CHF-COV Reduced (Chronic Heart Failure With Reduced Ejection Fraction – COngestion eValuation)

Overview

Heart failure (HF) is a significant cause of death and the leading cause of hospitalization in patients over 65 years of age. Congestion is the main source of symptoms and the leading cause of hospitalization for HF. Furthermore, congestive signs identified in asymptomatic patients are associated with the risk of developing symptomatic HF. The literature supports a multi-modality / integrative evaluation of congestion, combining clinical examination, laboratory results and ultrasound evaluation. The main objective of the CHF-COVReduced study is to identify congestion markers (clinical, biological and ultrasound) quantified during a consultation or day hospitalization for the monitoring of chronic HF with reduced left ventricular ejection fraction that are associated with the risk of all-cause death, hospitalization for acute HF or IV diuretics injection in a day hospital.

Full Title of Study: “Evaluation de la Congestion en Hospitalisation de Jour Pour un Bilan d’Insuffisance Cardiaque Chronique à Fraction d’éjection altérée ou modérément altérée CHF-COV Reduced (Chronic Heart Failure With Reduced Ejection Fraction – COngestion eValuation)”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Diagnostic
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 14, 2028

Interventions

  • Procedure: Clinical examination centered on congestion
    • Clinical examination centered on congestion (including the EVEREST, ASCEND and Ambrosy scores) will be performed during day hospitalization or consultation
  • Procedure: Cardiac, pulmonary, peritoneal, jugular and renal Doppler ultrasounds
    • Cardiac, pulmonary, peritoneal, jugular and renal Doppler ultrasounds and liver elastography will be performed during day hospitalization or consultation/ peritoneal, jugular and renal Doppler ultrasounds are optional
  • Procedure: Blood sample retrieved for biological assessment and biobanking
    • Blood sample retrieved for biological assessment and biobanking will be performed during day hospitalization or consultation
  • Other: Telephone follow-up
    • Telephone follow-up will be performed 3, 12 and 24 months after day hospitalization or consultation
  • Behavioral: Kansas City Cardiomyopathy Questionnaire (KCCQ)
    • Questionnaire centered on patient’s quality of life at discharge and 3, 12 and 24 months after discharge

Arms, Groups and Cohorts

  • Experimental: Patients with chronic HF with reduced ventricular ejection fraction coming for scheduled day

Clinical Trial Outcome Measures

Primary Measures

  • Rate of death from all causes
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint : rate of death from all causes, hospitalisation for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 2 and 3)
  • Rate of hospitalisation for acute heart failure
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint : rate of death from all causes, hospitalisation for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 1 and 3)
  • Rate of day-hospital or in-home IV diuretics injection for acute HF
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint : rate of death from all causes, hospitalisation for acute heart failure or day-hospital IV diuretics injection for acute HF during 24 months following day hospitalization (with outcome 1 and 2)

Secondary Measures

  • Rate of death from all causes
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint of rate of death from all causes or hospitalisation for acute heart failure 24 months after day hospitalization (with outcome 5)
  • Rate of hospitalisation for acute heart failure
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint of rate of death from all causes or hospitalisation for acute heart failure 24 months after day hospitalization (with outcome 4)
  • Rate of death from all causes
    • Time Frame: 24 months after day hospitalization or consultation
  • Rate of hospitalisation for acute heart failure
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint: Rate of hospitalisation for acute heart failure or day-hospital/in-home IV diuretics injection for acute HF 24 months after day hospitalization (with outcome 8)
  • Rate of day-hospital or in-home IV diuretics injection for acute HF
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint: Rate of hospitalisation for acute heart failure or day-hospital/in-home IV diuretics injection for acute HF 24 months after day hospitalization (with outcome 7)
  • Rate of hospitalisation for cardiovascular reason
    • Time Frame: 24 months after day hospitalization or consultation
  • Rate of death from all causes
    • Time Frame: 3, 12 and 24 months after day hospitalization or consulation
    • composite endpoint: Rate of hospitalisation for acute heart failure or day-hospital/in-home IV diuretics injection for acute HF 24 months after day hospitalization (with outcome 11)
  • Rate of hospitalisation for acute heart failure
    • Time Frame: 24 months after day hospitalization or consultation
    • composite endpoint: Rate of hospitalisation for acute heart failure or day-hospital/in-home IV diuretics injection for acute HF 24 months after day hospitalization (with outcome 10)
  • Rate of cardiovascular death
    • Time Frame: 24 months after day hospitalization or consultation
  • NYHA (New York Heart Association) class measured
    • Time Frame: 3, 12 and 24 months after day hospitalization or consultation
  • Natriuretic peptides
    • Time Frame: At inclusion
    • BNP or Nt-Pro BNP
  • Renal function
    • Time Frame: At inclusion
    • Assessed by glomerular filtration rate
  • Plasma volume
    • Time Frame: At inclusion
    • calculated from haemoglobin and haematocrit value
  • Rate of Bilirubin
    • Time Frame: At inclusion
  • Rate of ASAT
    • Time Frame: At inclusion
  • Rate of ALAT
    • Time Frame: At inclusion
  • Rate of V factor
    • Time Frame: At inclusion
  • Blood potassium concentration
    • Time Frame: At inclusion
  • Circulating NtProBNP
    • Time Frame: At inclusion
  • Liver elastography value
    • Time Frame: At inclusion
    • Measured with Fibroscan®
  • Quality of life assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ)
    • Time Frame: At inclusion and 3, 6 and 24 months

Participating in This Clinical Trial

Inclusion Criteria

  • Patients with chronic acute heart failure with reduced ventricular ejection fraction admitted in hospital for scheduled day hospitalization or in consultation – Patient with altered (left ventricular ejection fraction <40%) and moderately altered (left ventricular ejection fraction between 40 and 50%) left ventricular ejection fraction – Age ≥18 years – Patients having received complete information regarding the study design and having signed their informed consent form. – Patient affiliated to or beneficiary of a social security scheme. Exclusion Criteria:

  • Comorbidity for which the life expectancy is ≤ 3 months – Dialysis patient (peritoneal dialysis or hemodialysis) or patients with glomerular filtration rate <15 ml/min/m2 at inclusion. – History of lobectomy or pneumonectomy lung surgery – Severe pulmonary or pleural pathology preventing reliable acquisition of lung ultrasound images: severe emphysema, chronic pleurisy, pulmonary fibrosis, etc. – Pregnant woman, parturient or nursing mother – Adult person subject to a legal protection measure (guardianship, curatorship, safeguard of justice) – Adult person who is unable to give consent – Person deprived of liberty by a judicial or administrative decision, – Person subject to psychiatric care pursuant to Articles L. 3212-1 and L. 3213-1 of the Public Health Code.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Pr. Nicolas GIRERD
  • Provider of Information About this Clinical Study
    • Sponsor-Investigator: Pr. Nicolas GIRERD, Principal Investigator – Central Hospital, Nancy, France
  • Overall Contact(s)
    • Nicolas GIRERD, MD, PhD, 0033383157322, n.girerd@chru-nancy.fr

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.