Management of Acute Heart Failure: Contribution of Ultrasound Daily in Bed Patient Adjustment on Therapy With Impact Measure on re Hospital Rate During 30 Days

Study Overview
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Brief Summary
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Our hypothesis: a daily bedside echocardiographic assessment, protocolized, simple and reproducible estimation of filling pressures with an evaluation of mitral inflow and the inferior vena cava, allow a more reliable estimate of the true blood volume of the patient and thus lead to a therapeutic adjustment more suitable. This therapeutic adjustment closer to patient's needs would impact fewer readmissions at 30 days and mortality, less alteration of biological parameters myocardial, kidney and liver.

Conditions
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Heart Failure

Intervention / Treatment
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* Procedure: Transmitral flow estimation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient or his representative must be given free and informed consent and signed consent. The patient must be affiliated or beneficiary of a health insurance plan. The patient is available for a follow-up 6 months. The patient is of age or older (>) 18. Patients hospitalized for acute heart failure who received at least 40mg of furosemide IV. Patient with impaired LVEF <50%. Patient with Nt-proBNP values> 1200pg / ml. Exclusion Criteria: The subject takes part in another study. The subject is exclusion period determined by a previous study. The subject is under judicial protection. The subject or his representative refuses to sign the consent. It is not possible to give the subject or his representative informed information. Non-inclusion criteria for those diseases or conditions associated (s) interfere (s): The patient is pregnant or is breastfeeding. The patient is already included in a surveillance program (PRADO, OSICAT). Patient with a mechanical or biological mitral prosthesis. History of mitral stenosis. severe valvular surgery with maturity in months (<30 days). chronic renal impairment on dialysis. High grade AV block (AVB and BAV3 2/1). Hypertrophic cardiomyopathy. Cardiogenic shock. Contraindications to furosemide.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: JET ECHO<br>Transmitral flow estimation | Procedure: Transmitral flow estimation<br>* Estimation of the transmitral flow of the inferior vena cava and its variations<br>|
| No Intervention: NO JET ECHO<br>no bedside echocardiography | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| rehospitalization |  | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mortality |  | 6 months | 
| worsening heart failure |  | during hospitalization | 
| average length of stay |  | during hospitalization | 
| alteration of biological parameters myocardial, kidney and liver |  | Hospital discharge +7 days, Hospital discharge +30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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bedside echography