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The Effects of a Therapeutic Strategy Guided by Lung Ultrasound on 6-Month Outcomes in Patients with Heart Failure: Results from the EPICC Randomized Controlled Trial.
Torres-Macho, Juan; Cerqueiro-González, Jose Manuel; Arévalo-Lorido, Jose Carlos; Llácer-Iborra, Pau; Cepeda-Rodrigo, Jose María; Cubo-Romano, Pilar; Casas-Rojo, Jose Manuel; Ruiz-Ortega, Raúl; Manzano-Espinosa, Luis; Lorenzo-Villalba, Noel; Méndez-Bailón, Manuel.
  • Torres-Macho J; Internal Medicine Department, Hospital Universitario Infanta Leonor-Virgen de la Torre, 28031 Madrid, Spain.
  • Cerqueiro-González JM; Internal Medicine Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain.
  • Arévalo-Lorido JC; Internal Medicine Department, Hospital Universitario de Badajoz, 06085 Badajoz, Spain.
  • Llácer-Iborra P; Internal Medicine Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
  • Cepeda-Rodrigo JM; Internal Medicine Department, Hospital Vega Baja, 03314 Orihuela, Spain.
  • Cubo-Romano P; Internal Medicine Department, Hospital Universitario Infanta Cristina, 28981 Madrid, Spain.
  • Casas-Rojo JM; Internal Medicine Department, Hospital Universitario Infanta Cristina, 28981 Madrid, Spain.
  • Ruiz-Ortega R; Internal Medicine Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
  • Manzano-Espinosa L; Internal Medicine Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain.
  • Lorenzo-Villalba N; Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Méndez-Bailón M; Internal Medicine Department, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain.
J Clin Med ; 11(16)2022 Aug 22.
Article in English | MEDLINE | ID: covidwho-2023791
ABSTRACT

BACKGROUND:

Pulmonary congestion (PC) is associated with an increased risk of hospitalization and death in patients with heart failure (HF). Lung ultrasound is highly sensitive for detecting PC. The aim of this study is to evaluate whether lung ultrasound-guided therapy improves 6-month outcomes in patients with HF.

METHODS:

A randomized, multicenter, single-blind clinical trial in patients discharged after hospitalization for decompensated HF. Participants were assigned 11 to receive treatment guided according to the presence of lung ultrasound signs of congestion (semi-quantitative evaluation of B lines and the presence of pleural effusion) versus standard of care (SOC). The primary endpoint was the combination of cardiovascular death, readmission, or emergency department or day hospital visit due to worsening HF at 6 months. In September 2020, after an interim analysis, patient recruitment was stopped.

RESULTS:

A total of 79 patients were randomized (mean age 81.2 +/- 9 years) and 41 patients (51.8%) showed a left ventricular ejection fraction >50%. The primary endpoint occurred in 11 patients (29.7%) in the SOC group and in 11 patients (26.1%) in the LUS group (log-rank = 0.83). Regarding nonserious adverse events, no significant differences were found.

CONCLUSIONS:

LUS-guided diuretic therapy after hospital discharge due to ADHF did not show any benefit in survival or a need for intravenous diuretics compared with SOC.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11164930

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Diagnostic study / Experimental Studies / Prognostic study / Randomized controlled trials Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11164930