Congestion and LActate at diScHarge in Acute Heart Failure
Recruiting · NCT07345156 · Observational (researchers observe without assigning treatment) · Lead sponsor: University of Monastir
View the official record on ClinicalTrials.gov →Interventions studied
What this trial is about
Acute heart failure (AHF) is a leading cause of hospitalization and is associated with high short-term morbidity and mortality, with 20-30% of patients experiencing rehospitalization or death within 30 days. Early adverse events often reflect incomplete recovery, highlighting the need for improved risk stratification after clinical stabilization .Current prognostic approaches mainly focus on hemodynamic congestion. Persistent pulmonary congestion at discharge is a strong predictor of poor outcomes, but these markers primarily assess macrocirculatory abnormalities and do not capture microcirculatory dysfunction, which may persist despite apparent clinical improvement. Lung ultrasound, through the Lung Ultrasound Score (LUS), provides a validated assessment of pulmonary congestion and has demonstrated prognostic value in AHF. However, LUS does not reflect systemic tissue perfusion. In contrast, blood lactate is a robust marker of tissue hypoperfusion, and even mild elevations have been associated with worse outcomes in AHF. A combined score integrating LUS and lactate may therefore better reflect the dual pathophysiology of AHF-persistent congestion and impaired tissue perfusion-and improve prediction of early adverse events. This protocol aims to validate the prognostic value of this combined score for predicting 30-day rehospitalization or death in patients hospitalized for AHF, with the hypothesis that it outperforms LUS alone.
Who can take part
Inclusion criteria
- Age ≥ 18 years.
- Hospitalization for acute heart failure/decompensation (clinical diagnosis + imaging/laboratory tests according to local practice).
- Patient deemed ready for discharge (decision made by the team, discharge within 24 hours).
Exclusion criteria
- Septic shock/severe active infection at the time of discharge.
- Hypoxemia or respiratory distress requiring high-flow oxygen/ventilation at the scheduled time of discharge.
- Severe cirrhosis/advanced liver failure.
- Refusal to participate.
- Technical impossibility of LUS.
Where it is running
1 location listed.
- Fattouma Bourguiba Hospital of Monastir - Monastir, Monastir Governorate, Tunisia