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A randomized controlled trial of lung ultrasound-guided therapy in heart failure (CLUSTER-HF study)

The American heart journal, 2020-09, Vol.227, p.31-39 [Peer Reviewed Journal]

2020 Elsevier Inc. ;2020. Elsevier Inc. ;ISSN: 0002-8703 ;EISSN: 1097-6744 ;DOI: 10.1016/j.ahj.2020.06.003

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Title:
A randomized controlled trial of lung ultrasound-guided therapy in heart failure (CLUSTER-HF study)
Author: Araiza-Garaygordobil, Diego ; Gopar-Nieto, Rodrigo ; Martinez-Amezcua, Pablo ; Cabello-López, Alejandro ; Alanis-Estrada, Gabriela ; Luna-Herbert, Abraham ; González-Pacheco, Héctor ; Paredes-Paucar, Cynthia Paola ; Sierra-Lara, Martinez Daniel ; Briseño-De la Cruz, Jose Luis ; Rodriguez-Zanella, Hugo ; Martinez-Rios, Marco Antonio ; Arias-Mendoza, Alexandra
Subjects: Cardiology ; Clinical trials ; Congestion ; Congestive heart failure ; Creatinine ; Health hazards ; Heart failure ; Hospitalization ; Hypotheses ; Kidneys ; Lungs ; Patients ; Randomization ; Risk management ; Studies ; Ultrasonic imaging ; Ultrasound ; Ventricle
Is Part Of: The American heart journal, 2020-09, Vol.227, p.31-39
Description: Lung ultrasound (LUS) has emerged as a new tool for the evaluation of congestion in heart failure (HF); incorporation of LUS during follow-up may detect congestion earlier and prompt interventions to prevent hospitalizations. The aim of this study was to test the hypothesis that the incorporation of LUS during follow-up of patients with HF may reduce the rate of adverse events compared with usual care. In this single-blinded, randomized controlled trial, patients were randomized into an LUS-guided arm or control arm. Patients were followed in 4 prespecified visits during a 6-month period. LUS was performed in every patient visit in both groups; however, LUS results were available for the treating physician only in the LUS group. The primary outcome was the composite of urgent HF visits, rehospitalization for worsening HF, and death from any cause. One hundred twenty-six patients were randomized to either LUS (n = 63) or control (n = 63) (age 62.5 ± 10 years, median left ventricular ejection fraction 31%). The primary end point occurred in 30 (47.6%) patients in the control group and 20 (31.7%) patients in the LUS group (P = .041). LUS-guided treatment was associated with a 45% risk reduction in the primary end point (hazard ratio 0.55, 95% CI 0.31-0.98, P = .044), mainly driven by a reduction in urgent HF visits (hazard ratio 0.28, 95% CI 0.13-0.62, P = .001). No significant differences in rehospitalizations for HF or death were found. Incorporation of LUS into clinical follow-up of patients with HF significantly reduced the risk of urgent visits for worsening HF. [Display omitted]
Publisher: Philadelphia: Elsevier Inc
Language: English
Identifier: ISSN: 0002-8703
EISSN: 1097-6744
DOI: 10.1016/j.ahj.2020.06.003
Source: ProQuest Central

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A randomized controlled trial of lung ultrasound-guided therapy in heart failure (CLUSTER-HF study)

2020 Elsevier Inc. ;2020. Elsevier Inc. ;ISSN: 0002-8703 ;EISSN: 1097-6744 ;DOI: 10.1016/j.ahj.2020.06.003

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