Shun Kohsaka Takayuki Abe Kazumasa Harada Tetsuro Miyazaki Takamichi Miyamoto Kiyoshi Iida Shuzou Tanimoto Mayuko Yagawa Makoto Takei Yuji Nagatomo Toru Hosoda Takeshi Yamamoto Ken Nagao Morimasa Takayama 《The American journal of medicine》2018,131(2):156-164.e2
Background
The onset of acute heart failure is known to be associated with increased physical activity and other specific behaviors that can trigger hemodynamic deterioration. This analysis aimed to describe the distribution of triggers in patients hospitalized for acute heart failure, and investigate their effects on in-hospital outcomes.Methods
Consecutive patients hospitalized for acute heart failure between 2010 and 2014 were registered in a multicenter data registration system (72 institutions within Tokyo, Japan). Baseline demographics and in-hospital mortality were extracted from 17,473 patients. Patients with a trigger were grouped based on their triggering event: those with onset during (a) physical activity; (b) sleeping; (c) eating or watching television; (d) bathing or excretion (use of restrooms); and (e) engaging in other activities. These patients were compared with patients without identifiable triggers. Multiple imputation was used for missing data.Results
Patients were predominantly men (57.1%), with a mean age of 76.0 ± 13.0 years; a triggering event was present in 49.1%. No significant difference in baseline characteristics was noted between groups except for younger age, higher blood pressure, and prevalence of signs of congestion in the trigger-positive group. In-hospital mortality rate was 7.9%. Presence of triggers was positively associated with a reduced risk of in-hospital mortality (adjusted odds ratio 0.79; 95% confidence interval, 0.70-0.90; P = .0003). In a delta-adjusted pattern mixture model, the effect of a triggering event on in-hospital mortality remained consistently significant.Conclusion
Triggering events for acute heart failure can provide additional information for risk prediction. Efforts to identify the triggers should be made to classify patients according to risk group. 相似文献5.
Marilyn Schallom Donna Prentice Carrie Sona Cassandra Arroyo John Mazuski 《Heart & lung : the journal of critical care》2018,47(2):93-99
Background
In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements.Objective
To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury.Methods
43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours.Results
Oxygen saturations ranged from 69.8%-97.8%, with 18% of measures < 90%. Measurements were within 3% of co-oximetry values for 54% of nasal alar compared to 35% of forehead measurements. Measurement failures occurred in 6% for nasal alar and 22% for forehead. Three patients developed a pressure injury with the nasal alar sensor and 13 patients developed a pressure injury with the forehead sensor (χ2 = 7.68; p = .006).Conclusions
In this group of patients with decreased perfusion, nasal alar sensors provided a potential alternative for continuous monitoring of oxygen saturation. 相似文献6.
Bartłomiej Paleczny Martyna Olesińska Agnieszka Siennicka Piotr Niewiński Ewa A. Jankowska Beata Ponikowska Waldemar Banasiak Stephan Von Haehling Stefan D. Anker Piotr Ponikowski 《Journal of cardiac failure》2017,23(1):83-87
Background
Clinical and prognostic consequences of enhanced central chemosensitivity in the contemporary optimally treated patients with chronic heart failure (CHF) are unknown.Methods and Results
We studied central chemosensitivity (defined as hypercapnic ventilatory response [HCVR; L/min/mmHg]) in 161 CHF patients (mean left ventricular ejection fraction [LVEF] 31?±?6%, all receiving a combination of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and beta-blocker) and 55 sex- and age-matched healthy controls. HCVR did not differ between CHF patients and controls (median 0.63 vs 0.57?L/min?1/mmHg?1, P?=?.76). When the CHF patients were divided into tertiles according to their HCVR values, there were no significant differences in clinical characteristics (except for ischemic etiology, which was more frequent in those with the highest HCVR), results of the cardiopulmonary exercise testing, and indices of heart rate variability. During the follow-up (median 28 months, range 1–48 months, ≥15 months in all survivors), 21 patients died. HCVR was not related to survival in the Cox proportional hazards analysis.Conclusions
Central chemosensitivity is not enhanced in contemporary, optimally treated CHF patients and its assessment does not provide significant clinical or prognostic information. 相似文献7.
Kenneth C. Bilchick Eliany Mejia-Lopez Peter McCullough Khadijah Breathett Jamie L. Kennedy Jose Tallaj James Bergin Salpy Pamboukian Mohammad Abuannadi Sula Mazimba 《Journal of cardiac failure》2018,24(1):43-50
Background
The objective of this work was to determine the impact of improving right ventricular versus left ventricular stroke work indexes (RVSWI vs LVSWI) during therapy for acute decompensated heart failure (ADHF).Methods and Results
Cox proportional hazards regression and logistic regression were used to analyze key factors associated with outcomes in 175 patients (mean age 56.7?±?13.6 years, 29.1% female) with hemodynamic data from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial. In this cohort, 28.6% and 69.7%, respectively, experienced the outcomes of death, transplantation, or ventricular assist device implantatation (DVADTX) and DVADTX or HF rehospitalization (DVADTXHF) during 6 months of follow-up. Increasing RVSWI (ΔRVSWI) from baseline to discharge was associated with a decrease in DVADTXHF (hazard ratio [HR] 0.923, 95% confidence interval [CI] 0.871–0.979) per 0.1?mm?Hg?L?m?2 increase); however, increasing LVSWI (ΔLVSWI) had only a nonsignificant association with decreased DVADTXHF (P?=?.11) In a multivariable model, patients with ΔRVSWI ≤1.07?mm?Hg?L?m?2 and ΔLVSWI ≤4.57?mm?Hg?L?m?2 had a >2-fold risk of DVADTXHF (HR 2.05, 95% CI 1.23–3.41; P?=?.006).Conclusion
Compared with left ventricular stroke work, increasing right ventricular stroke work during treatment of ADHF was associated with better outcomes. The results promise to inform optimal hemodynamic targets for ADHF. 相似文献8.
Merrick Miles Bret D. Alvis Kyle Hocking Franz Baudenbacher Christy Guth Joann Lindenfeld Colleen Brophy Susan Eagle 《Journal of cardiac failure》2018,24(8):525-532
Background
To determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF).Methods
Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis.Results
ADHF patients had a significantly greater PIVA signal on admission compared with the control group (P?=?.0013, n?=?18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not brain natriuretic peptide or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R2?=?0.781, n?=?14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate.Conclusions
This study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF. 相似文献9.
Wei Huang Rudolf K.F. Oliveira Han Lei David M. Systrom Aaron B. Waxman 《Journal of cardiac failure》2018,24(3):169-176
Background
In heart failure with preserved ejection fraction (HFpEF), the prognostic value of pulmonary vascular dysfunction (PV-dysfunction), identified by elevated pulmonary vascular resistance (PVR) at peak exercise, is not completely understood. We evaluated the long-term prognostic implications of PV-dysfunction in HFpEF during exercise in consecutive patients undergoing invasive cardiopulmonary exercise testing for unexplained dyspnea.Methods
Patients with HFpEF were classified into 2 main groups: resting HFpEF (n?=?104, 62% female, age 61 years) with a pulmonary arterial wedge pressure (PAWP)?>15?mmHg at rest; and exercise HFpEF (eHFpEF; n?=?81) with a PAWP?<15?mmHg at rest, but >20?mmHg during exercise. The eHFpEF group was further subdivided into eHFpEF + PV-dysfunction (peak PVR?≥80 dynes/s/cm?5; n?=?55, 60% female, age 64) group and eHFpEF – PV-dysfunction (peak PVR?<80 dynes/s/cm?5; n?=?26, 42% female, age 54 years) group. Outcomes were analyzed for the first 9 years of follow-up and included any cause mortality and heart failure (HF)-related hospitalizations. The mean follow-up time was 6.7?±?2.6 years (0.5–9.0).Results
Mortality rate did not differ among the groups. However, survival free of HF-related hospitalization was lower for the eHFpEF + PV-dysfunction group compared with eHFpEF – PV-dysfunction (P?=?.01). These findings were similar between eHFpEF + PV-dysfunction and the resting HFpEF group (P?=?.774). By Cox analysis, peak PVR ≥80 dynes/s/cm?5 was a predictor of HF-related hospitalization for eHFpEF (hazard ratio 5.73, 95% confidence interval 1.05–31.22, P?=?.01). In conclusion, the present study provides insight into the impact of PV-dysfunction on outcomes of patients with exercise-induced HFpEF. An elevated peak PVR is associated with a high risk of HF-related hospitalization. 相似文献10.
Jemima Boyd Jenny Paratz Oystein Tronstad Lawrence Caruana Paul McCormack James Walsh 《Heart & lung : the journal of critical care》2018,47(2):81-86
Rationale
Consensus recommendations have been developed to guide exercise rehabilitation of mechanically ventilated patients in the intensive care unit.Objective
This study aimed to investigate the safety of exercise rehabilitation of mechanically ventilated patients and evaluate the consensus recommendations.Methods
This was a prospective, single-centre, cohort study conducted in a specialist cardiothoracic intensive care unit of a tertiary, university affiliated hospital in Australia.Results
91 mechanically ventilated participants; 54 (59.3%) male; mean age of 56.52 (16.3) years; were studied with 809 occasions of service recorded. Ten (0.0182%) minor adverse events were recorded, with only one adverse event occurring when a patient was receiving moderate level of vasoactive support.Conclusions
The consensus recommendations are a useful tool in guiding safe exercise rehabilitation of mechanically ventilated patients. Our findings suggest that there is further scope to safely commence exercise rehabilitation in patients receiving vasoactive support. 相似文献11.
Kelly D. Stamp Marilyn Prasun Christopher S. Lee Tiny Jaarsma Mariann R. Piano Nancy M. Albert 《Heart & lung : the journal of critical care》2018,47(2):169-175
Background
Heart Failure (HF) is a public health problem globally affecting approximately 6 million in the United States.Objectives
A tailored position statement was developed by the American Association of Heart Failure Nurses (AAHFN) and their Research Consortium to assist researchers, funding institutions and policymakers with improving HF clinical advancements and outcomes.Methods
A comprehensive review was conducted using multiple search terms in various combinations to describe gaps in HF nursing science. Based on gaps described in the literature, the AAHFN made recommendations for future areas of research in HF.Results
Nursing has made positive contributions through disease management interventions, however, quality, rigorous research is needed to improve the lives of patients and families while advancing nursing science.Conclusions
Advancing HF science is critical to managing and improving patient outcomes while promoting the nursing profession. Based on this review, the AAHFN is putting forth a call to action for research designs that promote validity, sustainability, and funding of future nursing research. 相似文献12.
James M. Walter Chitaru Kurihara Thomas C. Corbridge Ankit Bharat 《Heart & lung : the journal of critical care》2018,47(4):398-400
Background
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications.Objectives
To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS.Methods
We use a clinical case to illustrate chugging and discuss potential management strategies.Results
Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation.Conclusions
Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS. 相似文献13.
Federica Dellafiore Harleah G. Buck Gianluca Pucciarelli Claudio Barbaranelli Marco Paturzo Rosaria Alvaro Ercole Vellone 《Heart & lung : the journal of critical care》2018,47(6):553-561
Background
Higher patient-caregiver mutuality is associated with improved patient and caregiver outcomes, but no studies have tested the psychometric characteristics of the mutuality scale (MS) in heart failure (HF) patient and caregiver population.Objectives
To test the validity and reliability of the MS.Methods
A cross-sectional design. The MS validity and reliability were tested with confirmatory factor analysis (CFA) and hypothesis testing, and with Cronbach's alpha and model-based internal consistency index, respectively.Results
CFA supported the validity of the MS in the HF patient and caregiver versions. Hypothesis testing showed significant correlations between both versions of the MS and anxiety, depression, quality of life, and self-care. Also, MS caregiver version scores correlated significantly with caregiver preparedness. Cronbach's alphas and the model-based internal consistency index ranged between 0.72 and 0.94 in both versions.Conclusions
The Mutuality Scale showed supportive validity and reliability for HF patients and caregivers. 相似文献14.
Robert L. Gottlieb Teena Sam Suzanne Y. Wada James F. Trotter Sumeet K. Asrani Brian Lima Susan M. Joseph Gonzalo V. Gonzalez-Stawinski Shelley A. Hall 《Journal of cardiac failure》2017,23(10):765-767
Background
Donors with hepatitis C (HCV) viremia are rarely used for orthotopic heart transplantation (HT) owing to post-transplantation risks. New highly effective HCV antivirals may alter the landscape.Methods
An adult patient unsuitable for bridging mechanical support therapy accepted a heart transplant offer from a donor with HCV viremia. On daily logarithmic rise in HCV viral load and adequate titers to ensure successful genotyping, once daily sofosbuvir (400?mg)–velpatasvir (100?mg) (Epclusa; Gilead) was initiated empirically pending HCV genotype (genotype 3a confirmed after initiation of therapy).Results
We report the kinetics of acute hepatitis C viremia and therapeutic response to treatment with a new pangenotypic antiviral agent after donor-derived acute HCV infection transmitted incidentally with successful cardiac transplantation to an HCV-negative recipient. Prompt resolution of viremia was noted by the 1st week of a 12 week course of antiviral therapy. Sustained virologic remission continued beyond 12 weeks after completion of HCV therapy (SVR-12).Conclusions
The availability of effective pangenotypic therapy for HCV may expand donor availability. The feasibility of early versus late treatment of HCV remains to be determined through formalized protocols. We hypothesize pharmacoeconomics to be the greatest limitation to widespread availability of this promising tool. 相似文献15.
Xue Yu Qin Luo Zhihong Liu Zhihui Zhao Qing Zhao Chenhong An Zhiwei Huang Qi Jin Liu Gao Lu Yan 《Heart & lung : the journal of critical care》2018,47(4):308-313
Objectives
Iron deficiency (ID) prevalence in Chinese patients suffering from pulmonary hypertension (PH) is unclear so far. This study aimed to investigate ID prevalence in different subtypes of PH and its relevant factors.Methods
Hospitalized patients diagnosed with PH from September 2015 to March 2017 were retrospectively enrolled. Patients were grouped based on etiology. Logistic regression analysis was performed to determine factors associated with ID.Results
ID was found in 38.25% of 251 PH patients; with the highest prevalence in connective tissue disease associated pulmonary arterial hypertension (CTD-PAH). Univariate logistic regression analysis showed that female sex, age, CTD-PAH diagnosis and high sensitive C reactive protein (hs-CRP) were associated with ID. After adjusting for age, sex and hs-CRP, the diagnosis of CTD-PAH was still associated with ID (OR = 3.01, 95%CI 1.02–8.90, P < 0.05).Conclusions
ID is common in PH in China. CTD-PAH is independently associated with ID, after adjustment for age, sex, and hs-CRP. 相似文献16.
Wenjia Guo Tingting Lv Fei She Guobin Miao Yuanwei Liu Rong He Yajun Xue Nang Kham Nu Jing Yang Kun Li Ping Zhang 《Heart & lung : the journal of critical care》2018,47(5):516-524
Background
Heart rate variability (HRV), modulated by cardiac autonomic function, is impaired in obstructive sleep apnea (OSA). However, the effect of continuous positive airway pressure (CPAP) on HRV is debated.Objectives
To investigate the associations between CPAP and HRV in OSA.Methods
Based on literature from five databases published through August 2017, we performed a meta-analysis of cohort studies of OSA treated with CPAP. The change of low-frequency band (LF), high-frequency band (HF) and the ratio between LF and HF (LHR) were analyzed.Results
Eleven studies were included. Decreased LF (SMD = ?0.32, 95%CI: ?0.62,?0.01; P = 0.043) and HF (SMD = ?0.51, 95%CI: ?0.95, ?0.08, P = 0.020) were shown while measured on CPAP. When measured off CPAP, HF was increased remarkably (SMD: 0.31, 95%CI: 0.02, 0.60, P = 0.034).Conclusions
CPAP can improve autonomic activity, which might be one mechanism to reduce the risk of cardiovascular diseases in OSA. 相似文献17.
Yong-Fang Kuo Deepak Adhikari Chiemeziem G. Eke James S. Goodwin Mukaila A. Raji 《Journal of cardiac failure》2018,24(1):9-18
Background
Having nurse practitioners (NPs) as primary care providers for patients with congestive heart failure (CHF) is 1 way to address the growing shortage of primary care physicians (PCPs).Methods and Results
We used inverse probability of treatment weighted with propensity score to examine the processes and outcomes of care for patients under 3 care models. Approximately 72.9%, 0.8%, and 26.3% of CHF patients received care under the PCP model, the NP model, and the shared care model, respectively. Patients under the NP or shared care models were more likely than those under the PCP model to be referred to cardiologists (odds ratio?1.35, 95% confidence interval 1.32–1.37; odds ratio ?1.32, 95% confidence interval 1.30–1.35) and to get guideline-recommended medications. NPs and PCPs had similar rates of emergency room (ER) visits and Medicare spending after adjusting for processes of care. Patients under the shared care model had a higher burden of comorbidity and experienced a higher rate of ER visits and hospitalizations than those under the PCP model.Conclusion
The delivery of CHF care mirrors the severity of comorbidity in these patients. The high rate of hospitalization and ER visits in the shared care model underscores the need to design and implement more effective chronic disease management and integrated care programs. 相似文献18.
Suzanne Elize van Wijngaarden Vasileios Kamperidis Ibtihal Al-Amri Frank van der Kley Martin J. Schalij Nina Ajmone Marsan Jeroen J. Bax Victoria Delgado 《Journal of cardiac failure》2018,24(3):137-145
Aims
To evaluate the effects of MitraClip on left ventricular (LV) and left atrial (LA) myocardial wall stress as assessed with the use of N-terminal pro–B-type natriuretic peptide (NT-proBNP) and strain imaging.Methods and results
Sixty-five patients with symptomatic moderate and severe mitral regurgitation (MR; age 75?±?9 y, 57% male, 89% functional MR) treated with the use of MitraClip were evaluated. Patients were divided according to 6-month NT-proBNP tertiles. Changes in echocardiographic parameters over 6 months were assessed. Reductions in LV end-diastolic volumes (178?±?77?mL to 170?±?79?mL; P?=?.045) and LV end-systolic volumes (120?±?70?mL to 111?±?69?mL; P?=?.040) were observed in the overall population. Interestingly, low–NT-proBNP–tertile patients showed slight improvements in LV and LA longitudinal strain, whereas high–NT-proBNP–tertile patients showed impairment.Conclusions
Although MitraClip induces hemodynamic unloading in patients with predominantly functional MR, myocardial wall stress is not consistently improved. In patients with reduced NT-proBNP, improvements in LA volume index and LV and LA strains were observed. Patients who showed an increase in NT-proBNP exhibited impairment in LV and LA strain, suggesting an increase of myocardial wall stress. 相似文献19.
Naoki Sato Carolyn S.P. Lam John R. Teerlink Barry H. Greenberg Hiroyuki Tsutsui Byung-Hee Oh Jian Zhang Martin Lefkowitz Tsushung A. Hua Thomas Holbro Miriam Marshood Xing Li Wang Junbo Ge 《Journal of cardiac failure》2017,23(1):63-71
Background
Acute heart failure (AHF), a common and growing health concern worldwide, is associated with high risk of post-discharge rehospitalization and mortality. Existing evidence indicates potential therapeutic benefits of serelaxin in Caucasian AHF patients, but corresponding data in Asians remain scarce. RELAX-AHF-ASIA, a multinational, randomized, double-blind, placebo-controlled, phase III trial, will evaluate the effects of serelaxin on symptom relief and clinical outcomes in Asian AHF patients, with the use of novel assessments.Methods and Results
Patients with AHF, systolic blood pressure ≥125?mm?Hg, and mild to moderate renal dysfunction will be randomized within 16 hours of presentation to receive 48-hour intravenous infusion of 30?µg ? kg?1 ? d?1 serelaxin or placebo in addition to standard therapy. The composite primary end point includes: (1) treatment success (moderate/marked improvement in patient-reported dyspnea and physician-assessed signs of congestion on day 2); (2) treatment failure (in-hospital worsening of signs and/or symptoms of heart failure [HF] requiring intensification of intravenous HF therapy or mechanical ventilation, renal/circulatory support, rehospitalization due to HF/renal-failure, or death through day 5); and (3) unchanged status. Secondary end points include time to in-hospital worsening HF through day 5 and all-cause and cardiovascular deaths through day 180.Conclusions
RELAX-AHF-ASIA, the largest randomized clinical trial in Asian AHF patients to date, has a novel composite primary end point and the potential to become a hallmark of AHF trials. 相似文献20.
Sandra A. Carey Kristen M. Tecson Kyle Bass Joost Felius Shelley A. Hall 《Heart & lung : the journal of critical care》2018,47(4):285-289