Assessment of Residual Congestion in Acute Decompensated Heart Failure (VExUS-AHF)
DESIGN:
A prospective, multicenter, observational cohort study including 580 patients admitted for acute decompensated heart failure (ADHF).
Ultrasound assessment of congestion (VExUS and LUS) will be performed serially during admission: within 48 hours of admission, at the time diuretic therapy is switched from intravenous to oral, and on the day of discharge. The discharge assessment will serve as the primary predictor.
Treating physicians will be blinded to all ultrasound findings. Patients will be followed for 90 days by telephone follow-up and chart review for the primary endpoint, with extended chart review at one year for selected secondary endpoints.
AIMS:
To determine whether combined ultrasound assessment of venous (VExUS) and pulmonary congestion (LUS) at discharge predicts heart failure readmission and all-cause mortality in patients hospitalized with ADHF.
HYPOTHESIS:
Abnormal VExUS and/or LUS findings at discharge are associated with a higher risk of heart failure readmission and all-cause mortality after 90 days.
Studieoversigt
Status
Status
Betingelser
Betingelser
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Kristoffer Berg-Hansen, MD, PhD
- Telefonnummer: +4560540700
- E-mail: krisbe@rm.dk
Studiesteder
-
-
-
Aarhus, Danmark, 8200
- Rekruttering
- Aarhus University Hospital - Department of Cardiology
-
Kontakt:
- Kristoffer Berg-Hansen, MD, PhD
- Telefonnummer: +456054070
- E-mail: krisbe@rm.dk
-
Copenhagen, Danmark, 2650
- Ikke rekrutterer endnu
- Copenhagen University Hospital, Amager and Hvidovre Hospital - Department of Cardiology
-
Kontakt:
- Johannes Grand, MD, PhD
- E-mail: johannes.grand@regionh.dk
-
Roskilde, Danmark, 400
- Ikke rekrutterer endnu
- Zealand University Hospital - Department of Cardiology
-
Kontakt:
- Martin Frydland, MD, PhD
- E-mail: mafry@regionsjaelland.dk
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Inclusion criteria Age ≥18 years admitted with ADHF, treated with intravenous loop diuretics (≥40 mg furosemide or an equivalent dose of another loop diuretic) during admission, and able to provide written consent will be eligible for inclusion. Clinical evidence of congestion during admission, indicated by ≥1 of the following: pitting peripheral edema, ascites, elevated jugular venous pressure, or radiologic/ultrasound evidence of pulmonary congestion.
Exclusion criteria Pregnancy, moribund, solitary kidney, or inability to provide written consent
Beskrivelse
Inclusion Criteria:
- Adults (≥18 years) admitted with ADHF.
- Clinical evidence of congestion during admission, indicated by ≥1 of the following: pitting peripheral edema, ascites, elevated jugular venous pressure, or radiologic/ultrasound evidence of pulmonary congestion.
- Treatment with ≥40 mg i.v. furosemide or equivalent dose loop diuretic during admission.
Exclusion Criteria:
- Pregnancy
- Moribund
- Solitary kidney
- Inability to provide written consent
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Antal grupper/kohorter
Kohorter og interventioner
Gruppe / kohorteGruppe / kohorte |
|---|
|
Patients admitted for acute decompensated heart failure
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Composite of heart failure readmission and all-cause mortality
Tidsramme: 90 days
|
Time-to-event analysis. Endpoints appointed by a blinded adjudication committee. Abnormal VExUS will be defined according to criteria from our ongoing validation study. Abnormal LUS is defined as ≥3 B-lines in ≥2 scanning zones per hemithorax (8-zone method) or ≥15 total B-lines overall. |
90 days
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Days alive and out of hospital
Tidsramme: Within 90 days and one year after discharge
|
Days alive and out of any hospital within 90 days and 1 year, indexed to discharge; death counts as 0 days.
Computed over the complete fixed window using chart-based ascertainment of vital status and admissions.
Patients censored early for reasons other than death (e.g.
withdrawal) are handled by censoring or exclusion (not scored 0, since 0 denotes death).
Analyzed with rank-based methods given the zero-spike and skew.
|
Within 90 days and one year after discharge
|
|
Individual components of the primary endpoint
Tidsramme: 90 days and one year after discharge
|
90 days and one year after discharge
|
|
|
Association between discharge VExUS and markers of congestion
Tidsramme: At discharge
|
Markers of congestion: Objective markers (jugular venous pressure, peripheral edema, pulmonary rales, and weight change), NT-proBNP, renal function, and echocardiographic measures of cardiac function.
|
At discharge
|
|
Incremental prognostic value of discharge VExUS and LUS beyond standard clinical assessment of congestion for predicting 90-day and one-year heart-failure readmission and all-cause mortality
Tidsramme: 90 days and 1 year
|
90 days and 1 year
|
|
|
Post-discharge diuretic use
Tidsramme: 90 days
|
Defined as the change in loop diuretic dose (furosemide-equivalent) from discharge to 30- and 90-day follow-up, and occurrence of diuretic intensification (dose increase or addition of thiazide-type diuretic) within 90 day
|
90 days
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 1-10-72-199-25
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .