Key result
Early AHF presentation links to ~109% greater odds of high serum catecholamines.
Why the study?
The mechanisms underlying urgently presenting acute heart failure were not clear.
Is early presentation (< 3 hours) of acute heart failure associated with higher serum catecholamine levels and distinct clinical characteristics compared to later presentations?
Population
484 AHF patients admitted from home with immediate serum catecholamine evaluation
Comparison
Onset-to-admission time < 3 hours vs 3-24 hours vs >=24 hours
Design
Observational cohort study
Authors
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May warrant closer monitoring in early presenters; leaves open need for prospective validation of catecholamine-targeted strategies.
Observational (n=484)
Is early presentation (< 3 hours) of acute heart failure associated with higher serum catecholamine levels and distinct clinical characteristics compared to later presentations?
Effect estimate: OR 2.091 (95% CI 1.161-3.767)
Urgently presenting acute heart failure (<3 hours from symptom onset) is associated with an endogenous catecholamine surge, leading to higher blood pressure and more severe clinical presentation requiring noninvasive ventilation.
Matsushita et al. (2020) conducted an observational in Acute heart failure (n=484). Early onset to admission (< 3 hours) vs. Middle (3-24 hours) and late (≥24 hours) onset to admission was evaluated on High serum catecholamine value (adrenaline > 0.96 ng/mL, noradrenaline > 3.39 ng/mL, and dopamine > 0.21 ng/mL) (OR 2.091, 95% CI 1.161-3.767). Early presentation (<3 hours) of acute heart failure was independently associated with high serum catecholamine values (OR 2.091; 95% CI 1.161-3.767) and systolic blood pressure >140 mmHg.
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