Acute heart failure (AHF) is a major public health problem, associated with a 40% risk of death or re-hospitalisation at 3 months. This risk is significantly increased by insufficient decongestion at the end of hospitalisation for AHF assessed by a standardised clinical score, a natriuretic peptide dosage or by cardiac and pulmonary ultrasound . Adapting treatment according to lung congestion assessed by implantable devices (not reimbursed in France) improves the prognosis. However, due to the lack of a standardised congestion assessment, therapeutic adaptation in acute heart failure is currently empirical. The best multimodality approach to congestion evaluation is uncertain.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
110
Clinical examination centered on congestion (ASCEND, NYHA and Ambrosy Score) will be performed before discharge from hospital
Cardiac, pulmonary, peritoneal, jugular and renal Doppler ultrasounds and liver elastography will be performed before discharge from hospital
Blood sample retrieved for biological assessment and biobanking will be performed before discharge from hospital
Telephone follow-up will be performed 3, 12 and 24 months after discharge from hospital
Questionnaire centered on patient's quality of life at discharge and 3, 12 and 24 months after discharge
CHRU de Nancy
Vandœuvre-lès-Nancy, France
RECRUITINGRate of all-cause death
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 2 and 3)
Time frame: 3 months after hospital discharge
Rate of re-hospitalisation for acute heart failure
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 1 and 3)
Time frame: 3 months after hospital discharge
Rate of day-hospital or in-home IV diuretics injection for acute HF
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 1 and 2)
Time frame: 3 months after hospital discharge
Rate of all-cause death
Time frame: 3, 12 and 24 months after hospital discharge
Rate of re-hospitalisation for acute heart failure
Time frame: 3,12 and 24 months after hospital discharge
Rate of day-hospital or in-home IV diuretics injection for acute HF
Time frame: 3,12 and 24 months after hospital discharge
Rate of all-cause death
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF at 12 and 24 months following hospitalization (with outcome 8 and 9)
Time frame: 12 and 24 months after hospital discharge
Rate of re-hospitalisation for acute heart failure
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF at 12 and 24 months following hospitalization (with outcome 7 and 9)
Time frame: 12 and 24 months after hospital discharge
Rate of day-hospital or in-home IV diuretics injection for acute HF
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF at 12 and 24 months following hospitalization (with outcome 7 and 8)
Time frame: 12 and 24 months after hospital discharge.
Rate of all-cause death
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 11 and 12)
Time frame: 3, 12 and 24 months after hospital discharge.
Rate of hospitalization for acute heart failure
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 10 and 12)
Time frame: 3, 12 and 24 months after hospital discharge.
Rate of day-hospital or in-home IV diuretics injection for acute HF
composite endpoint: rate of all-cause death, hospitalization for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 10 and 11)
Time frame: 3, 12 and 24 months after hospital discharge.
NYHA (New York Heart Association) class measured
Time frame: 3, 12 and 24 months after hospital discharge
Natriuretic peptides
BNP or Nt-Pro BNP
Time frame: within 24 months after hospital discharge.
Renal function assessed by glomerular filtration rate
Time frame: within 24 months after hospital discharge.
Plasma volume
calculated from haemoglobin and haematocrit value
Time frame: within 24 months after hospital discharge.
Liver elastography value
Measured with Fibroscan
Time frame: At inclusion
Quality of life
Assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ)
Time frame: At inclusion and 3, 6 and 24 months
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