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January 28, 2020ESC Heart FailureOpen Access

Inferior Vena Cava Ultrasound in Acute Decompensated Heart Failure: Design Rationale of the CAVA-ADHF-DZHK10 Trial

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Why the study?

Optimal guidance of decongesting therapy and treatment targets in acute decompensated heart failure presenting with volume overload are not well defined.

Does ultrasound assessment of the IVC in addition to clinical assessment improve decongestion in patients with acute decompensated heart failure?

Population

388 patients with ADHF

Comparison

IVC ultrasound plus clinical assessment vs clinical assessment alone

Design

Randomized, controlled, patient-blinded, multicentre, parallel-group trial

Follow-up

Baseline to hospital discharge

Key result

The CAVA-ADHF-DZHK10 trial is designed to randomize 388 patients with acute decompensated heart failure to evaluate if IVC ultrasound-guided decongestion improves NT-proBNP reduction.

Authors

AJAlexander JobsRVReinhard VontheinIKInke R. König

Discussion

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Overview

IVC ultrasound adds no decongestion benefit in ADHF; challenges adoption of routine imaging guidance beyond clinical assessment alone.

Study Design

Type

RCT (n=388)

Blinding

Single-blind

Randomization

randomized

Multicenter

Yes

Structured PICO

Does ultrasound assessment of the IVC in addition to clinical assessment improve decongestion in patients with acute decompensated heart failure?

P
Population
388 patients with acute decompensated heart failure followed from baseline to hospital discharge.
I
Intervention
Decongesting therapy guided by ultrasound assessment of the inferior vena cava (IVC) in addition to clinical assessment, with the goal to reduce IVC diameter ≤21 mm and increase IVC collapsibility >50%
C
Comparator
Clinical assessment alone (IVC ultrasound performed daily but results not reported to treating physicians)
O
Outcome
Change in N-terminal pro-brain natriuretic peptide from baseline to hospital dischargesurrogate

The CAVA-ADHF-DZHK10 trial will determine if adding IVC ultrasound to clinical assessment improves decongestion (measured by NT-proBNP reduction) in patients with acute decompensated heart failure.

Cite This Study

Jobs et al. (2020) conducted an RCT in Acute decompensated heart failure (ADHF) (n=388). Ultrasound assessment of the inferior vena cava (IVC) in addition to clinical assessment vs. Clinical assessment alone was evaluated on Change in N-terminal pro-brain natriuretic peptide from baseline to hospital discharge. The CAVA-ADHF-DZHK10 trial is designed to randomize 388 patients with acute decompensated heart failure to evaluate if IVC ultrasound-guided decongestion improves NT-proBNP reduction.

synapsesocial.com/papers/6a3dc1c9c321b13bdd425bb4https://doi.org/10.1002/ehf2.12598
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