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The investigators will determine the feasibility of identifying and quantifying changes in interstitial and intravascular congestion by imaging in participants with heart failure. The investigators will either continue or temporarily suspend both loop diuretics and mineralo-corticoid antagonists (MRA) for 48 hours in participants with heart failure that is both stable and mild and compare measurements of interstitial (B-lines) and intra-vascular fluids (IVC and JV diameter and renal venous flow) by ultrasound and, in a subset of participants without contra-indications, by cardiac MRI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Diuretic cessation | Other | Participants will be asked to withhold their diuretic therapy (loop diuretics and mineralocorticoid receptor antagonists) 48 hours prior to visit |
|
| Usual diuretic regimen | Other | Participants will take their usual diuretic regimen prior to study visit. At least one week is required between cross-over visits |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Diuretics | Other | As per group descriptions |
|
| Measure | Description | Time Frame |
|---|---|---|
| Differences in ultrasound markers or congestion following continuation or suspension of diuretics for 48 hours. | Differences in interstitial (B-lines) and intravascular (IVC and JV diameter, and renal venous flow) congestion by ultrasound in patients with heart failure following continuation or suspension of diuretics for 48 hours. | at baseline |
| Measure | Description | Time Frame |
|---|---|---|
| The acute variation in interstitial and intravascular congestion on imaging tests following administration of diuretics. | The acute variation in interstitial (B-lines) and intravascular (inferior vena cava, jugular vein diameter and renal venous flow) congestion on imaging tests following administration of diuretics. | up to 3 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Pierpaolo Pellicori, MD, FESC | Contact | +44 0141 330 4744 | pierpaolo.pellicori@glasgow.ac.uk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NHS Greater Glasgow and Clyde | Glasgow | United Kingdom |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D004232 | Diuretics |
| ID | Term |
|---|---|
| D045283 | Natriuretic Agents |
| D045505 | Physiological Effects of Drugs |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
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| The acute variation in biomarkers of congestion, inflammation and myocardial injury following administration of diuretics. |
The acute variation in biomarkers of congestion (NT-proBNP), inflammation (HsCRP) and myocardial injury (Troponin) following administration of diuretics. |
| at 3 hours |