Background There are limited data comparing ultrafiltration with standard medical therapy as first-line treatment in patients with severe congestive heart failure (HF). We compared ultrafiltration and conventional therapy in patients hospitalized for HF and overt fluid overload. Methods and Results Fifty-six patients with congestive HF were randomized to receive standard medical therapy (control group; n = 29) or ultrafiltration (ultrafiltration group; n = 27). The primary end point of the study was rehospitalizations for congestive HF during a 1-year follow-up. Despite similar body weight reduction at hospital discharge in the 2 groups (7.5 ± 5.5 and 7.9 ± 9.0 kg, respectively; P =.75), a lower incidence of rehospitalizations for HF was observed in the ultrafiltration-treated patients during the following year (hazard ratio 0.14, 95% confidence interval 0.04-0.48; P =.002). Ultrafiltration-induced benefit was associated with a more stable renal function, unchanged furosemide dose, and lower B-type natriuretic peptide levels. At 1 year, 7 deaths (30%) occurred in the ultrafiltration group and 11 (44%) in the control group (P =.33). Conclusions In HF patients with severe fluid overload, first-line treatment with ultrafiltration is associated with a prolonged clinical stabilization and a greater freedom from rehospitalization for congestive HF.
Continuous ultrafiltration for congestive heart failure: the CUORE trial / G. Marenzi, M. Muratori, E.R. Cosentino, E.R. Rinaldi, V. Donghi, V. Milazzo, E. Ferramosca, C. Borghi, A. Santoro, P. Agostoni. - In: JOURNAL OF CARDIAC FAILURE. - ISSN 1071-9164. - 20:1(2014 Jan), pp. 9-17.
|Titolo:||Continuous ultrafiltration for congestive heart failure: the CUORE trial|
AGOSTONI, PIERGIUSEPPE (Ultimo)
|Parole Chiave:||Congestion ; diuretics ; heart failure ; ultrafiltration|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||gen-2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.cardfail.2013.11.004|
|Appare nelle tipologie:||01 - Articolo su periodico|
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