Publications by authors named "Isabelle Danier"
Background: Self-reported exercise capacity is a well-established prognostic measure in stable ambulatory patients with cardiac and pulmonary disease.
Objectives: The authors aimed to directly compare the prognostic accuracy of quantified self-reported exercise capacity using the Duke Activity Status Index (DASI) with the established objective disease-severity marker B-type natriuretic peptide (BNP) in patients presenting with acute dyspnea to the emergency department.
Methods: The DASI was obtained in a prospective multicenter diagnostic study recruiting unselected patients presenting with acute dyspnea to the emergency department.
Article Synopsis
- Current guidelines for interpreting natriuretic peptide concentrations in emergency settings do not account for the time of day when patients present.
- A study comparing diagnostic accuracy for acute heart failure in daytime versus evening/nighttime patients found significant diurnal variations in BNP and NT-proBNP levels, with lower concentrations at night affecting accuracy of diagnosis.
- Results show that BNP and NT-proBNP have a distinct diurnal rhythm, which could lead to misdiagnosis if not considered, while MR-proANP levels remained consistent regardless of the time of day.
Aims: We aimed to assess the long-term effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life (HRQL) among patients with acute heart failure (AHF).
Methods And Results: Health-related quality of life was prospectively assessed by the generic 3-levelled EQ-5D and the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ) among adult AHF patients enrolled in an international, multicentre, randomised, open-label blinded-end-point trial of a strategy that emphasized early intensive and sustained vasodilation using maximally tolerated doses of established oral and transdermal vasodilators according to systolic blood pressure. Changes in EQ-5D and KCCQ from admission to 180 day follow-up were individually compared between the intensive vasodilatation and the usual care group.