{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:50:58Z","timestamp":1779079858943,"version":"3.51.4"},"reference-count":10,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2009,10,20]],"date-time":"2009-10-20T00:00:00Z","timestamp":1255996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2009,10,20]],"date-time":"2009-10-20T00:00:00Z","timestamp":1255996800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2010]]},"abstract":"<i>Objectives:<\/i> To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). <i>Methods:<\/i> The PROTECT pilot study evaluated rolofylline, an adenosine A<sub>1<\/sub> receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60 days. Patients were categorized into three groups: (A) PD-WHF, based on worsening symptoms and signs of HF and need for additional intravenous (IV) or mechanical therapy (n = 29); (B) increased IV diuretic therapy without PD-WHF (n = 61), and (C) neither PD-WHF nor increase in IV diuretic dose (n = 211). <i>Results:<\/i> Patients in group A had slower resolution of dyspnea, longer mean (\u00b1SD) length of hospitalization (13.8 \u00b1 6.8 vs. 10.5 \u00b1 8.5 and 9.3 \u00b1 5.9 days in groups B and C, respectively; p < 0.05 for both), and higher 60-day death and cardiovascular or renal readmission rates [49.7 (95% confidence interval: 33.1\u201369.1) vs. 37.3 (26.4\u201350.9) vs. 19.5% (14.7\u201325.6) in groups B and C, respectively]. PD-WHF was a strong independent predictor of length of stay and 60-day death and cardiovascular or renal readmission. <i>Conclusions:<\/i> PD-WHF may be an indicator of short-term risk and treatment efficacy in AHF.<\/jats:p>","DOI":"10.1159\/000249280","type":"journal-article","created":{"date-parts":[[2009,10,21]],"date-time":"2009-10-21T13:50:36Z","timestamp":1256133036000},"page":"29-36","source":"Crossref","is-referenced-by-count":45,"title":["Physician-Determined Worsening Heart Failure: A Novel Definition for Early Worsening Heart Failure in Patients Hospitalized for Acute Heart Failure \u2013 Association with Signs and Symptoms, Hospitalization Duration, and 60-Day Outcomes"],"prefix":"10.1159","volume":"115","author":[{"given":"Gad","family":"Cotter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Metra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth Davison","family":"Weatherley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard C.","family":"Dittrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry M.","family":"Massie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Ponikowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Bloomfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2009,10,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093%2Feurheartj%2Fehi044"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.amjmed.2003.11.025"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016%2FS1388-9842%2802%2900017-X"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.ejheart.2005.12.003"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001%2Fjama.298.17.2009"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1093%2Feurheartj%2Fehm603"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.cardfail.2008.08.010"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1159%2F000180580"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1001%2Fjama.293.5.572"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.ahj.2006.02.038"}],"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/249280","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/249280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T21:24:17Z","timestamp":1745443457000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000249280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,10,20]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2009,11,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000249280","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"value":"0008-6312","type":"print"},{"value":"1421-9751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,10,20]]}}}