Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA-ADHF-DZHK10 trial
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Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA-ADHF-DZHK10 trial. / Jobs, Alexander; Vonthein, Reinhard; König, Inke R; Schäfer, Jane; Nauck, Matthias; Haag, Svenja; Fichera, Carlo Federico; Stiermaier, Thomas; Ledwoch, Jakob; Schneider, Alisa; Valentova, Miroslava; von Haehling, Stephan; Störk, Stefan; Westermann, Dirk; Lenz, Tobias; Arnold, Natalie; Edelmann, Frank; Seppelt, Philipp; Felix, Stephan; Lutz, Matthias; Hedwig, Felix; Borggrefe, Martin; Scherer, Clemens; Desch, Steffen; Thiele, Holger.
In: ESC HEART FAIL, Vol. 7, No. 3, 01.06.2020, p. 973-983.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA-ADHF-DZHK10 trial
AU - Jobs, Alexander
AU - Vonthein, Reinhard
AU - König, Inke R
AU - Schäfer, Jane
AU - Nauck, Matthias
AU - Haag, Svenja
AU - Fichera, Carlo Federico
AU - Stiermaier, Thomas
AU - Ledwoch, Jakob
AU - Schneider, Alisa
AU - Valentova, Miroslava
AU - von Haehling, Stephan
AU - Störk, Stefan
AU - Westermann, Dirk
AU - Lenz, Tobias
AU - Arnold, Natalie
AU - Edelmann, Frank
AU - Seppelt, Philipp
AU - Felix, Stephan
AU - Lutz, Matthias
AU - Hedwig, Felix
AU - Borggrefe, Martin
AU - Scherer, Clemens
AU - Desch, Steffen
AU - Thiele, Holger
N1 - © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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.
AB - 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.
KW - Heart Failure/diagnosis
KW - Hemodynamics
KW - Hospitalization
KW - Humans
KW - Ultrasonography
KW - Vena Cava, Inferior/diagnostic imaging
U2 - 10.1002/ehf2.12598
DO - 10.1002/ehf2.12598
M3 - SCORING: Journal article
C2 - 31991063
VL - 7
SP - 973
EP - 983
JO - ESC HEART FAIL
JF - ESC HEART FAIL
SN - 2055-5822
IS - 3
ER -
