Heart failure
Conditions
Interventions
Significantly titrated group:Titrate according to blood pressure, heart rate and renal function, and the titrated dose is relatively large.
Group with slight titration:Titrate according to blood pressure, heart rate and renal function, and the titrated dose is relatively small.
Conventional treatment group:Researchers conduct follow-up and titration based on clinical diagnosis and treatment experience as well as medical practice guidelines.
Sponsors
Fuwai Hospital, Chinese Academy of Medical Sciences
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Age >=18 years old; 2. Admitted to the hospital for treatment due to acute heart failure within 72 hours before screening; 3. Systolic blood pressure >= 85 mmHg and heart rate >=60 bpm within 24 hours before enrollment; 4. Serum potassium 1,000 pg/mL at the time of enrollment (within 2 days before discharge); 6. ACEi/ARB/ARNi and beta-blockers were not used or were used at a dose = 50% of the target dose before enrollment.
Exclusion criteria
Exclusion criteria: 1. Age less than 18 years old or greater than 80 years old; 2. There is a clear record indicating intolerance to high-dose beta-blockers; 3. There is a clear record indicating intolerance to high-dose RAS blockers (including ACEI/ARB/ARNI); 4. Unable to discontinue the use of the following traditional Chinese medicine preparations or traditional Chinese medicine preparations with similar ingredients, such as Danshen Injection, Guanxinning Injection, Shuxuening Injection, Ligustrazine Powder for Injection, Ginkgo Biloba Extract Preparations, Shexiang Baoxin Pills, Suxiao Jiuxin Pills, Ligustrazine Hydrochloride for Injection, Danshen Ligustrazine Injection, Fufang Xueshuantong Capsules, Xueshuantong Injection, Qili Qiangxin Capsules, Shenmai Yin, Shenmai Injection, Qishen Yiqi Dropping Pills, Gualou Tablets, etc., as well as traditional Chinese medicine decoctions and in-hospital traditional Chinese medicine preparations containing ginseng, American ginseng, pseudo-ginseng, Panax japonicus ingredients, etc.; 5. Received mechanical ventilation (excluding CPAP/BIPAP) within 5 days before screening; 6. Severe pulmonary diseases that cause significant dyspnea in patients, such as FEV1 130 beats per minute, or bradycardia with persistent ventricular arrhythmia < 45 beats per minute), infection, severe anemia, pulmonary embolism, exacerbation of chronic obstructive pulmonary disease; 9. Had a syncopal episode within 6 months before screening and the treatment was ineffective; 10. Any uncorrected severe valvular stenosis/insufficiency; 11. With a history of heart transplantation, or planning to implant a device/undergo heart transplantation within half a year; 12. Uncorrected thyroid diseases; 13. Active myocarditis or known amyloidosis or hypertrophic cardiomyopathy and other myocardial thickening and systemic diseases (except cardiac hypertrophy caused by hypertension); 14. Had a stroke or TIA within 3 months before screening; 15. Life-threatening primary liver diseases or cirrhosis; 16. Suffering from kidney diseases or eGFR < 20 mL/min/1.73m² (estimated according to the simplified MDRD formula) or having a history of dialysis at the time of screening; 17. Autoimmune diseases, mental or neurological disorders; 18. Active malignant tumors resulting in an expected lifespan of less than 6 months; 19. Due to severe comorbidities, social or economic problems, or a history of non-compliance with medical regimens, which may affect the patient's ability to understand and/or comply with the protocol or subsequent procedures, and thus unable to comply with all research requirements; 20. Participated (defined as less than 30 days since screening) o
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| NT-proBNP; | — |
Secondary
| Measure | Time frame |
|---|---|
| Hemoglobin;Hematocrit;Blood glucose;Blood potassium;Renal function; | — |
Countries
China
Contacts
Public ContactYuhui Zhang, Jian Zhang
Fuwai Hospital, Chinese Academy of Medical Sciences
Outcome results
None listed