Chronic Heart Failure
Conditions
Brief summary
Heart failure (HF) is a significant cause of death and the leading cause of hospitalization in patients over 65 years of age. Congestion is the main source of symptoms and the leading cause of hospitalization for HF. Furthermore, congestive signs identified in asymptomatic patients are associated with the risk of developing symptomatic HF. The literature supports a multi-modality / integrative evaluation of congestion, combining clinical examination, laboratory results and ultrasound evaluation. The main objective of the CHF-COV study is to identify congestion markers (clinical, biological and ultrasound) quantified during a consultation or day hospitalization for the monitoring of chronic HF that are associated with the risk of all-cause death or hospitalization for acute HF within 24 months after day hospitalization.
Interventions
Clinical examination (including the EVEREST, ASCEND and Ambrosy scores) centered on congestion will be performed during day hospitalization or consultation
Cardiac, pulmonary, peritoneal, jugular and renal Doppler ultrasounds will be performed during day hospitalization or consultation/ peritoneal, jugular and renal Doppler ultrasounds and liver elastography are optional
Blood sample retrieved for biological assessment and biobanking will be performed during day hospitalization or consultation
Telephone follow-up will be performed 3, 12 and 24 months after visit (during day hospitalization or consultation)
Questionnaire centered on patient's quality of life at discharge and 3, 12 and 24 months after discharge
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients with chronic acute heart failure admitted in hospital for scheduled day hospitalization or consultation * Age ≥18 years * Patients having received complete information regarding the study design and having signed their informed consent form. * Patient affiliated to or beneficiary of a social security scheme.
Exclusion criteria
* Comorbidity for which the life expectancy is ≤ 3 months * Dialysis patient (peritoneal dialysis or hemodialysis) or patients with glomerular filtration rate \<15 ml/min/m2 at inclusion. * History of lobectomy or pneumonectomy lung surgery * Severe pulmonary or pleural pathology preventing reliable acquisition of lung ultrasound images: severe emphysema, chronic pleurisy, pulmonary fibrosis, etc. * Pregnant woman, parturient or nursing mother * Adult person subject to a legal protection measure (guardianship, curatorship, safeguard of justice) * Adult person who is unable to give consent * Person deprived of liberty by a judicial or administrative decision, * Person subject to psychiatric care pursuant to Articles L. 3212-1 and L. 3213-1 of the Public Health Code.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of death from all causes | 24 months after day hospitalization or consultation | composite endpoint : rate of death from all causes or hospitalisation for acute heart failure during 24 months following day hospitalization (with outcome 2) |
| Rate of hospitalisation for acute heart failure | 24 months after day hospitalization or consultation | composite endpoint : rate of death from all causes or hospitalisation for acute heart failure during 24 months following day hospitalization (with outcome 1) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of hospitalisation for cardiovascular reason | 24 months after day hospitalization or consultation | — |
| Rate of cardiovascular death | 24 months after day hospitalization or consultation | — |
| NYHA (New York Heart Association) class measured | 3, 12 and 24 months after day hospitalization or consulation | — |
| Natriuretic peptides | At inclusion | BNP or Nt-Pro BNP |
| Renal function assessed by glomerular filtration rate | At inclusion | — |
| Plasma volume | At inclusion | Calculated from haemoglobin and haematocrit value |
| Rate of death from all causes | 24 months after day hospitalization or consultation | — |
| Rate of ASAT | At inclusion | — |
| Rate of ALAT | At inclusion | — |
| Rate of V factor | At inclusion | — |
| Blood potassium concentration | At inclusion | — |
| Liver elastography value | At inclusion | Measured with Fibroscan® |
| Quality of life assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) | At inclusion and 3, 6 and 24 months | — |
| Rate of Bilirubin | At inclusion | — |
| Rate of hospitalisation for acute heart failure | 24 months after day hospitalization or consultation | — |
Countries
France