congestive heart failure MedDRA version: 20.0 Level: SOC Classification code 10007541 Term: Cardiac disorders System Organ Class: 10007541 - Cardiac disorders
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1) written informed consent signed 2) Age: 18-80 3) Patients with chronic heart failure (at reduced or preserved ejection fraction) 4) Patients discharged after hospitalization for acute heart failure (at least second episode of decompensation in the past 12 months) 5) Patients being treated with loop diuretics at the same or higher dosage of furosemide 40 mg (or equivalent) at the time of admission Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 40 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 40
Exclusion criteria
Exclusion criteria: 1) age 85 years 2) patients with severe aortic stenosis 3) patients with severe renal failure (eGFR<20 ml/min/1.73m2 according to Cockroft-Gault) 4) patients with severe hyponatremia 5) Medical therapy for heart failure optimized during hospitalization 6) Documented current pregnancy and lactating status in women of childbearing potential
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To compare two different treatment strategies (control arm treated with loop diuretic and potassium sparing and experimental arm that will combine such therapy with acetazolamide and free-dose metolazone) in patients with chronic heart failure. Specifically, the following will be assessed: trend of short- to medium-term re-hospitalizations, degree of congestion and volemia by body weight assessment and vector impedance measurement (BIVA), functional capacity by cardiopulmonary exercise testing (CPET), subjective perception of health status assessed by questionnaires, and neurohormonal response.;Secondary Objective: • Assess the degree of congestion and volemia through the course of body weight and measurement of vector impedance (BIVA) between patients with chronic heart failure treated with standard diuretic therapy and combined diuretic therapy • To evaluate differences in the effects on functional capacity through CPET with VO2 max measurement and on alveolar-capillary diffusion between patients with chronic heart failure treated with standard diuretic therapy and combined diuretic therapy • Assess differences in the trend of subjective perception of health through Kansas City Cardiomiopathy Questioning between patients with chronic heart failure treated with standard diuretic therapy and combined diuretic therapy • Assess differences in neurohormonal response by measuring NT-proBNP between patients with chronic heart failure treated with standard diuretic therapy and combined diuretic therapy;Primary end point(s): Evaluate differences in the trend of short- to medium-term re-hospitalizations between chronic heart failure patients treated with standard diuretic therapy (control arm) and combination diuretic therapy (experimental arm);Timepoint(s) of evaluation of this end point: 3 months | — |
Countries
Italy
Contacts
CENTRO CARDIOLOGICO MONZINO