Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
BMJ Open. 2023 Nov 19;13(11):e075302. doi: 10.1136/bmjopen-2023-075302.
This study aimed to assess the prognostic significance of residual (discharge) dyspnoea in acute heart failure (AHF) patients.
Single-centre, prospective observational study.
Patients hospitalised for decompensated AHF in a single cardiology centre, in Poland.
All patients (n=202) who survived the hospitalisation with the primary diagnosis of AHF and were discharged from the hospital.
1-year all-cause mortality; and the composite endpoint of 1-year all-cause mortality and rehospitalisation for the HF (whichever occurred first).
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.
Among AHF patients the residual dyspnoea at discharge was unexpectedly common and was associated with an unfavourable outcome during 1-year follow-up.
本研究旨在评估急性心力衰竭（AHF）患者出院时残留（出院时）呼吸困难的预后意义。
单中心前瞻性观察研究。
波兰一家心脏病学中心因失代偿性 AHF 住院的患者。
所有在因 AHF 住院并出院的患者（n=202）。
1 年全因死亡率；1 年全因死亡率和心力衰竭再住院的复合终点（以先发生者为准）。
入院时，159 例（78.7%）AHF 患者存在静息时呼吸困难，而 16 例（7.9%）患者出院时存在静息时残余呼吸困难。出院时有 48 例（24%）患者存在中重度用力呼吸困难。在多变量模型中，出院时的静息呼吸困难与 1 年死亡率和复合结局的风险增加相关，HR（95%CI）分别为 8.0（3.7 至 17.3）和 5.1（2.6 至 10.2），均<0.0001。类似地，出院时存在中度或重度残余呼吸困难与研究结果的两个结局的风险增加相关，HR（95%CI）分别为 3.1（1.8 至 5.4）和 1.8（1.1 至 2.9），均<0.01。
在 AHF 患者中，出院时的残余呼吸困难出乎意料地常见，并与 1 年随访期间的不良结局相关。
