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Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial

Acute heart failure (AHF) management is challenging, with high morbidity and readmission rates. There is little evidence of the benefit of HF monitoring during hospitalization. The aim of the study was to assess whether daily bedside echocardiographic monitoring (JetEcho) improved outcomes in AHF. I...

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Autores principales: Ricci, Jean-Etienne, Aguilhon, Sylvain, Occean, Bob-Valéry, Soullier, Camille, Solecki, Kamila, Robert, Christelle, Huet, Fabien, Cornillet, Luc, Schmutz, Laurent, Chevallier, Thierry, Akodad, Mariama, Leclercq, Florence, Cayla, Guillaume, Lattuca, Benoît, Roubille, François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999405/
https://www.ncbi.nlm.nih.gov/pubmed/35407655
http://dx.doi.org/10.3390/jcm11072047
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author Ricci, Jean-Etienne
Aguilhon, Sylvain
Occean, Bob-Valéry
Soullier, Camille
Solecki, Kamila
Robert, Christelle
Huet, Fabien
Cornillet, Luc
Schmutz, Laurent
Chevallier, Thierry
Akodad, Mariama
Leclercq, Florence
Cayla, Guillaume
Lattuca, Benoît
Roubille, François
author_facet Ricci, Jean-Etienne
Aguilhon, Sylvain
Occean, Bob-Valéry
Soullier, Camille
Solecki, Kamila
Robert, Christelle
Huet, Fabien
Cornillet, Luc
Schmutz, Laurent
Chevallier, Thierry
Akodad, Mariama
Leclercq, Florence
Cayla, Guillaume
Lattuca, Benoît
Roubille, François
author_sort Ricci, Jean-Etienne
collection PubMed
description Acute heart failure (AHF) management is challenging, with high morbidity and readmission rates. There is little evidence of the benefit of HF monitoring during hospitalization. The aim of the study was to assess whether daily bedside echocardiographic monitoring (JetEcho) improved outcomes in AHF. In this prospective, open, two parallel-arm study (clinicaltrials.gov: NCT02892227), participants from two university hospitals were randomized to either standard of care (SC) or daily treatment adjustment including diuretics guided by JetEcho evaluating left ventricular filling pressure and volemia. The primary outcome was 30-day readmission rate. Key secondary outcomes were six-month cumulative incidence death, worsening HF during hospitalization and increasing of myocardial and renal biomarkers. From 250 included patients, 115 were finally analyzed in JetEcho group and 112 in SC group. Twenty-two (19%) patients were readmitted within 30 days in JetEcho group and 17 (15%) in SC group (relative risk [RR] 1.26; 95% confidence interval [CI], 0.70–2.24; p = 0.4). Worsening HF occurred in 17 (14%) patients in the JetEcho group and 24 (20%) in the SC group (RR 0.7; 95% [CI] 0.39 to 1.2; p = 0.2). No significant difference was found between the two groups concerning natriuretic peptides and renal function (p > 0.05 for all). The cumulative incidence rate of death from any cause at six months from discharge was 8.7% in the JetEcho group and 11.6% in the SC group (HR 0.63, 95% [CI] 0.3–1.4, p = 0.3). In AHF patients, a systematic daily bedside echocardiographic monitoring did not reduce 30-day readmission rate for HF and short-term clinical outcomes.
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spelling pubmed-89994052022-04-12 Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial Ricci, Jean-Etienne Aguilhon, Sylvain Occean, Bob-Valéry Soullier, Camille Solecki, Kamila Robert, Christelle Huet, Fabien Cornillet, Luc Schmutz, Laurent Chevallier, Thierry Akodad, Mariama Leclercq, Florence Cayla, Guillaume Lattuca, Benoît Roubille, François J Clin Med Article Acute heart failure (AHF) management is challenging, with high morbidity and readmission rates. There is little evidence of the benefit of HF monitoring during hospitalization. The aim of the study was to assess whether daily bedside echocardiographic monitoring (JetEcho) improved outcomes in AHF. In this prospective, open, two parallel-arm study (clinicaltrials.gov: NCT02892227), participants from two university hospitals were randomized to either standard of care (SC) or daily treatment adjustment including diuretics guided by JetEcho evaluating left ventricular filling pressure and volemia. The primary outcome was 30-day readmission rate. Key secondary outcomes were six-month cumulative incidence death, worsening HF during hospitalization and increasing of myocardial and renal biomarkers. From 250 included patients, 115 were finally analyzed in JetEcho group and 112 in SC group. Twenty-two (19%) patients were readmitted within 30 days in JetEcho group and 17 (15%) in SC group (relative risk [RR] 1.26; 95% confidence interval [CI], 0.70–2.24; p = 0.4). Worsening HF occurred in 17 (14%) patients in the JetEcho group and 24 (20%) in the SC group (RR 0.7; 95% [CI] 0.39 to 1.2; p = 0.2). No significant difference was found between the two groups concerning natriuretic peptides and renal function (p > 0.05 for all). The cumulative incidence rate of death from any cause at six months from discharge was 8.7% in the JetEcho group and 11.6% in the SC group (HR 0.63, 95% [CI] 0.3–1.4, p = 0.3). In AHF patients, a systematic daily bedside echocardiographic monitoring did not reduce 30-day readmission rate for HF and short-term clinical outcomes. MDPI 2022-04-06 /pmc/articles/PMC8999405/ /pubmed/35407655 http://dx.doi.org/10.3390/jcm11072047 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ricci, Jean-Etienne
Aguilhon, Sylvain
Occean, Bob-Valéry
Soullier, Camille
Solecki, Kamila
Robert, Christelle
Huet, Fabien
Cornillet, Luc
Schmutz, Laurent
Chevallier, Thierry
Akodad, Mariama
Leclercq, Florence
Cayla, Guillaume
Lattuca, Benoît
Roubille, François
Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title_full Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title_fullStr Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title_full_unstemmed Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title_short Impact of Daily Bedside Echocardiographic Assessment on Readmissions in Acute Heart Failure: A Randomized Clinical Trial
title_sort impact of daily bedside echocardiographic assessment on readmissions in acute heart failure: a randomized clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999405/
https://www.ncbi.nlm.nih.gov/pubmed/35407655
http://dx.doi.org/10.3390/jcm11072047
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