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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients hospitalized for acute heart failure | Experimental | Patients hospitalized for acute heart failure will undergo the following evaluations:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clinical examination centered on congestion | Procedure | Clinical examination centered on congestion (ASCEND, NYHA and Ambrosy Score) will be performed before discharge from hospital |
| Measure | Description | Time Frame |
|---|---|---|
| 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 2 and 3) | 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) | 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) | 3 months after hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of all-cause death | 3, 12 and 24 months after hospital discharge | |
| Rate of re-hospitalisation for acute heart failure | 3,12 and 24 months after hospital discharge | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nicolas GIRERD, MD,PhD | Contact | + 33 3 83 15 73 22 | + 33 3 | n.girerd@chru-nancy.fr |
| Sanae BOUALI, PhD | Contact | + 33 3 83 15 73 22 | + 33 3 | s.bouali@chru-nancy.fr |
| Name | Affiliation | Role |
|---|---|---|
| Nicolas GIRERD, MD,PhD | CHRU of Nancy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHRU de Nancy | Recruiting | Vandœuvre-lès-Nancy | 54500 | France |
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| Cardiac, pulmonary, peritoneal, jugular, renal Doppler ultrasounds and liver elastography | Procedure | Cardiac, pulmonary, peritoneal, jugular and renal Doppler ultrasounds and liver elastography will be performed before discharge from hospital |
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| Blood sample retrieved for biological assessment and biobanking | Procedure | Blood sample retrieved for biological assessment and biobanking will be performed before discharge from hospital |
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| Telephone follow-up | Procedure | Telephone follow-up will be performed 3, 12 and 24 months after discharge from hospital |
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| Kansas City Cardiomyopathy Questionnaire (KCCQ) | Behavioral | Questionnaire centered on patient's quality of life at discharge and 3, 12 and 24 months after discharge |
|
| Rate of day-hospital or in-home IV diuretics injection for acute HF |
| 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) | 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) | 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) | 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) | 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) | 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) | 3, 12 and 24 months after hospital discharge. |
| NYHA (New York Heart Association) class measured | 3, 12 and 24 months after hospital discharge |
| Natriuretic peptides | BNP or Nt-Pro BNP | within 24 months after hospital discharge. |
| Renal function assessed by glomerular filtration rate | within 24 months after hospital discharge. |
| Plasma volume | calculated from haemoglobin and haematocrit value | within 24 months after hospital discharge. |
| Liver elastography value | Measured with Fibroscan | At inclusion |
| Quality of life | Assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) | At inclusion and 3, 6 and 24 months |