Relief and Recurrence of Congestion During and After Hospitalization for Acute Heart Failure: Insights from DOSE-AHF and CARRESS-HF Lala et al: Relief and Recurrence of Congestion
Anuradha Lala, MD1,2; Steven E. McNulty, MS3; Robert J. Mentz, MD3; Shannon Dunlay, MD4; Justin M. Vader, MD5; Omar F. AbouEzzeddine, MD4; Adam D. DeVore3; Prateeti Khazanie, MD, MPH3; Margaret M. Redfield, MD4; Steven R. Goldsmith, MD6; Bradley A. Bart, MD6; Kevin J. Anstrom, PhD3; Michael Felker, MD3; Adrian F. Hernandez, MD3; Lynne W. Stevenson, MD1; NHLBI Heart Failure Network Netw work Steering Committee, Investigators, and Apprentice Network
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Brigham Bri Br igham and W Women’s om men’ n s Ho Hosp Hospital, sppit ital, Bo Bost Boston, ton n, MA Thee Zena and Michael Th Micchaeel A. A. Wiener Wiener Cardiovascular Wie Carddioovasscuularr In Institute nsti titu tute tu te att thee M Mount ountt S Sinai innai Hosp Hospital, pitaal,, N New ew York, Yo ork rk, NY N 3 Duke k Clinical Clinical i l Research Research h IInstitute, nstitute te,, Du Durham, Durh ham am, NC N 4 Mayo Clinic, Rochester, MN 5 Washington University School ooff Me Medi Medicine, dici di cine ci ne, St ne S L Louis, ouis ou is, MO is M 6 Hennepin County Medical Center, Minneapolis, MN 2
Correspondence to Anuradha Lala The Zena and Michael A. Wiener Cardiovascular Institute at the Mount Sinai Hospital 1 Gustave Levy Place, New York, NY 10029 Phone 212-241-7300 Fax: 212-289-5971 Email: [email protected] DOI: 10.1161/CIRCHEARTFAILURE.114.001957 Journal Subject Codes: [10] Cardio-renal physiology/pathophysiology, [110] Congestive, [11] other heart failure
1 Downloaded from http://circheartfailure.ahajournals.org/ by guest on June 4, 2015
Abstract Background—Congestion is the most frequent cause for hospitalization in acute decompensated heart failure (ADHF). Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (e.g., peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. Methods and Results—A post-hoc analysis was performed of 496 patients enrolled in the DOSE-AHF and CARRESS-HF trials during hospitalization with ADHF and clinical congestion. A simple “orthodema” congestion score was generated based on symptoms of orthopnea (2 pillows=2 points,
Anuradha Lala, MD1,2; Steven E. McNulty, MS3; Robert J. Mentz, MD3; Shannon Dunlay, MD4; Justin M. Vader, MD5; Omar F. AbouEzzeddine, MD4; Adam D. DeVore3; Prateeti Khazanie, MD, MPH3; Margaret M. Redfield, MD4; Steven R. Goldsmith, MD6; Bradley A. Bart, MD6; Kevin J. Anstrom, PhD3; Michael Felker, MD3; Adrian F. Hernandez, MD3; Lynne W. Stevenson, MD1; NHLBI Heart Failure Network Netw work Steering Committee, Investigators, and Apprentice Network
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Brigham Bri Br igham and W Women’s om men’ n s Ho Hosp Hospital, sppit ital, Bo Bost Boston, ton n, MA Thee Zena and Michael Th Micchaeel A. A. Wiener Wiener Cardiovascular Wie Carddioovasscuularr In Institute nsti titu tute tu te att thee M Mount ountt S Sinai innai Hosp Hospital, pitaal,, N New ew York, Yo ork rk, NY N 3 Duke k Clinical Clinical i l Research Research h IInstitute, nstitute te,, Du Durham, Durh ham am, NC N 4 Mayo Clinic, Rochester, MN 5 Washington University School ooff Me Medi Medicine, dici di cine ci ne, St ne S L Louis, ouis ou is, MO is M 6 Hennepin County Medical Center, Minneapolis, MN 2
Correspondence to Anuradha Lala The Zena and Michael A. Wiener Cardiovascular Institute at the Mount Sinai Hospital 1 Gustave Levy Place, New York, NY 10029 Phone 212-241-7300 Fax: 212-289-5971 Email: [email protected] DOI: 10.1161/CIRCHEARTFAILURE.114.001957 Journal Subject Codes: [10] Cardio-renal physiology/pathophysiology, [110] Congestive, [11] other heart failure
1 Downloaded from http://circheartfailure.ahajournals.org/ by guest on June 4, 2015
Abstract Background—Congestion is the most frequent cause for hospitalization in acute decompensated heart failure (ADHF). Although decongestion is a major goal of acute therapy, it is unclear how the clinical components of congestion (e.g., peripheral edema, orthopnea) contribute to outcomes after discharge or how well decongestion is maintained. Methods and Results—A post-hoc analysis was performed of 496 patients enrolled in the DOSE-AHF and CARRESS-HF trials during hospitalization with ADHF and clinical congestion. A simple “orthodema” congestion score was generated based on symptoms of orthopnea (2 pillows=2 points,
