{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:44:25Z","timestamp":1774950265700,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1597,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016015","name":"University Hospital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016015","name":"Universit\u00e4tsspital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>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. Among 666 patients eligible for 180 day follow-up, 284 (43%, median age 79 years, 35% women) and 198 (30%, median age 77 years, 35% women) had completed the EQ-5D and KCCQ at baseline and follow-up, respectively. There was a significant improvement in HRQL as quantified by both, EQ-5D and KCCQ, from hospitalization to 180 day follow-up, with no significant differences in the change of HRQL between both treatment strategies. For instance, 39 (26%) versus 33 (25%) patients had an improvement by at least one level in at least two categories in the EQ-5D. Median increase in KCCQ overall summary score (KCCQ-OSS) was 17.6 (IQR 2.0\u201342.6) in the intervention group versus 18.5 (IQR 3.9\u201339.3) in the usual care group (P &amp;lt; 0.001 vs. baseline, P = 0.945 between groups).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients with AHF, long-term HRQL quantified by EQ-5D and KCCQ improved substantially, with overall no significant differences between a strategy of comprehensive vasodilation versus usual care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13543","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T03:53:38Z","timestamp":1628222018000},"page":"4218-4227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of a Strategy of Comprehensive Vasodilation Versus Usual Care on Health-Related Quality of Life Among Patients with Acute Heart Failure"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4643-8473","authenticated-orcid":false,"given":"Maria","family":"Belkin","sequence":"first","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1793-5297","authenticated-orcid":false,"given":"Desiree","family":"Wussler","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9041-6250","authenticated-orcid":false,"given":"Danielle Menosi","family":"Gualandro","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]},{"name":"Department of Cardiology, University of Sao Paulo Medical School , Sao Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9189-3830","authenticated-orcid":false,"given":"Samyut","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9976-4112","authenticated-orcid":false,"given":"Ivo","family":"Strebel","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2014-1885","authenticated-orcid":false,"given":"Assen","family":"Goudev","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Queen Ioanna University Hospital Sofia , Sofia ,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-5791","authenticated-orcid":false,"given":"Micha T.","family":"Maeder","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cantonal Hospital St Gallen , St Gallen ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6077-6941","authenticated-orcid":false,"given":"Joan","family":"Walter","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]},{"name":"Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4396-4008","authenticated-orcid":false,"given":"Dayana","family":"Flores","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-3690","authenticated-orcid":false,"given":"Nikola","family":"Kozhuharov","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]},{"name":"Department of Cardiology, Institute of Cardiovascular Medicine and Science, Liverpool Heart and Chest Hospital , Liverpool ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-0640","authenticated-orcid":false,"given":"Pedro","family":"Lopez-Ayala","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Danier","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9413-3792","authenticated-orcid":false,"suffix":"Junior","given":"Mucio Tavares","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Sao Paulo Medical School , Sao Paulo ,","place":["Brazil"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-7262","authenticated-orcid":false,"given":"Richard","family":"Kobza","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lucerne Cantonal Hospital , Lucerne ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4070-6513","authenticated-orcid":false,"given":"Hans","family":"Rickli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cantonal Hospital St Gallen , St Gallen ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2671-6456","authenticated-orcid":false,"given":"Tobias","family":"Breidthardt","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"Department of Internal Medicine, University Hospital Basel, University of Basel , Basel ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4535-2950","authenticated-orcid":false,"given":"Paul","family":"Erne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lucerne Cantonal Hospital , Lucerne ,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-4150","authenticated-orcid":false,"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medicine Mainz , Mainz ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-6405","authenticated-orcid":false,"given":"Christian","family":"Mueller","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University of Basel , Petersgraben 4, Basel, CH-4031 ,","place":["Switzerland"]},{"name":"GREAT Network , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"2026012114223183100_ehf213543-bib-0001","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur Heart J"},{"key":"2026012114223183100_ehf213543-bib-0002","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1161\/CIR.0000000000000509","article-title":"2017 ACC\/AHA\/HFSA Focused Update of the 2013 ACCF\/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"136","author":"Yancy","year":"2017","journal-title":"Circulation"},{"key":"2026012114223183100_ehf213543-bib-0003","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1001\/jama.2019.18598","article-title":"Effect of a strategy of comprehensive vasodilation vs usual care on mortality and heart failure rehospitalization among patients with acute heart failure: the GALACTIC randomized clinical trial","volume":"322","author":"Kozhuharov","year":"2019","journal-title":"JAMA"},{"key":"2026012114223183100_ehf213543-bib-0004","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1111\/j.1365-2796.2009.02146.x","article-title":"Impact of a high-dose nitrate strategy on cardiac stress in acute heart failure: a pilot study","volume":"267","author":"Breidthardt","year":"2010","journal-title":"J Intern Med"},{"key":"2026012114223183100_ehf213543-bib-0005","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1161\/CIR.0b013e3182949a2e","article-title":"Cardiovascular health: the importance of measuring patient-reported health status","volume":"127","author":"Rumsfeld","year":"2013","journal-title":"Circulation"},{"key":"2026012114223183100_ehf213543-bib-0006","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1002\/ejhf.2119","article-title":"One-year results of the first-in-man study investigating the atrial flow regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study","volume":"23","author":"Paitazoglou","year":"2021","journal-title":"Eur J Heart Fail"},{"key":"2026012114223183100_ehf213543-bib-0007","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol- a new facility for the measurement of health-related quality of life","volume":"16","author":"EuroQol Group","year":"1990","journal-title":"Health Policy"},{"key":"2026012114223183100_ehf213543-bib-0008","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/S0735-1097(00)00531-3","article-title":"Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure","volume":"35","author":"Green","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"2026012114223183100_ehf213543-bib-0009","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3389\/fpsyg.2018.00223","article-title":"Assessing individual change without knowing the test properties: item bootstrapping","volume":"9","author":"Botella","year":"2018","journal-title":"Front Psychol"},{"key":"2026012114223183100_ehf213543-bib-0010","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.cardfail.2013.11.010","article-title":"Quality of life assessment for acute heart failure patients from emergency department presentation through 30 days after discharge: a pilot study with the Kansas City Cardiomyopathy Questionnaire","volume":"20","author":"Sauser","year":"2014","journal-title":"J Card Fail"},{"key":"2026012114223183100_ehf213543-bib-0011","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/j.ahj.2004.12.010","article-title":"Monitoring clinical changes in patients with heart failure: a comparison of methods","volume":"150","author":"Spertus","year":"2005","journal-title":"Am Heart J"},{"key":"2026012114223183100_ehf213543-bib-0012","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/jamacardio.2017.3983","article-title":"Association of serial Kansas City cardiomyopathy questionnaire assessments with death and hospitalization in patients with heart failure with preserved and reduced ejection fraction: a secondary analysis of 2 randomized clinical trials","volume":"2","author":"Pokharel","year":"2017","journal-title":"JAMA Cardio"},{"key":"2026012114223183100_ehf213543-bib-0013","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1002\/ejhf.1810","article-title":"Minimal clinically important difference in quality of life scores for patients with heart failure and reduced ejection fraction","volume":"22","author":"Butler","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"2026012114223183100_ehf213543-bib-0014","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1056\/NEJMoa1100171","article-title":"Effect of nesiritide in patients with acute decompensated heart failure","volume":"365","author":"O'Connor","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012114223183100_ehf213543-bib-0015","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.1056\/NEJMoa1601895","article-title":"Effect of ularitide on cardiovascular mortality in acute heart failure","volume":"376","author":"Packer","year":"2017","journal-title":"N Engl J Med"},{"key":"2026012114223183100_ehf213543-bib-0016","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/ejhf.890","article-title":"Clinical phenotypes and outcome of patients hospitalized for acute heart failure: the ESC Heart Failure Long-Term Registry","volume":"19","author":"Chioncel","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026012114223183100_ehf213543-bib-0017","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1001\/jamacardio.2020.5763","article-title":"Effect of a self-care intervention on 90-day outcomes in patients with acute heart failure discharged from the emergency department: a randomized clinical trial","volume":"6","author":"Collins","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2026012114223183100_ehf213543-bib-0018","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1001\/jama.2020.19378","article-title":"Effect of an emergency department care bundle on 30-day hospital discharge and survival among elderly patients with acute heart failure: the ELISABETH randomized clinical trial","volume":"324","author":"Freund","year":"2020","journal-title":"JAMA"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13543","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13543","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/5\/4218\/65566263\/eschf_8_5_4218.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/8\/5\/4218\/65566263\/eschf_8_5_4218.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:27:59Z","timestamp":1769023679000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/8\/5\/4218\/8345847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,8,6]]},"published-print":{"date-parts":[[2021,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13543","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,10]]},"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2021-06-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}