Peripheral Venous Pressure-Guided Diuretic Treatment for Adults with Heart Failure to Improve Long-Term Outcomes

What this Trial Is About

Researchers are evaluating whether measuring peripheral venous pressure PVP can better guide the need for diuretic treatment and improve long-term outcomes such as mortality, hospital readmissions, and emergency visits in patients hospitalized with heart failure compared to standard evaluation methods. This study focuses on adults aged 18 to 99 with new or worsened chronic heart failure, regardless of heart function or cause. The trial aims to address the challenge of persistent congestion after hospital discharge, which contributes to high readmission and death rates. Participants will be randomly assigned to two groups one receiving diuretic therapy guided by PVP measurements aiming for a PVP less than 9 mmHg before discharge, and the other receiving standard diuretic therapy based on physician judgment. Peripheral IV lines will be placed to measure PVP using a defined procedure, and treatment will follow European Society of Cardiology guidelines. Patients unable to have PVP measured or requiring intensive support will be excluded. The study will last one year, with follow-up to track major adverse events including death and hospital readmissions. During the study, participants will undergo blood sampling, electrocardiogram, echocardiogram, daily monitoring of fluid intake and output, weight, and biochemistry tests. Data will be collected electronically, and PVP measurements taken at admission and before discharge will be analyzed for correlation with outcomes. Researchers will also evaluate kidney function changes and hospitalization patterns. The study involves 650 participants and includes statistical analyses to compare the two treatment approaches over one year.

PVP-Guided Decongestive Therapy in HF 2