Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial
Abstract Aims Treating patients with acute decompensated heart failure (ADHF) presenting with volume overload is a common task. However, optimal guidance of decongesting therapy and treatment targets are not well defined. The inferior vena cava (IVC) diameter and its collapsibility can be used to es...
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12598 |
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| author | Alexander Jobs Reinhard Vonthein Inke R. König Jane Schäfer Matthias Nauck Svenja Haag Carlo Federico Fichera Thomas Stiermaier Jakob Ledwoch Alisa Schneider Miroslava Valentova Stephan vonHaehling Stefan Störk Dirk Westermann Tobias Lenz Natalie Arnold Frank Edelmann Philipp Seppelt Stephan Felix Matthias Lutz Felix Hedwig Martin Borggrefe Clemens Scherer Steffen Desch Holger Thiele |
| author_facet | Alexander Jobs Reinhard Vonthein Inke R. König Jane Schäfer Matthias Nauck Svenja Haag Carlo Federico Fichera Thomas Stiermaier Jakob Ledwoch Alisa Schneider Miroslava Valentova Stephan vonHaehling Stefan Störk Dirk Westermann Tobias Lenz Natalie Arnold Frank Edelmann Philipp Seppelt Stephan Felix Matthias Lutz Felix Hedwig Martin Borggrefe Clemens Scherer Steffen Desch Holger Thiele |
| author_sort | Alexander Jobs |
| collection | DOAJ |
| description | Abstract Aims Treating patients with acute decompensated heart failure (ADHF) presenting with volume overload is a common task. However, optimal guidance of decongesting therapy and treatment targets are not well defined. The inferior vena cava (IVC) diameter and its collapsibility can be used to estimate right atrial pressure, which is a measure of right‐sided haemodynamic congestion. The CAVA‐ADHF‐DZHK10 trial is designed to test the hypothesis that ultrasound assessment of the IVC in addition to clinical assessment improves decongestion as compared with clinical assessment alone. Methods and results CAVA‐ADHF‐DZHK10 is a randomized, controlled, patient‐blinded, multicentre, parallel‐group trial randomly assigning 388 patients with ADHF to either decongesting therapy guided by ultrasound assessment of the IVC in addition to clinical assessment or clinical assessment alone. IVC ultrasound will be performed daily between baseline and hospital discharge in all patients. However, ultrasound results will only be reported to treating physicians in the intervention group. Treatment target is relief of congestion‐related signs and symptoms in both groups with the additional goal to reduce the IVC diameter ≤21 mm and increase IVC collapsibility >50% in the intervention group. The primary endpoint is change in N‐terminal pro‐brain natriuretic peptide from baseline to hospital discharge. Secondary endpoints evaluate feasibility, efficacy of decongestion on other scales, and the impact of the intervention on clinical endpoints. Conclusions CAVA‐ADHF‐DZHK10 will investigate whether IVC ultrasound supplementing clinical assessment improves decongestion in patients admitted for ADHF. |
| format | Article |
| id | doaj-art-1225f01c1eec49eb85e0345c8023d239 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-1225f01c1eec49eb85e0345c8023d2392025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017397398310.1002/ehf2.12598Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trialAlexander Jobs0Reinhard Vonthein1Inke R. König2Jane Schäfer3Matthias Nauck4Svenja Haag5Carlo Federico Fichera6Thomas Stiermaier7Jakob Ledwoch8Alisa Schneider9Miroslava Valentova10Stephan vonHaehling11Stefan Störk12Dirk Westermann13Tobias Lenz14Natalie Arnold15Frank Edelmann16Philipp Seppelt17Stephan Felix18Matthias Lutz19Felix Hedwig20Martin Borggrefe21Clemens Scherer22Steffen Desch23Holger Thiele24Department of Cardiology/Angiology/Intensive Care Medicine University Heart Center Lübeck, University Hospital Schleswig‐Holstein Lübeck GermanyInstitut für Medizinische Biometrie und Statistik Universitätsklinikum Schleswig‐Holstein, Campus Lübeck, Universität zu Lübeck Lübeck GermanyInstitut für Medizinische Biometrie und Statistik Universitätsklinikum Schleswig‐Holstein, Campus Lübeck, Universität zu Lübeck Lübeck GermanyZentrum für Klinische Studien Universität Lübeck Lübeck GermanyDZHK (German Centre for Cardiovascular Research)Department of Cardiology/Angiology/Intensive Care Medicine University Heart Center Lübeck, University Hospital Schleswig‐Holstein Lübeck GermanyDepartment of Cardiology/Angiology/Intensive Care Medicine University Heart Center Lübeck, University Hospital Schleswig‐Holstein Lübeck GermanyDepartment of Cardiology/Angiology/Intensive Care Medicine University Heart Center Lübeck, University Hospital Schleswig‐Holstein Lübeck GermanyDZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)Comprehensive Heart Failure Center University and University Hospital Würzburg GermanyDZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)DZHK (German Centre for Cardiovascular Research)Department of Internal Medicine/Cardiology Heart Center Leipzig at University of Leipzig Strümpellstr. 39 04289 Leipzig GermanyAbstract Aims Treating patients with acute decompensated heart failure (ADHF) presenting with volume overload is a common task. However, optimal guidance of decongesting therapy and treatment targets are not well defined. The inferior vena cava (IVC) diameter and its collapsibility can be used to estimate right atrial pressure, which is a measure of right‐sided haemodynamic congestion. The CAVA‐ADHF‐DZHK10 trial is designed to test the hypothesis that ultrasound assessment of the IVC in addition to clinical assessment improves decongestion as compared with clinical assessment alone. Methods and results CAVA‐ADHF‐DZHK10 is a randomized, controlled, patient‐blinded, multicentre, parallel‐group trial randomly assigning 388 patients with ADHF to either decongesting therapy guided by ultrasound assessment of the IVC in addition to clinical assessment or clinical assessment alone. IVC ultrasound will be performed daily between baseline and hospital discharge in all patients. However, ultrasound results will only be reported to treating physicians in the intervention group. Treatment target is relief of congestion‐related signs and symptoms in both groups with the additional goal to reduce the IVC diameter ≤21 mm and increase IVC collapsibility >50% in the intervention group. The primary endpoint is change in N‐terminal pro‐brain natriuretic peptide from baseline to hospital discharge. Secondary endpoints evaluate feasibility, efficacy of decongestion on other scales, and the impact of the intervention on clinical endpoints. Conclusions CAVA‐ADHF‐DZHK10 will investigate whether IVC ultrasound supplementing clinical assessment improves decongestion in patients admitted for ADHF.https://doi.org/10.1002/ehf2.12598Acute decompensated heart failureInferior vena cavaCongestionNT‐proBNPUltrasound |
| spellingShingle | Alexander Jobs Reinhard Vonthein Inke R. König Jane Schäfer Matthias Nauck Svenja Haag Carlo Federico Fichera Thomas Stiermaier Jakob Ledwoch Alisa Schneider Miroslava Valentova Stephan vonHaehling Stefan Störk Dirk Westermann Tobias Lenz Natalie Arnold Frank Edelmann Philipp Seppelt Stephan Felix Matthias Lutz Felix Hedwig Martin Borggrefe Clemens Scherer Steffen Desch Holger Thiele Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial ESC Heart Failure Acute decompensated heart failure Inferior vena cava Congestion NT‐proBNP Ultrasound |
| title | Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial |
| title_full | Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial |
| title_fullStr | Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial |
| title_full_unstemmed | Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial |
| title_short | Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial |
| title_sort | inferior vena cava ultrasound in acute decompensated heart failure design rationale of the cava adhf dzhk10 trial |
| topic | Acute decompensated heart failure Inferior vena cava Congestion NT‐proBNP Ultrasound |
| url | https://doi.org/10.1002/ehf2.12598 |
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