Dataset Information

Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines.

ABSTRACT:

Aims

Pulmonary congestion (PC) expressed by residual lung ultrasound B-lines (LUS-BL) could exist in some discharged heart failure (HF) patients, which is a known determinant of poor outcomes. Detection efficacy for PC is suboptimal with widely used imaging modalities, like X-ray or echocardiography, while lung ultrasound (LUS) can sufficiently detect PC by visualizing LUS-BL. In this trial, we sought to evaluate the impact LUS-BL-guided intensive HF management post-discharge on outcome of HF patients discharged with residual LUS-BL up to 1 year after discharge. IMP-OUTCOME is a prospective, single-centre, single-blinded, randomized cohort study, which is designed to investigate if LUS-BL-guided intensive HF management post-discharge in patients with residual LUS-BL could improve the clinical outcome up to 1 year after discharge or not.

Methods and results

After receiving the standardized treatment of HF according to current guidelines, 318 patients with ≥3 LUS-BL assessed by LUS within 48 h before discharge will be randomly divided into the conventional HF management group and the LUS-BL-guided intensive HF management group at 1:1 ratio. Patient-related basic clinical data including sex, age, blood chemistry, imaging examination, and drug utilization will be obtained and analysed. LUS-BL will be assessed at 2 month interval post-discharge in both groups, but LUS-BL results will be enveloped in the conventional HF management group, and diuretics will be adjusted based on symptom and physical examination results with or without knowing the LUS-BL results. Echocardiography examination will be performed for all patients at 12 month post-discharge. The primary endpoint is consisted of the composite of readmission for worsening HF and all-cause death during follow up as indicated. The secondary endpoints consisted of the change in the New York Heart Association classification, Duke Activity Status Index, N terminal pro brain natriuretic peptide value, malignant arrhythmia event and 6 min walk distance at each designed follow up, echocardiography-derived left ventricular ejection fraction, and number of LUS-BL at 12 month post-discharge. Safety profile will be recorded and managed accordingly for all patients.

Conclusions

This trial will explore the impact of LUS-BL-guided intensive HF management on the outcome of discharged HF patients with residual LUS-BL up to 1 year after discharge in the era of sodium-glucose cotransporter-2 inhibitors and angiotensin receptor blocker-neprilysin inhibitor.

Trial registration

ClinicalTrials.gov: NCT05035459.

SUBMITTER: Zhu Y

PROVIDER: S-EPMC9288787 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines.

Zhu Yunlong Y Li Na N Wu Mingxing M Peng Zhiliu Z Huang Haobo H Zhao Wenjiao W Yi Liqing L Liao Min M Liu Zhican Z Peng Yiqun Y Zhou Yuying Y Lu Jinxin J Li Guohua G Zeng Jianping J

ESC heart failure 20220520 4

<h4>Aims</h4>Pulmonary congestion (PC) expressed by residual lung ultrasound B-lines (LUS-BL) could exist in some discharged heart failure (HF) patients, which is a known determinant of poor outcomes. Detection efficacy for PC is suboptimal with widely used imaging modalities, like X-ray or echocardiography, while lung ultrasound (LUS) can sufficiently detect PC by visualizing LUS-BL. In this trial, we sought to evaluate the impact LUS-BL-guided intensive HF management post-discharge on outcome ...[more]

PMID: 35595501

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Dataset Information

Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines.

Aims

Methods and results

Conclusions

Trial registration

Publications

Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines.

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