Heart Failure
Conditions
Brief summary
The aim of the study is to assess the efficacy of this new ambulatory service model in reducing heart failure hospitalization (HHF), improving clinical as well as functional outcomes of post-discharge patients with Heart Failure of reduced ejection fraction (HFrEF) and Heart failure with preserved Ejection Fraction (HFpEF).
Interventions
OTHERStandard care
Standard clinical care
Sponsors
Chinese University of Hong Kong
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Dyspnoea (exertional or at rest) and 2 of the following signs: * Congestion on chest X-ray * Rales on chest auscultation * Clinically relevant oedema (e.g. ≥1+ on a 0 to 3+ scale) * Elevated jugular venous pressure * NT-proBNP ≥300 pg/mL (Patients with AF: NT-proBNP ≥900 pg/mL) * Heart failure hospitalization that requires the treatment of a minimum single dose of 40 mg of i.v. furosemide (or equivalent i.v loop diuretics) * Ambulatory patients
Exclusion criteria
* Cardiogenic shock required inotropics * Cardiac mechanical support implantation like LVAD * Life expectancy less than 1 year due to underlying significant comorbidities like metastatic cancer or end-stage COPD * Haemodynamically severe uncorrected primary cardiac valvular disease planned for surgery or intervention during the course of the study. * End stage renal failure or eGFR \<15 mL/min/1.73m2 as measured during index hospitalization or requiring dialysis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical outcome | 90 days | A composite of all-cause mortality, number of heart failure events (including hospitalization for heart failure (HHF), urgent heart failure visits and unplanned outpatient visits), time to first heart failure event will be aggregated to evaluate overall clinical outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Kansas City Cardiomyopathy Questionnaire Total Symptom Score (KCCQ-TSS) | 1 year | Change from baseline in KCCQ-TSS, higher score reflects better outcome, Maximum score 100. |
| NT-proBNP level | 1 year | Change from baseline in NT-proBNP level |
| Risk of Heart failure | 1 year | Change in NYHA class, ELAN-HF score, and MAGGIC Risk score. and Seattle Heart Failure Model Risk Prediction |
| Change in overall Cardiac function | 90 days | Evaluated by left ventricular ejection fraction (LVEF), left ventricle volume index, global longitudinal strain (GLS), E/E' ratio, left atrial (LA) volume index and LA GLS, inferior vena cava (IVC) size, right ventricular systolic pressure (RVSP) and functional mitral regurgitation (MR) will be aggregated to represent the overall cardiac function |
| Major Adverse Cardiovascular Event | 1 year | Time to first occurrence of cardiovascular death or heart failure event |
| Hypertensive heart failure (HHF) | 90 days after initial hospital discharge | Occurrence of HHF |
| Quality adjusted Life years gained | 1 year | Cost effectiveness of ambulatory heart failure service for heart failure events avoided and quality adjusted life years (QALY) gained. |
| Change in 6 minute hall walk (6MHW) | 90 days | Change in 6 minute hall walk (6MHW) result compared with baseline |
Countries
Hong Kong
Contacts
Primary ContactDaniel Xu
Outcome results
None listed