Heart failure
Conditions
Interventions
Observation Group 1 (Acute Heart Failure):None
Observation Group 2 (Perioperative Period of Cardiac Surgery):None
Sponsors
First Affiliated Hospital, Zhejiang University School of Medicine
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Acute heart failure population (250 cases) (1) Age >=18 years, no gender restrictions; (2) Admitted to the ICU with symptoms and signs of acute heart failure, including but not limited to exertional dyspnea, paroxysmal nocturnal dyspnea, orthopnea, fatigue, fluid retention (e.g., pulmonary edema or peripheral edema), NYHA heart function class III-IV, BNP >400 ng/L, echocardiography showing structural and/or functional heart abnormalities; (3) All patients received renal vein ultrasound for intrarenal venous flow spectrum analysis, with recombinant human brain natriuretic peptide administered as clinically indicated; (4) Provided informed consent and agreed to participate in the study. Cardiac surgery perioperative population (150 cases) (1) Age >=18 years, no gender restrictions; (2) Admitted to the ICU during the perioperative period for cardiac surgery, including coronary artery bypass grafting, heart valve replacement/repair, combined coronary artery bypass grafting and valve procedures, great vessel surgery, adult congenital heart disease surgery, and heart transplantation; (3) NYHA heart function class II-IV; (4) All patients received renal vein ultrasound for intrarenal venous flow spectrum analysis, with recombinant human brain natriuretic peptide administered as clinically indicated; (5) Provided informed consent and agreed to participate in the study
Exclusion criteria
Exclusion criteria: (1) Loss of function in one kidney, solitary kidney, polycystic kidney, or conditions causing postrenal obstruction; (2) Previous diagnosis of chronic kidney disease stage 5 (end-stage) and/or undergoing regular dialysis; (3) Low cardiac filling pressure or use of angiotensin receptor-neprilysin inhibitor (ARNI) drugs within the past month; (4) Other severe conditions: active bleeding, end-stage liver disease, malignancy, or a life expectancy of less than 30 days; (5) Pregnant or breastfeeding women; (6) Investigator-determined ineligibility for the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| IRVF was improved in both rhBNP and non-rhBNP groups after 72 hours of treatment rate;Change in NYHA functional class from baseline after 72 hours of treatment; | — |
Secondary
| Measure | Time frame |
|---|---|
| Usage and duration of rhBNP during treatment;The BNP level was changed after 72 hours of treatment compared with baseline;The change of LVEF from baseline to the first discharge after ICU admission;Heart rate, systolic blood pressure, diastolic blood pressure, and oxygenation index were compared with baseline every 24 hours after treatment Heart rate, systolic blood pressure, diastolic blood pressure, and oxygenation index were recorded every 24 hours Numerical value);Changes from baseline in renal function-related biomarkers at 72 hours after treatment (indicators included: Serum creatinine, urea nitrogen, cystatin C, and neutrophil gelatinase-associated lipid transport Carrier protein);Changes in urine output every 24h after treatment;Incidence of acute kidney injury (AKI) within 7 days of treatment;The number of cases using CRRT during treatment and the duration of CRRT;The number of patients who used mechanical ventilation during the treatment and the duration of mechanical ventilation;The length of ICU stay and the total length of this hospital stay; | — |
Countries
China
Contacts
Public ContactShuiqiao Fu
First Affiliated Hospital, Zhejiang University School of Medicine
Outcome results
None listed